History of Fireworks

Many historians believe that fireworks originally were developed in the second century B.C. in ancient Liuyang, China. It is believed that the first natural "firecrackers" were bamboo stalks that when thrown in a fire, would explode with a bang because of the overheating of the hollow air pockets in the bamboo. The Chinese believed these natural "firecrackers" would ward off evil spirits.

Sometime during the period 600-900 AD, legend has it that a Chinese alchemist mixed potassium nitrate, sulfur and charcoal to produce a black, flaky powder – the first “gunpowder”.  This powder was poured into hallowed out bamboo sticks (and later stiff paper tubes) forming the first man made fireworks. 

Fireworks made their way to Europe in the 13th century and by the 15thcentury they were widely used for religious festivals and public entertainment. The Italians were the first Europeans to manufacture fireworks and European rulers were especially fond of the use of fireworks to “enchant their subjects and illuminate their castles on important occasions.”    

 Early U.S. settlers brought their love of fireworks with them to the New World and fireworks were part of the very first Independence Day – a tradition that continues every 4th of July when we celebrate as John Adams had hoped “with pomp, parade….bonfires and illuminations from one end of this continent to the other.” Americans' spirit of celebration continued to grow and in the late 18th century, politicians used displays to attract crowds to their speeches.

While July 4th is still the “big day”, Americans continue to use fireworks year-round to celebrate at festivals, special events, and sporting traditions such as the Olympics and Super Bowl.

Fireworks entertainment generates dollars as well as smiles. Thunder Over Louisville is one of the country’s largest fireworks displays and an economic study conducted by the Derby Festival determined that Thunder generates more than $56 million for the local economy.

But more than anything else, when you think of the fireworks, you think of the Fourth of July and the celebration of our country’s Independence.

Happy Indepence Day - Enjoy and be Safe!!

The Longest Day of the Year - June 21, 2019

ABOUT ALZHEIMER'S

ALZHEIMER’S DISEASE IS A GLOBAL EPIDEMIC.

Worldwide,
50 MILLION PEOPLE
are living with dementia.

The annual global cost of dementia is $818 BILLIONin U.S. dollars.

The number of people living with dementia worldwide is set to skyrocket to 75 MILLIONby 2030.

Alzheimer’s disease is the SIXTH-LEADING cause of death in the United States.

More than 5 MILLIONAmericans are living with the disease.

More than 16 MILLIONfamily and friends provide care to people with Alzheimer's and other dementias in the United States.

In the United States someone develops Alzheimer's every 65 SECONDS.

In 2018, more than 16 million caregivers of people living with Alzheimer's disease or other dementias provided an estimated 18.5 BILLIONhours of unpaid care, a contribution to the nation valued at nearly $234 billion.

In 2019, Alzheimer's disease will cost the United States $290 BILLION. This number is projected to rise to more than $1.1 trillion in 2050.

JOIN THE FIGHT AGAINST ALZHEIMER'S- JUNE 21, 2019

Birthday Traditions Around the World!

The Western idea of celebrating a birthday with cake and candles has certainly caught on in other parts of the world, but many cultures have long-standing traditional ways to celebrate that don’t involve a sugar rush.

Obviously, the practices found in the list below are not entirely representative of the preferences of every household or individual. We’re sure many of them are more traditional and hypothetical than a reality, but if you happen to be in Germany and see a group of men with a broom on the steps of city hall, you’ll at least know what they’re up to.

1. Canada: Nose Grease

On the Atlantic side of Canada, birthday boys and girls are sometimes “ambushed” and their noses are greased, usually with butter, to ward off bad luck. A friend who lives in Pictou told this writer that “The butter got worse as you got older.  It was good luck as much as torture as I remember it.” We would imagine so!

2. China: Long Noodles for Longevity

Chinese birthday tradition maintains that one should symbolize their longevity by eating a plate of long noodles, slurping them in as far as possible before biting.

3. Germany: Sweeping the Streets of City Hall

When single men in Germany turn 30, an old tradition is for them to sweep the steps of their local city hall as their friends toss rubble onto them. The ordeal, meant to embarrass, is supposed to carry on until the birthday boy is able to plant one on a passing woman. Also, as this author personally found out recently, you buy the drinks for your friends on your birthday, unlike in the States where it is the other way around.

4. Ireland: Hit the Deck

Think the Irish had a few when coming up with this one? Tradition maintains that a child is held upside down and is “bumped” on the floor, once for every year of their age plus one for good luck. We’re guessing lawyers would have something to say about this in the United States!

5. Jamaica: Modern Day Antiquing

Just like that one friend you had in college, Jamaicans think dousing their friends with flour is fun. Regardless of age, tradition calls for the birthday boy or girl to be “antiqued,” or coated with flour, by friends and family, either at an organized party or as part of an ambush. 

6. Mexico: The Birthday Piñata

Mexicans sure know how to have a good time, and it’s no surprise that they have what is in my opinion the most fun tradition for children: The birthday piñata filled with candy. Grab a blindfold and a broomstick, and let the celebration begin. I don’t know about you, but I certainly would trade my birthday cake for a piñata any day. 

7. Vietnam: Happy… New Year?

Everyone celebrates their birthday on New Year’s Day in Vietnam, a day they refer to as “tet.” Vietnamese tradition is that the actual day of birth is not to be acknowledged. Rather, people become a year older every year at tet.

Today Marks the 75th Anniversary of D-Day

Today marks the 75th anniversary of the World War II invasion in Normandy, France, commonly known as D-Day.

On June 6, 1944, an estimated 150,000 Allied service members engaged in a land, sea and air assault on the French shore, marking a pivotal moment in the fight against the Axis powers. While the monumental, coordinated effort has been immortalized in multiple films and television shows—including Band of Brothers, The Longest Day and Saving Private Ryan—some may not know what D-Day stands for.

Is it Designated Day, Decision Day, Doomsday, Death Day? All are guesses people have made as to the meaning of D-Day, however, the Army pointed out none of them are correct. Although, it's not entirely clear exactly what D-Day meant.

D-Day, in military speak, simply meant the designated day an important invasion or military operation occurred. Military planners described the days before and after the invasion or operation with minuses and pluses, respectively.

A French flag and an U.S. flag sit on the grave of a soldier during commemorations marking the 73th anniversary of D-Day, the June 6,1944, landings of Allied forces in Normandy at the American cemetery on June 06, 2017, in Colleville-sur-Mer, France.CHESNOT/GETTY IMAGES

Another possibility, which was given by Brigadier General Robert Schultz in 1964, was that it was the shortened term for "departed date." Every amphibious assault, Schultz explained, had its own D-Day.

The Allied assault included 6,000 ships and landing craft, 50,000 vehicles and 11,000 planes. Code names for the beaches along the Normandy coast were Utah, Omaha, Gold, Juno and Sword. British forces largely took Sword and Gold, Canadians led Juno and American forces took charge of Utah and Omaha.

Omaha, located between Sainte-Honorine-des Pertes and Vierville-sur-Mer, saw the worst casualties of all five sections. An estimated 6,603 Americans were killed wounded or missing in action on D-Day.

From D-Day until August 21, when Paris, located about 118 miles away, was liberated, 72,911 Allied service members were killed or missing and 153,475 were wounded.

Less than a year later, on May 8, Germany surrendered.

