I like this article:
I was reminiscing this morning about medical school and some of my psychiatric training.
I clearly remember the first day of my psychiatric rotation in medical school. It was my last rotation in my final 4th year. and knew by that time that psychiatry was the field for me. I felt anxious and excited when I walked into the hospital that morning. I met the attending psychiatrist who was assigned to me. Without further ado, we immediately went onto the locked ward to make morning rounds. He said, “Don’t worry. You’ll be fine. You’re training starts now. You’ve learned a lot of theory in the books, but this is where it’ll start for you.” I never had been on a locked psychiatric unit before. I felt apprehensive but not totally frightened. Short of 5 minutes on the unit, we discovered one of his patients sitting in a wheelchair in the middle of the hall. She looked to be in her 70s. Well made up. Hair curled. And pretty. She was energetic and animated given my internal concept of what “old” people were supposed to be like.
The Dr. began to speak with her. She smiled warmly and it appeared that she totally understood him. Then she spontaneously looked over at the right side of her to the wall and stated, “Oh, yes. I totally understand what you mean. Aren’t those pink elephants up there on the wall pretty? I think they are playing. Let’s go over and look at them.”
I began to feel up with tears not knowing exactly what I was feeling. Being an astute man, the Dr. took me into a side staff room and sat down with me. He said, “I can already tell that you are going to be an excellent psychiatrist just by your reaction. But, I need to remind you of something. You’re going to see, hear, feel and experience more things in this field than you ever imagined—more than most people could ever dream or think of during their entire life. So, you can either laugh or cry. One of the two. For your own insanity during your career, you must learn to laugh. Otherwise, you’ll burnout and never last. It’ll take some time to learn to laugh but it will protect you in the long run. (And, yes. Humor is the 2nd best defense mechanisms out of over 30 of them. I don’t think we use it enough with patients with dementia and their caregivers.)
As I ponder this now, I would be highly convinced that she suffered from Lewy Body Dementia (LBD) since seeing non-existing animals and people can be a pleasant experience. This is one of the features that is different than Alzheimer’s disease.
Just think. Few people know about Lewy Body disease now in 2009. Imagine the little information that even neurologists knew back in 1977!
As I type this, I am reminded of how I saw pleasant flying peace doves, my dog, and other playing animals at the bottom of my bed last at the end of 2007 while in the hospital being evaluated for LBD.
So let’s use some humor. I laughed a lot when I tried to answer these questions…………I hope you do too!
Take the test presented here to determine if you’re losing it or not. The spaces below are so you don’t see the answers until you’ve made your answer. OK, relax, clear your mind and begin.
1. What do you put in a toaster?
Answer: “bread.” If you said “toast,” give up now and do something else. Try not to hurt yourself.. If you said, bread, go to Question 2.
2. Say “silk ” five times. Now spell “silk.” What do cows drink?
Answer: Cows drink water. If you said “milk,” don’t attempt the next question. Your brain is over-stressed and may even overheat. Content yourself with reading a more appropriate literature such as Auto World. However, if you said “water”, proceed to question 3.
3. If a red house is made from red bricks and a blue house is made from blue bricks and a pink house is made from pink bricks and a black house is made from black bricks, what is a green house made from?
Answer: Greenhouses are made from glass. If you said “green bricks,” why are you still reading these??? If you said “glass,” go on to Question 4.
4. It’s twenty years ago, and a plane is flying at 20,000 feet over Germany (If you will recall, Germany at the time was politically divided into West Germany and East Germany). Anyway, during the flight, two engines fail. The pilot, realizing that the last remaining engine is also failing, decides on a crash landing procedure. Unfortunately the engine fails before he can do so and the plane fatally crashes smack in the middle of “no man’s land” between East Germany and West Germany . Where would you bury the survivors? East Germany, West Germany, or no man’s land”?
