The Dementia Caregiver’s Risk for Dementia

According to researchers, spouses of dementia patients are six times more likely to get dementia themselves because of chronic stress. These stress reduction techniques for caregivers may help.

Researchers followed 1,221 married couples in Utah who were 65 and older for up to 12 years, tracking dementia diagnoses in the group. Among the 255 people who developed dementia, researchers found that their spouses were six times more likely to be diagnosed with dementia themselves, compared to those who didn’t have a spouse with dementia. Men were at higher risk than women after their partners became ill. The study authors concluded that dementia caregiving is a physical and emotional burden and that watching a partner deteriorate is very stressful.

The study is the first population-based research to explore dementia risk in spouses of people with dementia. Previous studies already signaled that having a spouse with dementia can lead to depression and cognitive decline, such as learning and memory problems. Researchers say more studies need to be done.

How Stress Can Increase Dementia Risk

Dementia caregiving already puts you at risk for developing depression and other health problems, but stress in particular affects the hippocampus area in the brain — where memories are stored.

When you’re under chronic stress from a responsibility such as caregiving, your body produces the stress hormone cortisol, which travels through the blood to every area of your body, including your brain, says Dharma Singh Khalsa, MD, the Tucson, Ariz.-based founding president and medical director of the Alzheimer’s Research and Prevention Foundation and author of Brain Longevity.

“It kills brain cells by the thousands or millions, especially in the memory center of the brain,” Dr. Khalsa says. People who are taking care of spouses with dementia are particularly at risk because their psychological well-being plummets, he says — when you’re a caregiver, it’s easy to lose touch with your own life and lose a sense of purpose other than taking care of your spouse.

5 Ways to Protect Yourself

Controlling your stress level is important for protecting your own mental health. Your brain has a stress center, but it also has a relaxation center, Khalsa says. Learning how to touch that relaxation spot will help bring balance when you’re dealing with chronic stress. You can lower your cortisol — and stress — levels and improve your well-being. Try these ideas:

• Keep your spouse active while you take a break. It’s healthy for people with dementia to stay active and be stimulated, so it’s important to get your spouse out of the house to spend time at a senior center or go to the movies with a friend, Khalsa says. This allows the caregiver some valuable “me time.”
• Do something for yourself every day. Whether it’s doing yoga, taking a long lunch with a friend, or getting a massage, know that it’s essential to your health do something you enjoy every day.
• Try meditation. Meditation has been shown to improve stress levels and feelings of well-being, Khalsa says.
• Work on your physical health. A nutrient-rich diet, such as the Mediterranean diet full of fruits and vegetables and limited red meat, can help you stay healthy physically and mentally, Khalsa says. Although not proven, taking supplements that contain C, E, and B vitamins and fish oil may also help keep your brain healthy, he says.
• Build your cognitive reserve. You may have heard that doing crossword puzzles or word games are good for your brain, but Khalsa says novel experiences are what really help memory — try going to a museum with a friend and then talking about the exhibit afterward, getting involved with a hobby, playing music, creating art, or simply taking a walk and noting the color of the sky, the cloud formations, and other details of your environment.

When you do these activities, you build your cognitive reserve, which is a lot like building muscle at the gym, says Khalsa. Your brain will be stronger when you keep it active and that may mean forestalling dementia or having fewer symptoms, should you develop it.

For the handful of you that monitor this blog: I have not posted in a while as I am preparing the relaunch of DementiaCareSecrets.com

This website will be for those of you that are frustrated by the hours you lost searching the internet for information that is relevent to you.

One stop search…and bonuses you will not believe.

Donahue

By Paula Spencer Scott, Caring.com senior editor

GUILT

Nobody would ever choose a smiley face as the perfect symbolic emoticon for a caregiver. Caregiving for an ailing loved one is just too stressful — often triggering damaging emotions that can not only undermine your good work but harm your health, as well. Here’s how to cope:

Guilt is virtually unavoidable as you try to “do it all.”

What causes guilt: Guilt stems from doing or saying what you believe is the wrong thing, not doing what you perceive to be enough, or otherwise not behaving in the “right” way, whether or not your perceptions are accurate. Caregivers often burden themselves with a long list of self-imposed “oughts,” “shoulds,” and “musts.” A few examples: I must avoid putting Mom in a nursing home. I ought to visit every day. I shouldn’t lose my temper with someone who has dementia.