In his message to Allied soldiers, then-General Dwight D. Eisenhower, informed them they were about to "embark upon the Great crusade" and noted "the eyes of the world are upon you." While it admittedly wouldn't be easy, Eisenhower said German suffered great defeats and expressed his confidence in the troops.

"The tide has turned! The freemen of the world are marching together to Victory!" Eisenhower said. "I have full confidence in your courage, devotion to duty and skill in battle. We will accept nothing less than full victory!"

Among those who landed at Normandy were Brigadier General Theodore Roosevelt, Jr., son of former president Theodore Roosevelt, and his son, Captain Quentin Roosevelt II. At 56 years old, Theodore was the oldest and only general in the first wave to storm the beaches and the only father to serve with his son.

I Can't Remember Anyone's Name. Maybe That's Not a Problem?

Decades of experience have taught me that many people have trouble remembering names — at least, the names of people they’ve met just once or twice. Acquaintances.

With me, that’s just the beginning. My memory is so flawed that I forget not just the names of acquaintances and friends but also people I know really well (my boyfriend, my mother) along with the names of basic things like “fork,” “car,” “cloud,” “diamonds.”

In extreme cases like this, it is viewed as a medical condition: anomic aphasia or dysnomia, and for decades it has been the bane of my life, charging every social situation with an electric fence of anxiety.

That’s because a lot of people get offended when you forget their names, and nothing smooths over this blow to the ego. Some people try to commiserate: “Yeah, I’m bad with names, too.” My rejoinder: “I’m bad with the past.” The things I do manage to remember bear an inverse relationship to any usefulness: Avogadro’s number, the Fibonacci sequence, the smell of Chanel No. 5. But names — no. Never.

Then, one fine May day in 2007, something happened that made this all so much worse and yet so much better. Ironically, I remember it like it was yesterday.

I was in Union Square with a photographer and three male models, styling a fashion shoot on the controversial topic of wearing shorts at work. I kept needing to get the guys’ attention for various reasons, but of course couldn’t remember any of their names, and as the sun and my irritation mounted, I finally snapped.

“O.K., look,” I said. “Here’s how this is going to work. From now on, you’re all Steve. I say Steve, you all turn around.”

Immediately, I felt a stab of fear. Would all three now call their agents to report a psychotic fashion break? But no. All three thought it was hilarious, and started calling one another Steve and me Steve and the photographer Steve, so the whole world was Steve for a day. It made the shoot much more fun, and when it was done I thought nothing more about it.

But the next day, I realized this approach might have legs. What I’d stumbled across helped me both practically and psychologically, and did it in a way that seemed endearingly screwball, rather than sad and mentally challenged.

So I went with it and started calling everyone Steve, from relatives and friends I knew well to people I didn’t know at all. Why Steve? No idea — it just popped out. There are a lot of great Steves I might have been summoning up — McQueen, Hawking, Sondheim.

And I have since discovered that there’s an excellent Hollywood tradition of gals calling guys Steve when it’s not their real name. See Lauren Bacall in “To Have and Have Not” (“You know how to whistle, don’t you, Steve?”)

and Barbra Streisand in “What’s Up, Doc?” (“Aw c’mon, Steve, you can tell her about us.”)

Almost all men responded really well to it. But while I can remember only one time in 12 years that a man said he refused to be called Steve (well, two if you count my father), I’ve had a very different experience with women.

Again and again, I’d try out a name with the same basic cultural valence as Steve: Rachel, Stephanie, Kelly, Sarah, Christine. Within a week or two, whatever name it was, a woman would say the following, as if reading off a cue card: “You can’t call me X, because I know a girl named X, and I hate her.”

I was rescued by “South Park.” Years ago an ex of mine and I had developed a habit of saying “Shut up Wendy” to each other (an Eric Cartman reference) so the name Wendy popped out one day quite naturally, and just kept going.

Why? Many women remember Wendy from Peter Pan with fondness; and it seems there are relatively few other Wendys out there to hate. The name peaked in 1970 as the 28th most popular name for baby girls, and has largely declined ever since, hitting a low in 2015 at No. 941, after which it vanished from the Social Security baby names index.

But she’s not foolproof. Once, a gal across the table at a dinner where I was describing all this heard me and piped up: “My husband’s first wife is named Wendy, and we hate her.”

My nonbinary go-to: Stevie, as in Nicks and Wonder.

Overall, as experiments go, Steve and Wendy have been an outstanding success. Sure, some people think it’s odd. But the overwhelming majority respond with visible relief and pleasure.

Here’s the thing, Not only does no one like remembering names, but no one really likes what names represent. That is, those awkward first moments of conversation with a stranger when you each of you lists your relevant data: name, profession, home location.

Skipping your name means skipping all of that — and the novel bond you forge by sharing in it means you can candidly go to topics that actually interest you both. It’s the linguistic equivalent of taking off your uncomfortable work shoes and pulling on your favorite sneakers.

Dozens of people now call me Steve, and hundreds of people have asked if they can steal the Steve strategy. It’s free for anyone to take. To ennoble what could seem a shallow, idiosyncratic gesture, I call this campaign the post-nominal revolution, hoping for a future when you will never have to use anyone’s name, ever.

You can call me David if you must, but I’d rather you didn’t. It’s a little personal.

By David Colman - NY Times

Only 55% of Americans Know Why the Nation Marks Memorial Day, Survey Finds

nly 55% of Americans know what Memorial Day is about, and only about one in five plan to fly a flag at half-staff or attend a patriotic event on May 27, according to a Harris poll survey commissioned by the University of Phoenix.

The survey, conducted April 9-11 among 2,025 adults, showed that only 28% had attended a local ceremony or patriotic event on a previous Memorial Day. It also found that only 23% had flown a flag at half-staff, while 22% had left a flag or flowers at a gravesite or visited a military monument.

Only 55% could correctly describe Memorial Day as a day to honor the fallen from all the nation's wars, the Harris survey states, and 45% said they either always or often attended a commemoration activity.

About 27% of those surveyed thought Memorial Day honored all military veterans, 5% thought it honored those currently serving, and 3% thought the day marked the official beginning of summer, the survey states.

Of those who said they had participated in some form of commemoration activity on Memorial Day, 52% said they had thanked a veteran, 14% said they had worn a Memorial Day button, and 14% said they had joined in a National Moment of Remembrance, according to the survey.

Older adults are more likely to observe Memorial Day and describe it correctly, the survey found. About 53% of those aged 55-64 commemorated Memorial Day, compared with 40% of those aged 18-34, according to the survey's findings.

Former Army Sgt. Brian Ishmael, director of Military and Veterans Affairs at the University of Phoenix, said in a phone interview that it is "a little bit disappointing" to know that so many Americans are unaware of the true meaning of Memorial Day.

Ishmael, who served two tours in Iraq with the 101st Airborne Division, said that "being a combat veteran myself, that has to be a bit disappointing."

At the University of Phoenix, "we put a lot of emphasis" on explaining the real meaning of Memorial Day, he said. For this Memorial Day, the mostly online university will continue a 10-year tradition of planting flags on the Phoenix campus.

This year, the university plans to plant 15,000 flags with the theme "Their Legacy Lives On," Ishmael said.

However, the for-profit University of Phoenix has had a checkered history of serving veterans and its use of GI Bill funds for tuition.

In 2009, the university agreed to a $67.5 million settlement with the federal government on allegations that it was illegally paying recruiters based on the number of students enrolled.