Answer: You don’t bury survivors. If you said ANYTHING else, you’re a dunce and you must stop. If you said, “You don’t bury survivors”, proceed to the next question
5. Without using a calculator – You are driving a bus from London to Milford Haven in Wales . In London, 17 people get on the bus. In Reading, six people get off the bus and nine people get on. In Swindon, two people get off and four get on. In Cardiff, 11 people get off and 16 people get on. In Swansea, three people get off and five people get on. In Carmathen, six people get off and three get on. You then arrive at Milford Haven.What was the name of the bus driver?
Answer: Oh, for crying out loud! Don ‘t you remember your own name? It was YOU driving the bus.
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Filed under: Caregivers for Individuals with Dementia, Dementia, Humor, Lewy Body Dementia | Tagged: Alzheimer's Disease, defense mechanism, Dementia, Humor, Lewy Body Dementia, Medical school, Psychiatry | 17 Comments »
I’m noticing this coffee thing everywhere in the dementia news updates. For most of my life, I never drank coffee. Not in college, not in med school, not during residency, not in private practice. Am trying to remember when I started to drink 1-2 cups in the morning. Based on this article, maybe I should have been drinking coffee all along. And perhaps I need to drink a little more now. Coffee doesn’t seem to make me jittery but the teas sure do! By the way, what is your favorite brand of coffee?
ScienceDaily (Jan. 14, 2009) — Stockholm, Sweden — Midlife coffee drinking can decrease the risk of dementia/Alzheimer’s disease (AD) later in life. This conclusion is made in a Finnish Cardiovascular Risk Factors, Aging and Dementia (CAIDE) Study published in the Journal of Alzheimer’s Disease.
“We aimed to study the association between coffee and tea consumption at midlife and dementia/AD risk in late-life, because the long-term impact of caffeine on the central nervous system was still unknown, and as the pathologic processes leading to Alzheimer’s disease may start decades before the clinical manifestation of the disease,” says lead researcher, associate professor Miia Kivipelto, from the University of Kuopio, Finland and Karolinska Institutet, Stockholm, Sweden.
At the midlife examination, the consumption of coffee and tea was assessed with a previously validated semi-quantitative food-frequency questionnaire. Coffee drinking was categorized into three groups: 0-2 cups (low), 3-5 cups (moderate) and >5 cups (high) per day. Further, the question concerning tea consumption was dichotomized into those not drinking tea (0 cup/day) vs. those drinking tea (≥1 cup/day).
The study found that coffee drinkers at midlife had lower risk for dementia and AD later in life compared to those drinking no or only little coffee. The lowest risk (65% decreased) was found among moderate coffee drinkers (drinking 3-5 cups of coffee/day). Adjustments for various confounders did not change the results. Tea drinking was relatively uncommon and was not associated with dementia/AD.
Kivipelto also notes that, “Given the large amount of coffee consumption globally, the results might have important implications for the prevention of or delaying the onset of dementia/AD. The finding needs to be confirmed by other studies, but it opens the possibility that dietary interventions could modify the risk of dementia/AD. Also, identification of mechanisms of how coffee exerts its protection against dementia/AD might help in the development of new therapies for these diseases.”
- Marjo H. Eskelinen, Tiia Ngandu, Jaakko Tuomilehto, Hilkka Soininen, Miia Kivipelto. Midlife Coffee and Tea Drinking and the Risk of Late-Life Dementia: A Population-based CAIDE Study. Journal of Alzheimer’s Disease, 16(1), xx-xx
Fun and more fun. Here’s the weekender for you. Just pretend you’re at McDonalds.
Fast Food Frank stopped in a brand-new burger joint for his quick lunch. Checking the lighted menu behind the counter, he saw that the following combinations were available:
- Burger and fries: $3.50
- Fries and a small drink: $2.25
- Small drink and a cookie: $1.50
- Burger and cookie: ??
Unfortunately, the lights behind the price of Frank’s favorite combo, a burger and cookie, were burned out and he didn’t know how much it was. It was the counter clerk’s first day on the job, and he didn’t know the price either. Luckily, Fast Food Frank was fast at figures and figured out how much a burger-and-cookie combo cost just by lookint at the other combo prices. What is the price of the burger-and-cookie combo?