Risks of guilt: Caregiver Guilt is an especially corrosive emotion because you’re beating yourself up over faults that are imagined, unavoidable — or simply human. That’s counterproductive at a time when you need to be your own best advocate.

What you can do: Lower your standards from ideal to real; aim for a B+ in the many aspects of your life rather than an across-the-board A+. When guilt nags, ask yourself what’s triggering it: A rigid “ought”? An unrealistic belief about your abilities? Above all, recognize that guilt is virtually unavoidable. Because your intentions are good but your time, resources, and skills are limited, you’re just plain going to feel guilty sometimes — so try to get comfortable with that gap between perfection and reality instead of beating yourself up over it.

RESENTMENT

This emotion is still so taboo that many caregivers are loathe to admit to it.

What causes resentment: Caregivers often feel put-upon and upset because of imagined slights by others, including siblings and adult children who don’t do enough to help. Caregiver Resentment is especially felt toward the person being cared for, when the caregiver’s life feels hijacked by responsibility and out of his or her own control.

Risks of resentment: Without enough support or noncaregiving outlets, feelings of being ignored, abandoned, or criticized can fester into anger and depression.

What you can do: Simply naming this tricky emotion to a trusted confidante can bring some release. Try venting to a journal or anonymous blog. Know that resentment is a very natural and common response to long-term caregiving, especially if your work life, marriage, health, or outside activities are compromised as a result. Know, too, that you can feel this complicated emotion yet still be a good person and a good caregiver.

ANGER

Some people outwardly show their anger more than others, but almost no one is never angry.

What causes anger: We get mad for reasons both direct (a balky loved one, an unfair criticism, one too many mishaps in a day) and indirect (lack of sleep, frustration over lack of control, pent-up disappointment).

Risks of anger: Chronic anger and hostility have been linked to high blood pressure, heart attack and heart disease, digestive-tract disorders, and headaches. Anger that builds up unexpressed can lead to depression or anxiety, while anger that explodes outward can jeopardize relationships and even harm others. Managing caregiver anger not only helps your well-being but makes you less likely to take out your fury on your loved one.

What you can do: Rather than trying to avoid anger, learn to express it in healthy ways. Simple deep-breathing exercises can channel mounting anger into a calmer state, for example. Talk yourself down with soothing chants: It’s okay. Let it go. Ask yourself if there’s a constructive solution to situations that make you angry: Is a compromise possible? Would being more assertive (which is different from anger) help you feel a sense of control? Laughing at absurdities and idiotic behavior can provide a healthier biological release than snapping.

WORRY

A little goes a long way, but sometimes we can’t turn off the fretting.

What causes worry: Good intentions, love, and wanting the best for your loved ones are the wellsprings of worry. Focusing intensely on the what-ifs provides a perverse kind of comfort to the brain: If we’re worrying, we’re engaged. Of course, that ultimately triggers more worry and upset because it’s engagement without accomplishing anything.

Risks of worry: Being concerned is harmless. Overworry and obsessing however, can disrupt sleep, cause headaches and stomach aches, and lead to mindless eating or under-eating.

What you can do: If you notice worrying thoughts interfering with getting through the day or sleeping at night, force a break to the cycle. Try setting a timer and resolving to focus on something else when the five minutes is up. Then flip negative thoughts to their productive side: How can you help? Who can you call? Are there possible solutions? And don’t be shy about seeking out a trained counselor to help you express and redirect obsessive ruminations more constructively.

LONELINESS

Your world can shrink almost before you realize what’s happened.

What causes loneliness: Friends may back away out of uncertainty or a belief they aren’t wanted. Intense time demands lead you to drop out of outside activities. If you’re dealing with dementia, the loss of your loved one’s former level of companionship is another keenly felt social loss adding to isolation

Risks of loneliness: Your very brain is altered: People with large, rich social networks have different brain structures, new research finds. Loneliness seems to curb willpower and the ability to persevere, and it can lead to overeating, smoking, and overuse of alcohol. Lonely people also have more cortisol, the stress hormone. And social isolation is a risk factor for dementia.

What you can do: Expand your social circles, real and virtual. Arrange respite help, so you can add at least one outside activity, such as one you’ve dropped. Take the initiative to reach out to old friends and invite them over if you can’t get out easily. Consider joining a support group related to caregiving or your loved one’s illness. In online support groups you can find kinship with those who know just what you’re going through.