And in 2015, the Defense Department suspended the university from recruiting on military bases and accessing federal education funds.

It was alleged that the university had violated rules against for-profit colleges seeking to gain preferential access to potential students from the military. The suspension was lifted in 2016.

Ishmael acknowledged the allegations against the university but said they are dated, and the school is now "100% focused on our veterans" and their education.

-- Richard Sisk can be reached at Richard.Sisk@Military.com.

Honoring Mother's Day When Mom Has Alzheimer's

Nearly two-thirds of the more than 5 million Americans with Alzheimer's are women.

Women are at the epicenter of the Alzheimer's crisis, and the burden on women is never more apparent than on Mother's Day, when families come together to celebrate their mothers and grandmothers. The disease places an unbalanced burden on women at work and at home, forcing them to make difficult choices about their careers, their relationships and their futures.

  • About 13 million women are either living with Alzheimer's or caring for someone who has it.

  • Nearly two-thirds of the more than 5 million Americans with Alzheimer's are women.

  • More than 60 percent of Alzheimer's and dementia caregivers are women.

Celebrating Mother's Day, like other holidays, can be challenging when a mom is living with Alzheimer's. On these kinds of special occasions, a person with Alzheimer's may feel a sense of loss because of the changes being experienced as a result of the disease. At the same time, caregivers and other family members may struggle with figuring out how to celebrate Mother's Day with someone living with dementia.

Mother's Day can remain a meaningful and enjoyable occasion for families impacted by Alzheimer's disease. Planning will take more thought and each family's unique circumstances will need to be taken into consideration. The following tips from the Alzheimer's Association can help:

  • Take a person-centered approach. Focus on what is enjoyable for the person with Alzheimer's, such as looking at family pictures or enjoying the person's favorite food. If they get overwhelmed in large groups, a small quiet gathering may be preferable.

  • Keep it simple. Consider a celebration over a lunch or brunch at home or where the person is most comfortable. Ask family or friends to bring dishes for a potluck meal or have food delivered by a local restaurant or grocery store.

  • Join In. If the person with Alzheimer's lives in a care facility, consider joining in any facility-planned activities.

  • Don't overdo it. Sticking to the person's normal routine will help keep the day from becoming disruptive or confusing. Depending on the person's stamina, plan time for breaks so the person can rest in a quiet area away from noise and crowds.

  • Adapt gift-giving. Encourage safe and useful gifts for the person with Alzheimer's. Diminishing capacity may make some gifts unusable or even dangerous to a person with dementia. If someone asks for gift ideas, suggest items the person with dementia needs or can easily enjoy. Ideas include: an identification bracelet, comfortable clothing, favorite foods and photo albums.

  • Educate yourself and find support. Call the 24/7 Helpline 800.272.3900, to speak with a trained social worker whenever you have questions or concerns. Learn more about Alzheimer's in the Alzheimer's and Dementia Caregiver Center at alz.org/care. For more tips on supporting a family member with Alzheimer's, join the ALZConnected online community, and find more information about your local Alzheimer's Association chapter services and programs.

SOURCE Alzheimer’s Association - NYC Chapter

Memory Loss - What's Normal, What's Not, and When to Seek Help

We’ve all misplaced keys, blanked on someone’s name, or forgotten a phone number. When we’re young, we don’t tend to pay much mind to these lapses, but as we grow older, sometimes we worry about what they mean. While it’s true that certain brain changes are inevitable when it comes to aging, major memory problems are not one of them. That’s why it’s important to know the difference between normal age-related forgetfulness and the symptoms that may indicate a developing cognitive problem.

Memory and aging

Forgetfulness is a common complaint among many of us as we get older. You start to talk about a movie you saw recently when you realize you can’t remember the title. You’re giving directions to your house when you suddenly blank on a familiar street name. You find yourself standing in the middle of the kitchen wondering what you went in there for.

Memory lapses can be frustrating, but most of the time they aren’t cause for concern. Age-related memory changes are not the same thing as dementia.

As we grow older, we experience physiological changes that can cause glitches in brain functions we’ve always taken for granted. It takes longer to learn and recall information. We’re not as quick as we used to be. In fact, we often mistake this slowing of our mental processes for true memory loss. But in most cases, if we give ourselves time, the information will come to mind.

Memory loss is not an inevitable part of the aging process

The brain is capable of producing new brain cells at any age, so significant memory loss is not an inevitable result of aging. But just as it is with muscle strength, you have to use it or lose it. Your lifestyle, habits, and daily activities have a huge impact on the health of your brain. Whatever your age, there are many ways you can improve your cognitive skills, prevent memory loss, and protect your grey matter.

Furthermore, many mental abilities are largely unaffected by normal aging, such as:

  • Your ability to do the things you’ve always done and continue to do often

  • The wisdom and knowledge you’ve acquired from life experience

  • Your innate common sense and your ability to form reasonable arguments and judgments

3 causes of age-related memory loss

  1. The hippocampus, a region of the brain involved in the formation and retrieval of memories, often deteriorates with age.

  2. Hormones and proteins that protect and repair brain cells and stimulate neural growth also decline with age.

  3. Older people often experience decreased blood flow to the brain, which can impair memory and lead to changes in cognitive skills.

Normal forgetfulness vs. dementia

For most people, occasional lapses in memory are a normal part of the aging process, not a warning sign of serious mental deterioration or the onset of dementia. The following types of memory lapses are normal among older adults and generally are not considered warning signs of dementia:

  • Occasionally forgetting where you left things you use regularly, such as glasses or keys.

  • Forgetting names of acquaintances or blocking one memory with a similar one, such as calling a grandson by your son’s name.

  • Occasionally forgetting an appointment or walking into a room and forgetting why you entered.

  • Becoming easily distracted or having trouble remembering what you’ve just read, or the details of a conversation.

  • Not quite being able to retrieve information you have “on the tip of your tongue.”

Does your memory loss affect your ability to function?

The primary difference between age-related memory loss and dementia is that the former isn’t disabling. The memory lapses have little impact on your daily performance and ability to do what you want to do. Dementia, on the other hand, is marked by a persistent, disabling decline in two or more intellectual abilities such as memory, language, judgment, and abstract thinking.

When memory loss becomes so pervasive and severe that it disrupts your work, hobbies, social activities, and family relationships, you may be experiencing the warning signs of Alzheimer’s disease, or another disorder that causes dementia, or a condition that mimics dementia.

Normal age-related memory changesSymptoms that may indicate dementiaAble to function independently and pursue normal activities, despite occasional memory lapsesDifficulty performing simple tasks (paying bills, dressing appropriately, washing up); forgetting how to do things you’ve done many timesAble to recall and describe incidents of forgetfulnessUnable to recall or describe specific instances where memory loss caused problems; May pause to remember directions, but doesn’t get lost in familiar placesGets lost or disoriented even in familiar places; unable to follow directionsOccasional difficulty finding the right word, but no trouble holding a conversationWords are frequently forgotten, misused, or garbled; Repeats phrases and stories in same conversationJudgment and decision-making ability the same as alwaysTrouble making choices; May show poor judgment or behave in socially inappropriate ways

See your healthcare professional if you are concerned about your memory.

reprinted: healthline.org

Easter Traditions Around the World

Easter is the time of the year when Christians remember the death of Christ and celebrate his resurrection, as described in the New Testament. It is considered to be a moveable feast, because Easter celebrations do not take place on a set date on the Gregorian calendar. Instead, the date is decided using a lunisolar calendar.