I’ll work on it too. I’ll give out the answer next week. Have a good weekend.
I’ve added Dementia for 2 to my Blogroll.
Stephanie Grabreck wrote this controversial article on brain donors for research.
Brain tissue —More donors are urgently needed
More people need to donate their brains to medical research if cures for diseases like dementia are to be found, UK scientists say.
They say research is being hampered by a gross shortage of brains and are urging healthy people as well as those with brain disorders to become donors.
Brain research has proved essential for finding new treatments – such as dopamine for Parkinson’s disease.
Brain investigator Dr Payam Rezaie called the current situation “dire”.
He said thousands more brains were needed to look for the cause and treatments for conditions like autism and Alzheimer’s disease.
Most drugs already developed for brain-related diseases have relied on research using human brains
Dr Rezaie, from the Neuropathology Research Laboratory at the Open University, said: “For autism, we only have maybe 15 or 20 brains that have been donated that we can do our research on. That is drastically awful.
“We would need at least 100 cases to get meaningful data. But that is just one example. A lot of research is being hindered by this restriction.”
Short supply — Professor James Ironside, of the Human Tissue Authority, which regulates the donation process, said as well as a shortage of diseased brains to study, there was a bigger problem of getting hold of healthy donor brains for comparison.
He said this was down to poor awareness rather than people being squeamish.
BRAIN BANK BREAKTHROUGHS
- Discovery of L-dopa treatment for Parkinson’s disease
- Discovery of amyloid deposition in Alzheimer’s disease
- Discovery of Lewy bodies in dementia
- Discovery of variant Creutzfeldt-Jakob Disease
- Discovery of the role of glutamate in Schizophrenia
He helped set up a brain bank in Scotland to collect normal “control” brains from people who had died unexpectedly and needed an autopsy by law to establish the cause of death.
“We were surprised and pleased that over 90% of the relatives approached in this way gave consent.” He said more needed to be done to raise public awareness.
Dr Kieran Breen, of the Parkinson’s Disease Society, said over 90% of the brains in their bank at Imperial College London were from patients, with the remaining 10% of “healthy” brains donated by friends or relatives of patients.
“It is a question of awareness rather than anything else.”
But he said scandals like Alder Hey – where organs were kept without consent – have put some off donating their organs to medical research.
“There is also confusion. Some people are under the impression that if they sign up for a donor card that will include donating their brain for research. But it won’t.
Dr Lorna Wing, a retired expert who studied autism and helped change thinking about the condition as a spectrum disease rather than a single disorder, consented to donating the brain of her daughter, who had autism, after she died unexpectedly aged 49. “My husband and I still mourn her loss. One consolation for us is that we donated her brain and are donating ours in our wills.”
“Donor cards are about donating organs for transplant, not for medical science.”
He said anyone interested in becoming a donor should contact one of the 15-20 brain banks dotted around the UK.
The Medical Research Council is setting up a network to coordinate the existing brain banks from one central location. It is hoped this will make it simpler for those wanting to donate and for researchers to pool information and resources.
Dr Marie Janson, of the Alzheimer’s Research Trust, said: “Donated brains can be an immense help in the fight against dementia and are likely to become more important in the future.
“Most drugs already developed for brain-related diseases have relied on research using human brains.
“Unfortunately dementia research is still severely underfunded, and – if new treatments are not found – the number of people with dementia in the UK could increase from 700,000 to 1.5 million within a generation.”
Comment? Opinions? Questions? Click here.
Oh yes. I’ve added a foreign language widget on the right side of the page. I’m finding there are more bilingual readers than I imagine.