GRIEF

Don’t think this one applies yet? Think again.

What causes grief: Although most people link grief with death, anticipatory grief is a similar emotion felt by caregivers who are coping with a loved one’s long-term chronic illness, especially when there are clear losses of ability (as in dementia) or when the diagnosis is almost certainly terminal.

Risks of grief: “Long good-byes” can trigger guilt as well as sadness if one mistakenly believes that it’s inappropriate to grieve someone still alive. Mourning the loss of a beloved companion is also a risk factor for depression.

What you can do: Know that your feelings are normal and as painful as “real” (postmortem) grief. Allow yourself to feel sadness and express it to your loved one as well as to supportive others; pasting on a happy face belies the truth and can be frustrating to the person who knows he or she is ill or dying. Make time for yourself so that you’re living a life outside of caregiving that will support you both now and later.

DEFENSIVENESS

Protecting yourself is good — to a point.

What causes defensiveness: When you’re doing so much, it’s only natural to bristle at suggestions that there might be different or better approaches. Especially if you’re feeling stressed, insecure, or unsure, hearing comments or criticisms by others, or reading information that’s contrary to your views, can inspire a knee-jerk response of self-protection: “I’m right; that’s wrong!”

Risks of defensiveness: While nobody knows your loved one and your situation as well as you do, being overly defensive can make you closed-minded. You risk losing out on real help. You may be so close to the situation that you can’t see the forest for the trees, for example; a social worker or friend may have a perspective that points to what really might be a better way.

What you can do: Try not to take everything you hear personally. Instead of immediately getting cross or discarding others’ input, vow to pause long enough to consider it. Remember the big picture. Is there merit in a new idea, or not? What you’re hearing as a criticism of you might be a well-intentioned attempt to help your loved one. You may decide things are fine as is, and that’s great. But if you start from a point of calm and confidence, the focus becomes (as it should be) your loved one, not you.

 

dementia can be slowed by weight training

Weight-Resistance Training: Best to Prevent and Slow Alzheimer’s?

By Esther Heerema, About.com GuideJuly 19, 2012

Sometimes they erroniously refer to a “living will”.  What you want is called an Advance Directive, and every State has guidlines for a legally binding document with  that name.

Healthinaging.org has the most current definition of an advance directive on thier website:

Advance Directives Basic Facts & Information

What are Advance Directives?

If you lose the capacity to make decisions, someone will have to make decisions on your behalf. In this case, the person you choose as a stand-in (surrogate) decision maker should try to honor any wishes you expressed while you were still capable of making decisions. Your expressed wishes are legally and ethically more important than what others want for you, even if they feel that they are acting in your best interests.

Two common types of advance directives (advance care plans) that express your wishes are: 1. living wills 2.durable power of attorney for healthcare. Different states may have different names for durable power of attorney for healthcare, such as healthcare proxy or healthcare declaration.

It is also important to remember that advance directives have some limitations. Whenever possible, healthcare professionals should respect the informed choices that you have expressed while you were still capable of making decisions. Following these advance directives demonstrates respect for your individuality and self-determination.

It is a legal and ethical obligation. Most commonly, advance directives come out of the conversations that you had with relatives, friends, and healthcare workers while you were still capable. Your advance directives should be written down carefully so that your wishes are specific, clear, and available later if needed. You should provide advance directives in writing whenever possible, because written directives clearly reflect your intention to direct future healthcare and cannot be easily challenged in court. Living Wills Laws or legal opinions that authorize living wills have been enacted throughout the United States. These are often called natural death, death with dignity, or right-to-die laws. Generally, these laws allow you to direct healthcare providers to withhold or withdraw treatment that is keeping you alive if you become terminally ill and are no longer capable of making decisions.

In a few states, an individual may also appoint surrogate decision makers. Legal immunity is given to caregivers who comply with an appropriately drafted living will. Durable Power of Attorney for Healthcare The durable power of attorney for healthcare is more flexible and comprehensive than a living will. It allows you to designate a surrogate decision maker (such as a friend or relative) to make your medical decisions if you lose the ability to make them yourself. You give the surrogate your informed consent (or refusal) while you are still capable. You should discuss with your surrogate ahead of time the types of treatment(s) you would or would not want in specific situations so that your surrogate has some guidelines if the need arises.