Much of the symbolism related to Easter also relates to the Jewish Passover and both celebrations occur at a similar time. Moreover, in addition to traditional Christian elements, Easter celebrations now have a commercial, non-religious element, including the eating of chocolate Easter eggs, Easter parades and the Easter bunny.

The Origins of Easter

Easter is significant to Christians, because it celebrates the resurrection of Jesus Christ, the story of which is one of the cornerstones of Christian faith. Christians believe that Jesus was the son of God, died for humanity’s sins and was resurrected before ascending to the heavens 40 days later.

Easter celebrations include Good Friday, which commemorates the day Jesus was crucified, and Easter Sunday, which commemorates the day he was resurrected. Jewish Christians were the first to celebrate Christ’s resurrection and timed the celebrations in accordance with the Jewish celebration of Passover.

Over the years, the time of Easter celebrations deviated slightly from Passover celebrations, to the point where the two are now completely distinct from one another. Nevertheless, Easter and Passover still take place at a similar time of year and are often very close to one another in the Gregorian calendar.

Easter Traditions Around the World

As it is a religious festival, many of the celebrations linked to Easter are common throughout the Christian world. That said, due to its modern commercial nature, Easter is sometimes celebrated by non-Christians too, while individual countries have developed their own Easter customs as time has gone by.

In some cases, the ways in which Easter is celebrated can tell you a lot about the culture of a country. With that in mind, here, we take a look at some of the Easter traditions observed in different parts of the world:

Spain

Easter holds special significance in Spain, where it is celebrated for an entire week known as Semana Santa, or Holy Week. Over the course of the week, several processions take place, where the crucifixion of Christ is re-enacted. These processions are usually organised by ‘cofradías’ or ‘brotherhoods’.

Semana Santa traditions date all the way back to the Middle Ages and are some of the most elaborate Easter celebrations in the world. Indeed, one of the largest celebrations takes place in the city of Seville, where around 50 different ‘cofradías’ come together to parade through the streets.

France

France has a strong Catholic history and Easter is an extremely important religious celebration in the country. While many of the Easter celebrations are similar to those observed elsewhere, one of the most significant relates to church bells. Indeed, starting on Maundy Thursday, the day before Good Friday, all church bells go silent.

The bells then remain silent until Easter Sunday, in memory of Christ’s resurrection. This particular tradition is referred to as the Flying Bells. It is believed that all of the church bells in France fly off to the Vatican, carrying the grief of those mourning Christ with them. Upon their return, they bring with them chocolates and other treats.

Germany

One of the most significant German traditions related to Easter is that of the ‘Osterhase’, or Easter Hare. This particular tradition originated in Germany, but has since become popular elsewhere. In many other countries, however, the ‘Osterhase’ is depicted as a rabbit, rather than a hare.

Easter egg hunts are a common tradition that children enjoy, while eggs are also sometimes displayed on trees, or on the streets, as decorations. In fact, it is not uncommon to see trees with hundreds of colourful Easter eggs hanging from them. After sunset on Saturday, but before sunrise on Easter Sunday, a church vigil is held.

United Kingdom

In the United Kingdom, church services are held on Good Friday and Easter Sunday, while children are typically given chocolate Easter eggs. In certain towns, the custom of egg rolling is still observed, where hard boiled eggs are rolled down a hill to see which one goes the furthest. This is said to reference the stone of Jesus’ tomb.

Most other traditions, including the presence of the Easter Bunny, are fairly typical. However, another popular tradition is the eating of hot cross buns. These originated in England and are sweet buns, containing raisins or currants. They are decorated with a cross on the top, which of course symbolises Christ’s crucifixion.

Other Countries

Several other countries across the globe have their own distinctive Easter celebrations. In the United States, celebrations are very similar to those in the United Kingdom, but one distinctive tradition from the country sees the President take part in an Easter Egg Roll on the lawn of the White House.

In Hungary, one of the more prevalent traditions is known as ‘sprinkling’. Here, boys ‘sprinkle’ water or perfume over the head of a woman and ask for a kiss. Meanwhile, in Brazil, many people engage in a tradition where they make straw models of Judas Iscariot, who is said to have betrayed Jesus, and then beat the models up.

Finally, in Sweden, Easter traditions have a lot in common with Halloween. Typically, children will dress up and go door-to-door, exchanging drawings or paintings they have made for sweets or chocolates.

Disappointing News for Alzheimer's Research

Pharmaceutical company Biogen is halting two global phase-three trials testing the once-promising Alzheimer’s drug aducanumab, delivering a late-stage blow to researchers searching for therapies for the incurable degenerative disease.

“This disappointing news confirms the complexity of treating Alzheimer’s disease and the need to further advance knowledge in neuroscience,” Biogen CEO Michel Vounatsos said in a statement Thursday. “We are incredibly grateful to all the Alzheimer’s disease patients, their families and the investigators who participated in the trials and contributed greatly to this research.”

Biogen and its Japanese partner Eisai decided to end the aducanumab trials after an independent data-monitoring committee determined that the drug was unlikely to provide benefit to Alzheimer’s patients compared to a placebo, the company said in its statement. The committee did not find safety issues associated with the drug.

Aducanumab was meant to slow the rate of cognitive decline and functional impairment in people with mild Alzheimer’s disease by clearing amyloid from the brain. Amyloid protein is thought to contribute to Alzheimer’s-related decline by forming sticky plaques in the brain, potentially compromising nerve cells and leading to dementia and memory loss. The trial’s failure, however, calls that amyloid hypothesis — and potential treatment path — into question.

It’s also yet another failure in the search for a drug that can fight Alzheimer’s disease, which has been riddled with bad news in recent years. In 2018, pharmaceutical companies including Eli Lilly, AstraZeneca, Pfizer and Merck halted research or development into possible Alzheimer’s and dementia therapies due to disappointing results.

  • Reprinted -  Jamie Ducharme at jamie.ducharme@time.com.

Daylight Saving Time Can Trigger Sundowning Behaviors

Daylight Saving Time Can Trigger Sundowning Behaviors

It’s almost that time again. On Sunday, Daylight Saving Time ends and we turn our clocks back. This can have a dramatic effect on those who are living with dementia and their loved ones.

I already suffer from sundowning, and Daylight Saving Time always makes it worse. Everyone has an internal clock, and light plays a huge role in our sleep/wake cycles. Changes in natural light are part of why sundowning occurs in the first place, but messing with the timing and amounts of daylight we receive only complicates things further.

I lost the concept of time long ago, but when it’s only 5:00 p.m. and it’s already getting dark, I’m aware that this isn’t “normal.” Change is one of the biggest things that affects me and other dementia patients. Even subtle changes can be stressful for us.

According to the Mayo Clinic, sundown syndrome is described as “…a state of confusion at the end of the day and into the night. Sundowning can cause a variety of behaviors, such as confusion, anxiety, aggression or ignoring directions. It can also lead to pacing or wandering. Sundowning isn’t a disease, but a group of symptoms that occur at a specific time of the day that may affect people with dementia, such as Alzheimer’s disease. The exact cause of this behavior is unknown.”

They had this mostly right, but the very first sentence is wrong in my opinion. Sundowning can actually affect people living with dementia during any time of day. It does not always have to be at dusk or in the evening.