Filed under: Caregivers for Individuals with Dementia, Dementia, Lewy Body Dementia, Miscellaneous | Tagged: Alzheimer's Disease, autism, Brain, Creutzfeldt-Jakob, donor, Lewy Bodies, Parkinson's Disease, schizophrenia | 4 Comments »
Well, we’re slowly on the mend. The Dr. prescribed antibiotics and prescription cough syrup for Pam, Chad and me. Fortunately they seem to be working. I have a little more energy than a few days ago. The extra sleep helps too. It’s ironic. I’ve always tended to prescribe antibiotics only when I felt someone truly needed them. Now scientific evidence supports this practice. Guess I was on the right track and didn’t know it. And here I am, taking antibiotics……..go figure~
I’m curious to know if others with LBD and dementia notice that they seem more sensitive to physical illnesses than normal. Even a cold makes me feel much worse than when I was younger. Or maybe it is truly part of the aging process. I don’t know.
WordPress has been very helpful to me since their version update. It turns out that I had been using the beta verion of Internet Explorer 8. Evidently the beta version isn’t ready for everyone yet. WordPress suggested I switch over to the Firefox browser. I’ve heard about it before but now I’m sold on it. It is so very easy to use with many extra features. I like WordPress and was afraid I’ve have to switch to a different blogging host. Looks like I’m back in business.
What do I say when someone asks me how I am doing? Especially when it is asked in a “you are different” way? I’m learning to simply say OK for the most part. For friends and family who truly are understanding, I can tell them the truth.
On the other hand, it must be difficult for others who don’t know what to say when they ask me how I am. Probably like when we are in a funeral home and find it hard to find the correct words.Maybe I could start using this as an opportunity to teach and to explain what LBD is.
Which leads me to another thought. I belong to several Yahoo Groups pertaining to LBD, Alzheimer’s disease, etc. I’m having a very difficult time answering some of the emails when someone makes a post that their loved one has died. I get mixed emotions. I think the remaining loved has to be relieved but at the same times feels the pain from the loss. I personally have never been good at dealing with loss. So, for those who may be reading this, please don’t take it personally when I don’t respond to those posts.
I vividly remember when my first wife died of lung cancer (she was a non-smoker). It took me a very long time to bounce back. Only in retrospect do I realize that I was in a deep clinical depression which should have been treated. But in those days, one didn’t think in those terms.
I had difficulty when any of my patients died with whom I developed a relationship. One guy was my age who died of liver cancer. I had a hard time going past that room for a long time. That was when I was in training. I even requested to switch to a different ward in order to avoid it. Another case was with a nun. She was a real sweetheart who had terminal cancer. We prayed together.She openly shared how she’d finished her work here on earth and was ready to go to heaven. One night I was on duty when the nurse called me because the Sr. had difficulty breathing. Sr. said to me, I’ll see you “up there ” and had thanked me for all I had done for her (which in my mind was nothing). I had been on one of those 36 hour stints when I felt brain dead. So it went right over my head. She was saying goodbye. She died within the hour. I had to go back and pronounce her dead. It was one of the most difficult aspects of practicing medicine for me.
If sense that I am beginning to ramble and to babble. So I’ll sign off for today.
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The Only Light You Really Need is the One Inside You!
Several days ago, I wrote about seasonal affective disorder and will focus on some treatment options today. Recently my wife, Pam, had some blood work done which revealed low levels of vitamin D. Recently there has been much talk in the medical community about whether the recommended daily requirement for vitamin D is sufficient. Vitamin D production is produced from sunlight. (But, wait)! We are also told to put on sunscreen to protect us from skin cancer. The sunscreen also acts as a barrier to producing vitamin D through the skin. Do we have a double whammy or not? Ironically, Pam tends to be very sensitive to sun deprivation!
In 1979, Norman Rosenthal, MD and Dr. Al Lewy headed research at the National Institute of Mental Health (NIMH) investigating the connection between light and mood. During the 1980s, I was most fortunate to have been mentored by Dr. Rosenthal in the theories of light and mood as well as in the treatment options available for mood disorders associated with light and dark cycles. Sometime, I will have to write down some specific examples of some of my patients who had a mood disorder and light therapy. Two individuals would not be alive today had it not been for light treatment.
I am sharing part of that information today. I have no intent to prescribe treatment to anyone. This is information only. Any attempt to treat SAD should begin with your physician. In this blog, I mention the use of light boxes or sun boxes. Dr. Rosenthal used the sun boxes from the SunBox company. Subsequently, that is the company I have relied upon during my psychiatric career. I do not have any financial interest in this company. However, there are other companies which sell light boxes as well.