Traditionally, family members act as surrogate decision makers (or stand-ins) for incapacitated individuals, because most probably best know the person’s preferences and will act in their best interests. Family members are also normally consulted by the healthcare provider. However, the healthcare provider may sometimes decide that decisions by family members are questionable because of conflicting personalities, values, or interests. In addition, some family members may be estranged or unwilling to make decisions, or they may disagree among themselves. In other cases, older adults have no surviving relatives. When there are no relatives or friends to represent you, it may be that your physician (or other healthcare provider) is the next best choice as your surrogate decision maker.

Your physician understands the medical procedures and your condition. Your lawyer is another possibility, but bear in mind that the courts can be cumbersome, expensive, and slow. Physician Orders for Life-Sustaining Treatment (POLST) Physician Orders for Life-Sustaining Treatment (POLST) is a recently developed program that is designed to improve the quality of care people receive at the end of life. It effectively communicates medical orders and patient wishes on a brightly colored form that can be transferred from one care setting to another and that healthcare professionals have promised to honor. Visit the National POLST Program website to find more information and to locate community or state-based POLST programs. Problems with Advance Directives Limitations. Advance directives have limitations. For example, an older adult may not fully understand treatment options or appreciate the consequences of certain choices in the future. Sometimes, people change their minds after expressing advance directives and forget to inform others.

Many times, advance directives are too vague to guide clinical decisions. For example, general statements rejecting “heroic treatments” are vague and do not indicate whether you want a particular treatment for a specific situation (such as antibiotics for pneumonia after a severe stroke). On the other hand, very specific directives for future care may not be useful when situations change in unexpected ways. New medical therapies may also have become available since an advance directive was given. You and your healthcare provider can do a great deal to avoid these problems by discussing advance directives with each other. Importance of communication. Good communication can resolve many problems posed by advance directives. You and your healthcare provider should routinely share information on advance directives. A straightforward question you can ask to open the topic is: “Can we talk about how decisions will be made for my medical care in case I become too sick to talk to you directly?” Ask or tell your healthcare professional about: •Situations that commonly develop with your particular illness or condition. •The various treatments and treatment options. •Your wishes, including your designation of a surrogate decision maker. •The amount of discretion that you want the surrogate to have and how you will let your surrogate know if you change your mind about something. It is also important for you to have periodic discussions about these issues with family members and friends.

But at what point should we become seriously concerned and step in, against their express wishes, and directly provide care or move them into a safer environment like a senior board & care or an assisted living community.  It’s never easy. Because they will rarely admit that they have lost the ability to take proper care of themselves. If dementia is involved you will face strong resistances. Because the ability to reason is severely damaged.  But waiting too long has serious consequences: accidents, illness that become crippling or terminal, injury to others, etc. etc.

The following are 30 signs that your older parent is not doing well. 3 or 4 of them are acceptable. 5 or 6 are a serious concern. 7 or more indicate it’s time to take action.
Signs that You need to Increase the level of care Provided

by Diane Carbo

Here is a list of things that you may want to observe to identify that more help is needed.

PHYSICAL SIGNS

1. There will be some difficulty with walking. May start to hold onto furniture or walls when ambulating.

2. Experiencing frequently falls or unsteadiness. You may see the presence of bruises.

3. Decline in personal hygiene or grooming. May start to wear stained clothes, have body odor, infrequently bathes or washes hair. May wear the same clothes day after day.

4 Experiences changes in eating habits. May only snack, have a decreased appetite, eat one meal a day, forget to eat, makes poor food choices, or has a refrigerator of expired food or no food in the refrigerator.

5. Starts having problems with incontinence.

6. The home environment is unsafe. Maybe it is unclean, has cluttered walkways or poor lighting. The home may need repairs. There are broken or missing smoke detectors, lack of security, may leave doors unlocked or the stove or oven on.

7. Experiences significant weight loss or gain.

8. Lives in chronic pain

9.Abuses alcohol or prescription drugs.