Just dealing with the fact that the days are shorter can be a struggle for dementia patients. I have said many times that every dementia patient has a routine. If you try to set the table differently or change the linens on their bed, you’ll see that even the smallest adjustments can be very disorienting for them.

Now, because of the time change, most of us will be eating supper when the sun has gone down or is at least in the process of setting. You will hear many experts recommend turning the lights up before the sun begins to set. They will say, “Change the time you begin dinner, that way you can be through with it before sunset and nightfall.” But again, you are dealing with people who have a set routine.

None of these suggestions have ever worked for me, but I am just one patient. Each one is entirely unique. For me, sundowning can happen mid-morning on an average Tuesday. It certainly doesn’t have to be at sunset, and it doesn’t happen solely around Daylight Saving Time. My wife and I just have to deal with this.

Unless a patient is in the very early or late stages, you can bet they will have increased confusion and agitation starting on Sunday. For the patient, it feels like everything changes, not just the time. They will know by their internal clocks that something isn’t quite right. As with all things dementia-related, you are dealing with something there simply isn’t a “fix” for. However, it is still important to do what you can to help with this.

Some will say, “Just explain to your loved one what is happening; that it is time to turn the clocks back.” The intention behind this is good, but remember that short-term memory is the first thing to go with dementia. People around me often forget this. My short-term memory is entirely gone and has been for some time. So, telling me that the clocks were turned back and why is waste of time. Pardon the pun, but it’s true. Your loved one may still have the ability to understand the concept of the time change, but the problem is that they won’t remember this from one minute, one hour or one day to the next.

Instead, make a point of keeping your home well lit and the atmosphere upbeat. Natural light is important, but dusk and twilight can cause distorting shadows and colors that are overwhelming to a patient. In the late afternoon or early evening, draw the curtains, close the blinds and switch on plenty of warm, artificial lights. Playing their favorite music can also help keep them calm and content.

Since people naturally tire as the day wears on, keep in mind that this applies to dementia patients tenfold. Plan evening activities that are low key and not too complex to avoid increased disorientation and frustration. These emotions can escalate into troublesome behaviors that are more difficult to handle, like wandering, delusions, hallucinations and paranoia.

You may be one of the lucky caregivers who can rearrange the timing of their loved one’s routine without much of an issue, but it isn’t likely. The time change is coming. Just be prepared and try to make the transition as calm and uneventful as you can.

Reprint: Agingcare.com

FDA Cracks Down on Supplement Makers Touting Alzheimer's Treatment

Federal officials are cracking down on supplement makers that claim that their products can treat Alzheimer’s and other diseases.

The Food and Drug Administration on Monday sent 12 warning letters and five online advisory letters to companies whose products are being “illegally marketed as unapproved new drugs” to prevent, treat or cure Alzheimer’s, diabetes and cancer.

“Such claims can harm patients by discouraging them from seeking FDA-approved medical products that have been demonstrated to be safe and effective for these medical conditions,” said FDA Commissioner Scott Gottlieb in a statement.

“As the popularity of supplements has grown, so have the number of entities marketing potentially dangerous products or making unproven or misleading claims about the health benefits they may deliver.”

The warning letters, some written in partnership with the Federal Trade Commission, were sent to companies including Earth Turns, TEK Naturals, John Gray's Mars Venus, Blue Ridge Silver and Gold Crown Natural Products. The full list is available on the FDA's website. Products that were illegally marketed included green tea extract, fish oil supplements, bovine colostrum and melatonin.

Three-quarters of adult Americans and a third of children regularly take a dietary supplement, the agency noted. The industry is now worth more than $40 billion, producing up to 80,000 products, including pills, powders and liquids.

But dietary supplements can’t claim to prevent, treat or cure diseases like Alzheimer’s, Gottlieb said. Previous FDA action has targeted companies that have made similar false claims about their products' helping patients with cancer and opioid addiction.

Monday’s crackdown came as the FDA also announced that it was starting what it called one the most sweeping modernizations of dietary supplement regulation and oversight in 25 years.

"I've personally benefited from the use of dietary supplements and, as a physician, recognize the benefits of certain supplements," Gottlieb said. "Consumers need to have access to safe, well-manufactured, and appropriately labeled products."

As part of that goal, the agency is creating a new “rapid-response tool“ to let people know more quickly when a supplement ingredient is potentially dangerous. It is also is looking into ways of being better notified when the industry develops a new dietary ingredient and has created a Botanical Safety Consortium, which will look at better ways to test the safety of supplement ingredients.

The Council for Responsible Nutrition, the trade group for the supplement industry, praised the FDA's "enthusiasm for rooting out bad actors who put consumers at risk by spiking products with unapproved ingredients or drugs."

"We welcome additional enforcement actions to bring to justice those who would cynically trade on the halo effect of responsible industry to make a quick buck while ignoring the safety and health of consumers," Steve Mister, president and CEO of the council, said in a statement.

Reprinted: A. Pawlowski is a regular NBC News contributor focusing on health, travel and business news and features. Previously, she was a writer, editor and producer at CNN.


Responding to Agitation in Dementia

Agitation is a general term to describe excessive physical movement and verbal activity. Agitation often develops in the middle stages of Alzheimer's disease and other types of dementia and can include restlessness, pacing, verbal aggressioncombativenesscalling out and crying, and wandering.

Prevalence of Agitation in Dementia

Statistics vary, but some research estimates that as high as 80 percent of people with dementia experience agitation. One study determined that approximately 68 percent of people with dementia who were living in the community experienced excessive agitation. Another study found that among people with dementia who were in nursing home care, approximately 75 percent of them experienced agitation.

How to Respond to Agitation

Investigate the Cause

The cause is the most important factor to consider if you see someone with dementia who is agitatedWe know that most behaviors that we may see as challenging in someone with dementia are really an effort to communicate something. You are charged with figuring that "something" out.

The cause can range from boredom to pain to a need for exercise. One study found that discomfort was the cause behind many occasions of agitation in nursing home residents with dementia. This was particularly true for agitation including non-aggressive physical behavior (such as restlessness) and for verbal agitation (such as calling out). 

Other causes may include environmental changes, routine changesunfamiliar caregivers, fear and fatigue. Review these possible causes:

  1. Environmental Causes of Challenging Behaviors

  2. Psychological / Cognitive Causes of Challenging Behaviors

Individualize It

Your response should be tailored to the particular person with whom you're working. Once you've determined the likely cause, you can choose an appropriate response to that person. It may be as simple as helping the person change positions because he's in pain, or going for a walk with her because she's feeling restless.

How you respond to someone who is agitated should depend on which behaviors he is demonstrating, possible reasons he might be agitated, what has worked well in the past when he's been agitated, and his personality, abilities, preferences, and needs.

What Research Says Is Effective

While each person is different, here are few research-proven interventions to try when a loved one or patient is agitated:

Addressing Unmet Needs

Making sure you've met the needs of someone who is hungry, tired, bored, lonely or in pain is paramount. Remember that the agitation is likely there for a reason, and be certain to meet the need it may be expressing.

Music

Both singing and listening to music have been shown to decrease agitation and even improve cognition in persons with dementia.

Physical Touch

Don't underestimate the importance of physical touch. A little tender loving care goes a long way- research has demonstrated that appropriate physical touch can diminish agitation.