Winter-onset seasonal affective disorder (SAD) or the winter blues is most likely caused by your body’s reaction to light deprivation (the lack of sunlight). In the dark days of fall and winter, you may turn your face to the afternoon sun, seeking out what little light filters through fading gray skies. You may throw open the blinds, leave lights on throughout your home or even head south for a vacation — anything for a little more light. Or you may even be unable to crawl out of bed in the morning. This can be a long walk outside or arranging your home or office so that you are exposed to a window during the day. Even being outside during a cloudy day provides more light than being indoors. Did you know that most rooms in our homes have little lighting? Even with lights on, most people’s brains interpret this small amount to be the same as being in darkness.
You may feel better if you get some exercise most days of the week. Being active during the daytime, especially first thing in the morning, may help you have more energy and feel less depressed. Gentle exercise such as walking, riding a stationary bike, or swimming is a good way to get started.
There are senior citizens residing in assisted living facilities, nursing homes, retirement homes or other long term care facilities. These individuals do not always have the luxury of being exposed to bright light. They may ask to have their bed near a window and to spend as much time as possible in a room with as much bright light as possible. Many dayrooms have large windows allowing for this. Light therapy has been found to be helpful to these elderly patients as well as those suffering from Alzheimer’s Disease, Lewy Body Dementia and vascular dementia (multi-infarct dementia). It is known that melatonin levels decrease as we age and there is a syndrome common in the elderly that is called “sundowner’s syndrome.” In winter months and summertime alike, when the sun goes down those with Alzheimer’s or dementia can become sullen, depressed anxious or morose as darkness approaches. Research published in the Journal of Geriatric Psychiatry and Neurology in 1997 and the American Journal of Psychiatry in 1992 are only two of the studies showing that light therapy can ameliorate symptoms in the elderly. Check out this article. Dementia Slowed by Light Therapy
There are two types of light therapy:
Bright light treatment. For this treatment, you sit in front of a “light box” or “sunbox” for half an hour or longer, usually in the morning. The light box is a special fluorescent lamp.
Dawn or sunshine simulation. For this treatment, a dim light goes on in the morning while you sleep, and it gets brighter over time, like a sunrise.
Light therapy works well for most people with SAD, and it is easy to use. You may start to feel better within 3-5 days or so after you start light therapy. But you need to stick with it and use it every day until the season changes. If you don’t, your depression could come back. Once you stop using the sunlight therapy or sunbox, the depression can return in 3-5 days as well. I think of so many individuals who go to Florida or to another sunny location in the winter for 1-2 weeks of vacation. Upon leaving their homes, they would suffer from anxiety, depression and arthritic aches and pains. They would tell me, “Wow. All that salt water from the ocean really helped me feel better. It even helped my arthritis go away.” Well, it wasn’t the salt water. It was the sunlight which traveled through the eyes to the brain which caused a marked elevation in their mood! Depression always tends to make aches and pains worse.
Other treatments that may help include:
— Antidepressants. These medicines can improve the balance of brain chemicals that affect mood.
— Counseling. Some types of counseling, such as cognitive-behavioral therapy, can help you learn
more about SAD and how to manage your symptoms.
If your doctor prescribes antidepressants, be sure you take them the way you are told to. Do not stop taking them just because you feel better. This could cause side effects or make your depression worse. When you are ready to stop, your doctor can help you slowly reduce the dose to prevent problems.
If you feel you are suffering from SAD, it is important to seek the help of a trained medical professional. SAD can be misdiagnosed as hypothyroidism, hypoglycemia, infectious mononucleosis, and other viral infections, so proper evaluation is necessary. For some people, SAD may be confused with a more serious condition like severe depression or bipolar disorder.
However, if you feel the depression is severe or if you are experiencing suicidal thoughts, consult a doctor immediately regarding treatment options or seek help at the closest emergency room.