FINANCIAL SIGNS

10. There are unpaid or past due bills.

11. Unopened piles of mail.

12. Becomes unable to manage their checkbook.

13. Difficulty dealing with money properly.

14. May be a victim of scams or financial abuse.

COGNITIVE SIGNS

15. Experiences poor or decreased judgment.

16. Has difficulty coordinating or monitoring prescriptions and being compliant with different medications.

17. May experience paranoia, forgetfulness or memory loss.

18. Gets lost and can’t find their way back home, in familiar surroundings.

19. Leaves stove on, unplugs the refrigerator.

20. Has difficulty recognizing friends or family members. May not remember them at all.

21. Forgets to take medications, or taking it improperly.

22. Becomes increasingly forgetful. Misses doctor’s appointments, family events. May forget names of individuals or objects. Frequently loses things or places things in unusual places.

23. May start to be repetitive in questions or stories.

24.May become physically or verbally abusive.

25. May start to experience delusions or hallucinations. This may exhibit as a different perspective of objects or events that others don’t see or developing false beliefs.

26. May start to call adult children or friends repeatedly at inappropriate hours of day or night.

SOCIAL / EMOTIONAL SIGNS

27. Social Isolation

28. Experiences mood changes such as anger, suspicion, paranoia, or agitation.

29. Becomes depressed or feels lonely. May exhibit this by crying, feelings of sadness or have lack of energy or feelings of hopelessness. May experience an increase or decrease in sleeping and/or appetite.

30 Exhibits a lack of interest in formerly enjoyable activities, may stop participating in social, church or volunteer activities.

But I am wondering about you.  I see how many people are reading this blog on a daily basis.  I don’t think they are all new readers…some of you have been here more than once.

If you find the information here to be useful, can you help me zoom in on the topics that are important to you?

Click on “comments” and write me a sentence or two about your situation…or if a particular story was helpful, please let me know.

You won’t get spammed. I promise.

Here’s an example. The following is a link to an ebook you can buy about Alzheimer’s. I cannot vouch for the quality of it…but I did buy it to see what kind of information is out there.

Quite honestly, I think I know 10 times what this person knows…but if you have some spare change, its less than $30 buck, maybe you can get everything you need in one book:

 Click Here! for an Ebook on Alzheimer's

Visits to the doctor are inevitable in the aging process

Cardiac arrhythmias. These heartbeat irregularities such as atrial fibrillation can cause palpitations, a sudden drop in blood pressure that can lead to unconsciousness, stroke and even sudden cardiac arrest. In 2009, 543,000 adults over the age of 65 were hospitalized for an irregular heartbeat.

By Paula Spencer Scott, Caring.com senior editor

GUILT

Nobody would ever choose a smiley face as the perfect symbolic emoticon for a caregiver. Caregiving for an ailing loved one is just too stressful — often triggering damaging emotions that can not only undermine your good work but harm your health, as well. Here’s how to cope:

What causes guilt: Guilt stems from doing or saying what you believe is the wrong thing, not doing what you perceive to be enough, or otherwise not behaving in the “right” way, whether or not your perceptions are accurate. Caregivers often burden themselves with a long list of self-imposed “oughts,” “shoulds,” and “musts.” A few examples: I must avoid putting Mom in a nursing home. I ought to visit every day. I shouldn’t lose my temper with someone who has dementia.

Risks of guilt: Caregiver Guilt is an especially corrosive emotion because you’re beating yourself up over faults that are imagined, unavoidable — or simply human. That’s counterproductive at a time when you need to be your own best advocate.

What you can do: Lower your standards from ideal to real; aim for a B+ in the many aspects of your life rather than an across-the-board A+. When guilt nags, ask yourself what’s triggering it: A rigid “ought”? An unrealistic belief about your abilities? Above all, recognize that guilt is virtually unavoidable. Because your intentions are good but your time, resources, and skills are limited, you’re just plain going to feel guilty sometimes — so try to get comfortable with that gap between perfection and reality instead of beating yourself up over it.

RESENTMENT

This emotion is still so taboo that many caregivers are loathe to admit to it.

What causes resentment: Caregivers often feel put-upon and upset because of imagined slights by others, including siblings and adult children who don’t do enough to help. Caregiver Resentment is especially felt toward the person being cared for, when the caregiver’s life feels hijacked by responsibility and out of his or her own control.

Risks of resentment: Without enough support or noncaregiving outlets, feelings of being ignored, abandoned, or criticized can fester into anger and depression.