Physical Exercise

Work it out. Physical exercise can help decrease challenging behaviors and improve cognitive ability, among other benefits.

Pet Therapy

Research has shown that animal-assisted therapy can improve mood and nutrition, as well as decrease agitated behaviors in people with dementia.

Caregiver Training

Several research studies have tested whether spending time on teaching caregivers (both family members and professionals) makes a difference in coping with and responding to agitation levels in people who have dementia. Research shows that education for caregivers benefits both the caregiver and the family member with dementia by decreasing caregivers' stress levels and enabling them to respond better to their family member, as well as decreasing the agitation in the person with dementia.

Helpful Medications

The short answer? There are occasionally times when psychotropic medications might be helpful and appropriate, but they should never be the first thing that you try. They also can cause a number of side effects and drug interactions. Many times, a person's agitation can be reduced simply by employing some of the strategies listed above.

If you are not able to determine a reason for the agitation and it is causing the person distress (for example, she's experiencing frightening hallucinations or significant anxiety), you can ask the physician if medication might be appropriate. 

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By Esther Heerema, MSW 

5 Ways the Elderly Can Hide Dementia

You’re not alone if you have a parent with memory loss. Millions are facing this reality every day. Finding out whether the memory loss is a part of aging or a cognitive disease, such as Alzheimer’s disease or dementia, can be the challenge. Discover ways the elderly can try to hide cognitive diseases, and why it’s crucial you get them testing and help.

Alzheimer’s and Dementia are scary diseases that slowly steal a person’s identity and personality; the very traits that make them who they are as individuals. No one wants to lose themselves to this heart wrenching and brain-destroying disease, which is why denial, changing the subject or compensating for symptoms is quite common.

5 Ways the Elderly Can Hide Dementia

The signs of dementia can be subtle at first. Mom gets disoriented or has trouble recalling certain words, or Dad forgets to pay the bills. If your aging parent or loved one is showing persistent memory loss, it’s a warning you should not ignore, because it could be more than a “senior moment.” There is even a condition called anosognosia, a lack of awareness of impairment, that may affect your parent when there is damage to the part of the brain that affects perception of one’s own illness.

Getting treatment for the problem can help slow down the disease progression, and even completely treat some forms of dementia. So, it is important to understand the ways that the elderly can hide dementia symptoms:

1. Refusing to participate in an activity they once loved.

Refusal to do a chore, play a game that was once simple, or try something new can signify a problem. Mom or Dad may be having trouble remembering how to do activities that were once second-nature, which makes learning new information even more difficult.

2. Covering-up problems.

Whether it’s having trouble driving or interacting with family and friends; spouses often cover for their loved ones. They’ll step in and complete tasks, finish sentences or make excuses for their spouse.

3. Being in denial of their own cognitive impairment.

Insisting they’re fine when there’s an obvious problem often signifies denial. Excuses such as, “This is normal forgetfulness for my age,” or “I’m fine, just tired” are some signs of denial. Making excuses protects the elder in their eyes by convincing himself or herself that everything is fine so they don’t need to worry, when, in reality, they may not be fine and might need either some form of treatment or an alternative living arrangement.

4. Keeping it a secret for fear of being put into a home.

No one wants to give up their freedom. Seniors will go to great lengths to cover up they are going downhill so that they can remain “independent.” Some studies have indicated that people who have a high intellect and more education can cover up the signs of dementia for a longer period of time. They can even deny it to themselves longer. These people simply start at such a high level of knowledge that others don’t notice a slight slip. This isn’t, of course, always true. Many who have not had higher education are very clever and can cover up memory slips with ease. No two people are the same, so adult children should be on the lookout for signs of deterioration in their parents.

5. Having anosognosia.

More than denial, anosognosia is a lack of awareness of impairment — most people do not even know that they are ill — and it affects up to 81% of those with Alzheimer’s. Anosognosia is still difficult to define, but researchers know it results from anatomical changes or damage to the part of the brain that affects perception of one’s own illness.

How Does Your Elderly Parent Function?

What matters is how your aging parent functions. If they are having trouble with everyday living and responsibilities, you need to address the problems you’re noticing.

Visiting a neurologist can help sort out the behavior that is not what the family is used to seeing and rule out various causes. Dehydration, infection, medication and stroke can all cause changes in brain function and behavior. It’s good to find out the reasons for the memory problems and learn whether they can be treated.

If there is no official diagnosis other than “early dementia” or ” mild cognitive impairment,” it’s not a signal to the family that everything is okay and no one needs to plan ahead. Rather, it’s time to take a look at Mom or Dad’s future.

Get prepared today, rather than wait for a crisis. Starting a tough conversation is easier than you think.

Moving into the New Year Without a Loved One

As we move into the new year, we always think about resolutions that we promise to accomplish. However, many people forget their resolutions after January. Resolutions, as they say, are "a dime a dozen," but when we look back over the past year, we recognize that people are not.

After losing someone, we reminisce and long for their presence, knowing that they will forever remain in our hearts, but not with us physically. It causes us to face the reality that they are forever gone and our lives are forever changed.

Thus, to be able to move forward with perseverance and hope, we must take time for remembrance. Look back over the pictures. Recall the good and bad memories that you experienced together. Weave those fond memories of your loved one into the fabric of your own life. Retell the stories so that future generations will know the characteristics of your loved one and the depth of the legacy that they left behind them.

Allow the loss that you experienced this year to cause you to love deeper and treasure other relationships that mean so much to you in your life. Don't allow their death to become a sea of constant regret, but allow it to spur you on to a greater depth of caring and compassion for your loved ones and others around you on a daily basis. Resolve this year to love deeper and to say those things that need to be said with a greater frequency—things like, "I love you," "I care," and "I'm sorry." Allow their memory to not only lead you to a greater depth of love, but also to encourage you in the coming year. Let it inspire you to keep putting one foot in front of the other, knowing that is exactly what your loved one would have wanted you to do.

It has been said that the past is gone and the present is indeed a present. It is a present that each of us is given with each new day. The new year is a present to remind us of our love for that special person and to remind us that life truly does go on and that we can choose how we live each day. In the words of that classic Scottish work from the 1700s: Should auld (old) acquaintance be forgot / And never brought to mind? / Should auld (old) acquaintance be forgot / And auld lang syne (long ago)?

Absolutely not! We must allow those memories to become a path steeped in love and grace, leading us to a life full of expectation, resolve and determination to live more fully each day.

—Saundra Yates, Bereavement Coordinator/Chaplain

Mountain Valley Hospice & Palliative Care offers free grief support to the community at large. For more information, contact us today toll-free at 1-888-789-2922.

Twas the Night Before Christmas

By Clement Clarke Moore

 

Twas the night before Christmas, when all through the house
Not a creature was stirring, not even a mouse.
The stockings were hung by the chimney with care,
In hopes that St Nicholas soon would be there.

The children were nestled all snug in their beds,
While visions of sugar-plums danced in their heads.
And mamma in her ‘kerchief, and I in my cap,
Had just settled our brains for a long winter’s nap.

When out on the lawn there arose such a clatter,
I sprang from the bed to see what was the matter.
Away to the window I flew like a flash,
Tore open the shutters and threw up the sash.

The moon on the breast of the new-fallen snow
Gave the lustre of mid-day to objects below.
When, what to my wondering eyes should appear,
But a miniature sleigh, and eight tinny reindeer.