Tanning beds should not be used to treat SAD. The light sources in tanning beds are high in ultraviolet (UV) rays, which harm both your eyes and your skin.
Melatonin, a sleep-related hormone, also has been associated to SAD. This hormone, which has been linked to depression, is produced at increased levels in the dark. When the days are shorter and darker, more melatonin is produced.
Researchers have proved that bright light makes a difference to the brain chemistry, although the exact means by which sufferers are affected is not yet known. Some evidence suggests that the farther someone lives from the equator, the more likely they are to develop SAD. For example, approximately 25 percent of the population at the middle-to-northern latitudes of the U.S. experience winter doldrums, a sub-clinical level of SAD. These people notice the return of SAD-like symptoms each winter, but remain fully functional.
Drs. Rosenthal and Lewy eventually focused on the hormone melatonin. Melatonin is produced in the pineal gland, located in the midbrain. When research the early 1980′s pointed to melatonin’s role in promoting sound and restful sleep, as an anti-aging supplement and showing success in fighting cancer, the public started gobbling tons of the hormone, easily available in health food stores. Melatonin showed virtually no danger of side-effects. In fact, government researchers who set out to determine the “LD 50″, — the amount necessary to kill fifty percent of the animals tested — couldn’t produce a concentration strong enough to kill one mouse.
Other research found that taking melatonin helps airline employees deal with jet lag affecting their sleep. Melatonin in as small an amount as 5 milligrams helped them adjust.
Melatonin controls the function of many glands and Rosenthal and Lewy found that melatonin production is affected by exposure to light in excess of 2500 lux. (Lux is a measure of luminosity.) The link between sunlight and hormonal and mood function was made.
Dr. Rosenthal and others demonstrated in research later published in the Archives of General Psychiatry in 1998 that the mechanism of melatonin affecting SAD may have to do with internal core temperature as well. Melatonin and serotonin are two hormones that regulate temperature while we sleep. The relative temperatures associated with sleep and waking may be part of the mood equation.
You can buy a light therapy box over-the-counter, without a doctor’s prescription. Internet retailers, drugstores and even some hardware stores offer a wide variety of light therapy boxes and other light devices for seasonal affective disorder treatment.
But take caution before buying. Not all light therapy boxes being sold have been tested to make sure they’re safe and effective. And different light boxes work in different ways, using different parts of the light spectrum and offering different illumination intensities. That’s why it’s especially important to understand what you’re buying and what features to consider. It’s also important to check with your health professional before buying a light therapy box.
Here are some features to understand and consider when buying a light therapy box for seasonal affective disorder treatment:
1. SAD-specific. Make sure the light therapy box is specifically designed to treat seasonal affective disorder. If it’s not, it may not be as effective in treating SAD.
2. Intensity. Look for a light therapy box that provides the right intensity of light when you’re a comfortable distance away. Some light boxes offer the preferred 10,000 lux only when you’re within a few inches of the box, while others can reach a distance of nearly two feet.
3. Minimal UV exposure. Many, but not all, light therapy boxes now filter out harmful ultraviolet (UV) light. UV light can cause eye and skin damage. Look for a light box that produces as little UV light as possible at high intensity or that carefully shields the UV rays it produces. If you’re not sure about the UV light exposure, ask the manufacturer for safety information.
4. LEDs. Traditionally, light therapy boxes have used fluorescent or incandescent lights. Some manufacturers are now selling light therapy boxes with light-emitting diodes (LEDs). LEDs can produce light in a narrower, more targeted wavelength. LEDs are also more efficient and lighter weight than standard lights.
5. Blue light. White light is the standard type of light used in light therapy boxes. But some newer light therapy boxes give off narrow-spectrum blue light. This blue light has a shorter wavelength, which some research shows is more effective at reducing seasonal affective disorder symptoms. On the other hand, blue light poses a greater risk than does white light of damaging your eye’s retina because your retina is more sensitive to the shorter blue wavelengths. To help reduce this risk, don’t look directly at the light source in any light therapy box. Check with the manufacturer if you have concerns about a light box’s safety.