What you can do: Simply naming this tricky emotion to a trusted confidante can bring some release. Try venting to a journal or anonymous blog. Know that resentment is a very natural and common response to long-term caregiving, especially if your work life, marriage, health, or outside activities are compromised as a result. Know, too, that you can feel this complicated emotion yet still be a good person and a good caregiver.

ANGER

Some people outwardly show their anger more than others, but almost no one is never angry.

What causes anger: We get mad for reasons both direct (a balky loved one, an unfair criticism, one too many mishaps in a day) and indirect (lack of sleep, frustration over lack of control, pent-up disappointment).

Risks of anger: Chronic anger and hostility have been linked to high blood pressure, heart attack and heart disease, digestive-tract disorders, and headaches. Anger that builds up unexpressed can lead to depression or anxiety, while anger that explodes outward can jeopardize relationships and even harm others. Managing Caregiver Anger not only helps your well-being but makes you less likely to take out your fury on your loved one.

What you can do: Rather than trying to avoid anger, learn to express it in healthy ways. Simple deep-breathing exercises can channel mounting anger into a calmer state, for example. Talk yourself down with soothing chants: It’s okay. Let it go. Ask yourself if there’s a constructive solution to situations that make you angry: Is a compromise possible? Would being more assertive (which is different from anger) help you feel a sense of control? Laughing at absurdities and idiotic behavior can provide a healthier biological release than snapping.

WORRY

A little goes a long way, but sometimes we can’t turn off the fretting.

What causes worry: Good intentions, love, and wanting the best for your loved ones are the wellsprings of worry. Focusing intensely on the what-ifs provides a perverse kind of comfort to the brain: If we’re worrying, we’re engaged. Of course, that ultimately triggers more worry and upset because it’s engagement without accomplishing anything.

Risks of worry: Being concerned is harmless. Overworry and Obsessing, however, can disrupt sleep, cause headaches and stomach aches, and lead to mindless eating or undereating.

What you can do: If you notice worrying thoughts interfering with getting through the day or sleeping at night, force a break to the cycle. Try setting a timer and resolving to focus on something else when the five minutes is up. Then flip negative thoughts to their productive side: How can you help? Who can you call? Are there possible solutions? And don’t be shy about seeking out a trained counselor to help you express and redirect obsessive ruminations more constructively.

LONELINESS

Your world can shrink almost before you realize what’s happened.

What causes loneliness: Friends may back away out of uncertainty or a belief they aren’t wanted. Intense time demands lead you to drop out of outside activities. If you’re dealing with dementia, the loss of your loved one’s former level of companionship is another keenly felt social loss adding to isolation.

Risks of loneliness: Your very brain is altered: People with large, rich social networks have different brain structures, new research finds. Loneliness seems to curb willpower and the ability to persevere, and it can lead to overeating, smoking, and overuse of alcohol. Lonely people also have more cortisol, the stress hormone. And social isolation is a risk factor for dementia.

What you can do: Expand your social circles, real and virtual. Arrange respite help, so you can add at least one outside activity, such as one you’ve dropped. Take the initiative to reach out to old friends and invite them over if you can’t get out easily. Consider joining a support group related to caregiving or your loved one’s illness. In online support groups you can find kinship with those who know just what you’re going through.

GRIEF

Don’t think this one applies yet? Think again.

What causes grief: Although most people link grief with death, anticipatory grief is a similar emotion felt by caregivers who are coping with a loved one’s long-term chronic illness, especially when there are clear losses of ability (as in dementia) or when the diagnosis is almost certainly terminal.

Risks of grief: “Long good-byes” can trigger guilt as well as sadness if one mistakenly believes that it’s inappropriate to grieve someone still alive. Mourning the loss of a beloved companion is also a risk factor for depression.

What you can do: Know that your feelings are normal and as painful as “real” (postmortem) grief. Allow yourself to feel sadness and express it to your loved one as well as to supportive others; pasting on a happy face belies the truth and can be frustrating to the person who knows he or she is ill or dying. Make time for yourself so that you’re living a life outside of caregiving that will support you both now and later.

DEFENSIVENESS

Protecting yourself is good — to a point.

What causes defensiveness: When you’re doing so much, it’s only natural to bristle at suggestions that there might be different or better approaches. Especially if you’re feeling stressed, insecure, or unsure, hearing comments or criticisms by others, or reading information that’s contrary to your views, can inspire a knee-jerk response of self-protection: “I’m right; that’s wrong!”