With a little old driver, so lively and quick,
I knew in a moment it must be St Nick.
More rapid than eagles his coursers they came,
And he whistled, and shouted, and called them by name!

"Now Dasher! now, Dancer! now, Prancer and Vixen!
On, Comet! On, Cupid! on, on Donner and Blitzen!
To the top of the porch! to the top of the wall!
Now dash away! Dash away! Dash away all!"

As dry leaves that before the wild hurricane fly,
When they meet with an obstacle, mount to the sky.
So up to the house-top the coursers they flew,
With the sleigh full of Toys, and St Nicholas too.

And then, in a twinkling, I heard on the roof
The prancing and pawing of each little hoof.
As I drew in my head, and was turning around,
Down the chimney St Nicholas came with a bound.

He was dressed all in fur, from his head to his foot,
And his clothes were all tarnished with ashes and soot.
A bundle of Toys he had flung on his back,
And he looked like a peddler, just opening his pack.

His eyes-how they twinkled! his dimples how merry!
His cheeks were like roses, his nose like a cherry!
His droll little mouth was drawn up like a bow,
And the beard of his chin was as white as the snow.

The stump of a pipe he held tight in his teeth,
And the smoke it encircled his head like a wreath.
He had a broad face and a little round belly,
That shook when he laughed, like a bowlful of jelly!

He was chubby and plump, a right jolly old elf,
And I laughed when I saw him, in spite of myself!
A wink of his eye and a twist of his head,
Soon gave me to know I had nothing to dread.

He spoke not a word, but went straight to his work,
And filled all the stockings, then turned with a jerk.
And laying his finger aside of his nose,
And giving a nod, up the chimney he rose!

He sprang to his sleigh, to his team gave a whistle,
And away they all flew like the down of a thistle.
But I heard him exclaim, ‘ere he drove out of sight,
"Happy Christmas to all, and to all a good-night!"

 

Celebrating the Holidays with a Loved One with Alzheimer's

Holidays are typically a festive time of the year with family and close friends.

Now, factor in being a caregiver to a family member with Alzheimer’s disease. Can you celebrate in the same way?  As a caregiver to my mother with Alzheimer’s, I can tell you that it’s possible. However, there are some things to consider when entertaining family and friends and adding a loved one with Alzheimer’s into the mix.

Caregiving is a stressful role in and of itself; throwing in entertaining friends and family during the holidays can become more stressful causing the caregiver to have less patience.

How does someone in a caregiving role pull off a celebration that includes guests, the Alzheimer’s patient and make it personally enjoyable?

  • Start early by enlisting help from local family members. They can help with meal preparations.

  • Ask some of your closest friends to run errands for you. More than likely they have errands to run too, so helping you out won’t be an inconvenience.

  • Ask your children to help with household chores, taking care of pets and anything else you need to have done around the house.

When you ask for help it doesn’t mean you’re weak and can’t handle hosting celebrations. By enlisting help wherever you can it actually demonstrates how organized you are about getting things done in an efficient way.

Keep Things Intimate

If the person with Alzheimer’s lives with you, or will be visiting for a short time, make sure to keep the amount of people invited to a small group. A more intimate party allows the person with Alzheimer’s to remain calm since loud voices, chaos and people talking over one another can create anxiety for a person with dementia.

All Is Calm—Including Your Noise Level

Holiday music is a favorite of most everyone; however, loud noises can be upsetting to your loved one. Try a selection of more classic soft carols playing in the background.

These kinds of visits are much more special than trying to figure out what kind of gift you want to give them; being with them is the ultimate gift.

Be considerate of your loved one with Alzheimer’s by paying close attention if they are getting tired and need to lie down. In my experience, they won’t tell you they are getting tired, but anyone with dementia or Alzheimer’s tires easily and can become agitated if they start feeling this way.

Prepare Family Members

You might notice how family and friends are doing their best to interact with your loved one so they don’t feel left out. If they haven’t been around this person in a long time remind them to speak slowly and in a calm voice, that way your loved one will be able to understand them and try to process what is being said. Have a conversation with other family members before the celebration. Whatever you do, don’t discuss the Alzheimer’s patient’s situation in front of them to other people. Even though you might think they don’t understand what’s being said, they know you’re talking about them.

Have Your Own Celebration

If your loved one lives in a nursing home or assisted living and isn’t able to go to your house, set aside a specific time to be with them. My mom had a sitter who decorated her room and we had our own little celebration with a few items I knew she needed. Afterwards, we joined a small group for refreshments and some Christmas carols. The time I spent with her didn’t tire her out and she seemed content.

I didn’t have family nearby, but if you do, take the children or grandchildren along. You can even take the family pet. These kinds of visits are much more special than trying to figure out what kind of gift you want to give them; being with them is the ultimate gift. This is also a great photo opportunity to get all the family together and make a special memory of this particular holiday.

Having a family member with dementia or Alzheimer’s doesn’t have to make the holidays stressful. Spending the holidays with that family member provides an opportunity for other family members to show how much they still love and care about them. This time together creates a new and different kind of bond with the person who has Alzheimer’s. These are keepsake memories.

Reprinted - Linda Jenkins writes about her experience with Alzheimer’s on her blog. 

Should You Tell a Person with Alzheimer's...that a loved one has passed?

On the Alzheimer List (from Washington University ADRC) we have dealt with this many times and for people in many stages of the disease. Bottom line...there are a few rules:

  • We feel the patient always has the right to know

  • The patient may cry, grieve, or respond negatively...but it is their honest and desirable response to a significant loss.

  • If they ask for details, tell them; if they seem to forget, let it go. * Even is the final stages of AD patients are capable of comprehending at some level -- they tell us this during lucid moments.

  • Always treat the patient with simplicity, compassion, and honesty.

  • Tell the patient at their best time of day in a quiet place that is free of distractions, tv, and other people -- You would be amazed at the number of people who do this in a crowded room or with the tv on. Take the person's hand and don't be afraid to let them see you cry. The non-verbal expression of tears is a powerful communicator.

  • If the person is capable of moving, you may want to take them to the funeral depending on behavior and cultural preferences.

  • Reminisce with the patient about the person who has passed in order to establish the link..yet avoid saying, "You remember Mary, right?"

  • And finally, remember that telling the patient is something you need for YOU. The patient is a member of the family who you need for moral support. You would be amazed at how often even nonverbal patients will stroke your hand or murmur words of comfort so you can grieve. It is a pretty amazing phenomenon. When my husband's uncle died, his wife was living in a nursing home for several years following a brain tumor. My husband didn't want to tell his wife but I insisted. We went to her after her nap and both took her hand. She turned and faced me -- which she had not done in quite a while. I quietly told her that her beloved husband had died and that the funeral had been lovely and well attended. She took my hand and turned away. A week later she peacefully died. I think she knew and was waiting.

Think about it. If it was you who had dementia, wouldn't you want to know if your loved one had passed?

** Reprinted
Geri R. Hall
 is an advanced practice nurse who works in the department of neurology at the University of Iowa College of Medicine and at the Banner Alzheimer Institute in Phoenix, Arizona. She's also a speaker and author who since 1996 has facilitated the online support group for the Washington University, St. Louis, Alzheimer's Disease Research Center's Alzheimer List.