6. Light direction. Light from a light therapy box should come from above your line of sight, not directly at it or below it. Make sure the light box you want can be positioned appropriately.
7. Dawn simulation. Some light therapy boxes simulate dawn — they turn on in the morning while you’re asleep and gradually get brighter until you wake up.
8. Cost. Prices vary greatly, from about $200 to $500, and more. Health insurance plans don’t always cover the cost of light therapy boxes. Check with your insurance company to see if your benefits will cover the cost.
9. Style. Some light boxes look like upright lamps, while others are small and rectangular. You can even buy a light therapy device attached to a visor, which enables you to receive light therapy while remaining active. However, keep in mind that scientific evidence about the effectiveness of light visors is lacking.
10. Convenience. Some light boxes are bigger than others, which can make them less portable. Find one that you can move easily and that fits the desired location in your home or office. Some light therapy boxes offer a variety of other features, such as programmable timers, clocks, carrying cases, stands, wall-mount options and extended batteries, among other features. Decide which features are important to you. Before plunking down any hard-earned cash, talk to your doctor, mental health provider or pharmacist about the light therapy box you’re thinking about buying. He or she may offer additional guidance or tips to make sure that seasonal affective disorder treatment with a light therapy box is both safe and effective for you.
Light therapy may trigger episodes of mania in people with bipolar disorder. In addition, although rare, some people, particularly those with severe forms of depression, have reported thoughts of suicide after treatment with light therapy. Light therapy alone may not be fully effective. You still may need treatment with medications or psychotherapy.
Filed under: Caregivers for Individuals with Dementia, Lewy Body Dementia | Tagged: 10000 lux, Alzheimer's Disease, American Journal of Psychiatry, Assisted living, Caregivers for Individuals with Dementia, Dawn simulation, Dementia, Elderly, Lewy Body Dementia, Light box, light therapy, Lux, Melatonin, midbrain, Multi-infarct dementia, NIMH, Norm Rosenthal MD, Nursing home, phototherapy, pineal gland, SAD, Seasonal Affective Disorder, seniors, sun box, Sundowners, vascular dementia, Vitamin D, Winter blues | 4 Comments »
Be bold and courageous. When you look
back on your life, you’ll regret the things
you didn’t do more than the ones you did.
I came across this on the Merck website today. Can’t believe how good it is. It lists all the types of dementias and the differences between them. I never gave much thought about there being a marked difference between vascular dementia, Alzheimer’s Disease and Lewy Body Dementia. Thanks to Kat on the Dementia Rescue Early Onset Yahoo group for prompting me to look this up.
There’s a saying I learned in training — “Who they were is still in there somewhere…” I think about this a lot of the time. I find it almost impossible to visualize ever being in a nursing facility (denial???), but if I were I think these would be some of the things that I’d like for someone to do:
Make an extra effort to show me you love me and care about me
A care package
An extra telephone call
Maybe a plant or some flowers
Send a card anytime
I may not totally understand what those gestures would mean, but the David in me would still be there inside me and still remember about good old-fashioned TLC!
Never take action when you’re angry or hungry.
I found this chart on the Merck Manual Medical Library site. I think it shows the clear and concise differences between Alzheimer’s Disease and Lewy Body Dementia.
Differences Between Alzheimer’s Disease and Lewy Body Dementia
Lewy Body Dementia
Senile plaques, neurofibrillary tangles, and β-amyloid deposits in the cerebral cortex and subcortical gray matter
Lewy bodies in neurons of the cortex
Affects twice as many women
Affects twice as many men
Familial in 5–15% cases
Lost early in the disease
Deficits in alertness and attention more than in memory acquisition
Very rare, occurring late in the disease
Prominent, obvious early in the disease
Axial rigidity and unstable gait
Occur in about 20% of patients, usually when disease is moderately advanced
Occur in about 80%, usually when disease is early
Most commonly, visual
Adverse effects with antipsychotics
Possible worsening of symptoms of dementia
Acute worsening of extrapyramidal symptoms, which may be severe or life threatening