Risks of defensiveness: While nobody knows your loved one and your situation as well as you do, being overly defensive can make you closed-minded. You risk losing out on real help. You may be so close to the situation that you can’t see the forest for the trees, for example; a social worker or friend may have a perspective that points to what really might be a better way.

What you can do: Try not to take everything you hear personally. Instead of immediately getting cross or discarding others’ input, vow to pause long enough to consider it. Remember the big picture. Is there merit in a new idea, or not? What you’re hearing as a criticism of you might be a well-intentioned attempt to help your loved one. You may decide things are fine as is, and that’s great. But if you start from a point of calm and confidence, the focus becomes (as it should be) your loved one, not you.

By Esther Heerema, About.com Guide

Updated July 02, 2012

Alzheimer’s disease and Lewy body dementia (LBD) are both types of dementia. They have several similarities, but there are also some clear differences between the two diseases.

Prevalence:
LBD: Lewy body dementia is the second most common type of dementia, with an estimated 1.3 million Americans diagnosed.

Alzheimer’s: Alzheimer’s disease is the most prevalent type of dementia. There are about 5.4 million Americans with Alzheimer’s disease.

Cognition:
LBD: Cognitive abilities can vary significantly in LBD, such that on one day your relative might not recognize you and the next day, she can recall the names of each of her grandchildren.

Alzheimer’s: While cognition can vary somewhat in Alzheimer’s, typically the person’s ability to think and use his memory gradually declines over time. In Alzheimer’s symptoms, there is not usually a big variance from one day to the next.

Walking and Physical Movement:
LBD: Often one of the early symptoms of LBD is difficulty in walking, a decrease in balance and ability to control physical movements. These symptoms are similar to Parkinson’s disease. Frequent falling is also common early in LBD.

Alzheimer’s: Physical deterioration usually does not occur in Alzheimer’s until the disease has significantly progressed unless the individual has other diseases or illnesses.

Facial Expressions:
LBD: Some people who have LBD display a flat affect, where their faces display very little emotion. This is another symptom that may present early in the disease and overlaps with Parkinson’s.

Alzheimer’s: While facial expressions often decrease as the disease progresses, this often doesn’t develop until the mid to later stages of Alzheimer’s.

Visual Hallucinations:
LBD: Visual hallucinations, where people see things that aren’t actually there, are quite common in LBD.

Alzheimer’s: Hallucinations do occur in Alzheimer’s, but are generally not as prevalent as in LBD.

REM Sleep Behavior Disorder:
LBD: People with LBD sometimes experience REM sleep behavior disorder, a dysfunction where they physically act out the situations in their dreams.

Alzheimer’s: REM sleep behavior disorder is not typically present in Alzheimer’s.

Significant Sensitivity to Antipsychotic Medications:
LBD: According to the Lewy Body Dementia Association, “Up to 50% of patients with LBD who are treated with any antipsychotic medication may experience severe neuroleptic sensitivity, such as worsening cognition, heavy sedation, increased or possibly irreversible parkinsonism, or symptoms resembling neuroleptic malignant syndrome (NMS), which can be fatal. (NMS causes severe fever, muscle rigidity and breakdown that can lead to kidney failure.)

Alzheimer’s: While anyone who takes an antipsychotic medication has a small risk of developing neuroleptic malignant syndrome, individuals with Alzheimer’s are not nearly as prone to develop the extreme sensitivity to antipsychotic medications that people with LBD demonstrate.

Disease Progression:
LBD: According to research conducted by James E. Galvin, MD, MPH and other researchers at the Washington University School of Medicine, the median survival time for those in the study with LBD was 78 years old, and survival after onset of Lewy body dementia was 7.3 years.

Alzheimer’s: In the above referenced study, the median survival time for participants with Alzheimer’s was 84.6 years old, and the survival rate after the beginning of symptoms was 8.4 years. It has been suggested that the difference in the disease progression between LBD and Alzheimer’s can partially be explained by the increase in falls, and therefore injuries and hospitalizations, by those with LBD.

Gender:
LBD: Men have a higher chance of developing LBD than women do.

Alzheimer’s: Women have a slightly higher chance of developing Alzheimer’s.

* For those of you on Facebook, please come take a look at our Dementia Care Secrets page.