Anxiety and Agitation in Alzheimer's Patients

A person with Alzheimer's may feel anxious or agitated. He or she may become restless, causing a need to move around or pace, or become upset in certain places or when focused on specific details.

Possible causes of agitation

  • Anxiety and agitation may be caused by a number of different medical conditions, medication interactions or by any circumstances that worsen the person's ability to think. Ultimately, the person with dementia is biologically experiencing a profound loss of their ability to negotiate new information and stimulus. It is a direct result of the disease.
     

Situations that may lead to agitation include:

  • Moving to a new residence or nursing home

  • Changes in environment, such as travel, hospitalization or the presence of house guests

  • Changes in caregiver arrangements

  • Misperceived threats

  • Fear and fatigue resulting from trying to make sense out of a confusing world

Treating Behavioral Symptoms

Anyone experiencing behavioral symptoms should receive a thorough medical checkup, especially when symptoms appear suddenly. Treatment depends on a careful diagnosis, determining possible causes and the types of behavior the person is experiencing. With proper treatment and intervention, symptoms of agitation can be reduced.
 

Tips to help prevent agitation

To prevent or reduce agitation:
 

  • Create a calm environment. Remove stressors. This may involve moving the person to a safer or quieter place, or offering a security object, rest or privacy. Try soothing rituals and limiting caffeine use.

  • Avoid environmental triggers. Noise, glare and background distraction (such as having the television on) can act as triggers.

  • Monitor personal comfort. Check for pain, hunger, thirst, constipation, full bladder, fatigue, infections and skin irritation. Make sure the room is at a comfortable temperature. Be sensitive to fears, misperceived threats and frustration with expressing what is wanted.

  • Simplify tasks and routines.

  • Provide an opportunity for exercise. Go for a walk. Garden together. Put on music and dance.

How to respond

Do: Back off and ask permission; use calm, positive statements; reassure; slow down; add light; offer guided choices between two options; focus on pleasant events; offer simple exercise options, try to limit stimulation.

Say: May I help you? Do you have time to help me? You're safe here. Everything is under control. I apologize. I'm sorry that you are upset. I know it's hard. I will stay with you until you feel better.
 

  • Listen to the frustration. Find out what may be causing the agitation, and try to understand.

  • Provide reassurance. Use calming phrases such as: "You're safe here;" "I'm sorry that you are upset;" and "I will stay until you feel better." Let the person know you are there.

  • Involve the person in activities. Try using art, music or other activities to help engage the person and divert attention away from the anxiety.

  • Modify the environment. Decrease noise and distractions, or relocate.

  • Find outlets for the person's energy. The person may be looking for something to do. Take a walk or go for a car ride.

  • Check yourself. Do not raise your voice, show alarm or offense, or corner, crowd, restrain, criticize, ignore or argue with the person. Take care not to make sudden movements out of the person's view.

  • See the doctor. See the person with dementia's primary care physician to rule out any physical causes or medication-related side effects.

    ** Reprint -Alzheimer’s Association

Tips on Caring for a Person with Alzheimer's or Dementia

Dressing is difficult for most dementia patients. Choose loose-fitting, comfortable clothes with easy zippers or snaps and minimal buttons. Reduce the person’s choices by removing seldom-worn clothes from the closet. It's common for people with dementia to continue layering on clothes even though they are fully dressed. To facilitate dressing and support independence, lay out one article of clothing at a time, in the order it is to be worn. Remove soiled clothes from the room. Don’t argue if the person insists on wearing the same thing again.

  • Hallucinations (seeing or hearing things that others don’t) and delusions (false beliefs, such as someone is trying to hurt or kill another) may occur as the dementia progresses. State simply and calmly your perception of the situation, but avoid arguing or trying to convince the person that their perceptions are wrong. Keep rooms well-lit to decrease shadows, and offer reassurance and a simple explanation if the curtains move from circulating air, or if a loud noise such as a plane or siren is heard. Distractions may help. Depending on the severity of symptoms, you might consider medication.

  • Sexually inappropriate behavior, such as masturbating or undressing in public, lewd remarks, unreasonable sexual demands, even sexually aggressive behavior, may occur during the course of the illness. Remember, this behavior is caused by the disease. Develop an action plan to follow before the behavior occurs, i.e., what you will say and do if the behavior happens at home, around other relatives, friends, or paid caregivers. If you can, identify what triggers the behavior.

  • Verbal outbursts such as cursing, arguing, and threatening often are expressions of anger or stress. React by staying calm and reassuring. Validate your loved one’s feelings and then try to distract or redirect his attention to something else.

  • “Shadowing” is when a person with dementia imitates and follows the caregiver, or constantly talks, asks questions, and interrupts. Like sundowning, this behavior often occurs late in the day and can be irritating for caregivers. Comfort the person with verbal and physical reassurance. Distraction or redirection might also help. Giving your loved one a job such as folding laundry might help to make her feel needed and useful.

  • People with dementia may become uncooperative and resistant to daily activities such as bathing, dressing, and eating. Often this is a response to feeling out of control, rushed, afraid, or confused by what you are asking of them. Break each task into steps and, in a reassuring voice, explain each step before you do it. Allow plenty of time. Find ways to have them assist to their ability in the process, or follow with an activity that they can perform.

  • Even with these many potential challenges, it’s important to remember that these behaviors are often coping tactics for a person with deteriorating brain function. There’s no question that dealing with these behaviors can make caregiving especially challenging.

Resources

Family Caregiver Alliance
National Center on Caregiving
(415) 434-3388 | (800) 445-8106
Website: www.caregiver.org
Email: info@caregiver.org
FCA CareJourney: www.caregiver.org/carejourney
Family Care Navigator: www.caregiver.org/family-care-navigator

Family Caregiver Alliance (FCA) seeks to improve the quality of life for caregivers through education, services, research, and advocacy. Through its National Center on Caregiving, FCA offers information on current social, public policy, and caregiving issues and provides assistance in the development of public and private programs for caregivers. For residents of the greater San Francisco Bay Area, FCA provides direct support services for caregivers of those with Alzheimer’s disease, stroke, traumatic brain injury, Parkinson’s, and other debilitating health conditions that strike adults.

 

FCA Fact Sheets

A listing of all facts and tips is available online at www.caregiver.org/fact-sheets.

Dementia, Caregiving and Controlling Frustration
Taking Care of YOU: Self-Care for Family Caregivers
Hiring In-Home Help
Community Care Options

 

Other Organizations and Links

Alzheimer's Disease Education and Referral (ADEAR) Center
www.nia.nih.gov/alzheimers
A service of the National Institute on Aging that offers information and publications on diagnosis, treatment, patient care, caregiver needs, long-term care, education, and research related to Alzheimer’s disease.

Eldercare Locator
eldercare.acl.gov
A service of the federal Administration on Aging that offers information about and referrals to respite care, as well as other home and community services available through state and Area Agencies on Aging.

Alzheimer’s Association Safe Return Program
www.alz.org/care/dementia-medic-alert-safe-return.asp
A nationwide program that identifies people with dementia who wander away and returns them to their homes. For a fee, families can register their loved one in a national confidential computer database. Participants receive an identification bracelet or necklace and other identification and educational materials.

 

This fact sheet was prepared by Family Caregiver Alliance and was reviewed by Beth Logan, M.S.W, education and training consultant and specialist in dementia care. © 2004, 2008, 2016 Family Caregiver Alliance. All rights reserved.