What Do I Need to Know as a Caregiver for the Elderly?

Not everyone is cut out for assisting older people because the job requires a unique skillset and, more importantly, empathy.

Big Easy’s recent article entitled “6 Things to Consider as a Caregiver for the Elderly” says it can be hard to understand that a senior has become dependent on others, and being assisted in everyday tasks may even lead to compromises in their privacy. This can put a senior in stressful conditions that lead to anxiety. In that case, hiring a professional caregiver for the elderly may be the best option.

However, no matter your training, caring for an older person can still be challenging. Consider these six things to develop the best possible relationship with the elderly and to provide the best care.

Compassion. Being compassionate helps develop a better connection to the elderly person. This can frequently solve many behavioral problems and can make for a pleasant caregiving environment. Most older people have some physical or mental disability that keeps them from being independent. In some situations, being abandoned by their loved ones creates even more emotional damage. To help, be empathetic and kind to them in these difficult times. This can significantly help to decrease the emotional pain that accompanies old age and illness. Being compassionate is one of the most effective ways of delivering the best care possible in these situations.

Communication. If you have the ability to have natural and comfortable conversations with elderly patients, you can develop a tighter emotional bond with them. Healthy communication and conversations also can distract a senior from things that may be troubling them, which will not only benefit the patient but will also help you carry out your tasks more easily. You may also be called upon to interact with other family members or doctors, so good communication skills are required.

Safety. Safety is vital for the elderly, and the slightest negligence can become a matter of life and death for them. The most common types of injuries for older people are attributed to falls. It is also even more dangerous because their bones are weak and don’t heal quickly. Use extreme care when assisting seniors in slippery areas, like the bathroom. Take precautions, such as de-cluttering the house and eliminating tripping hazards. Most importantly, keep them under constant observation, especially those with mental illnesses.

Hygiene. Maintaining quality hygiene can be a challenge, especially if people are shy or want their privacy. Take bathing as an example: it’s not surprising that the elderly are embarrassed, when caregivers have to bathe them. Even so, you are tasked with maintaining their hygiene. If you don’t, it can lead to more health-related issues.

Medications. Most seniors take medication, some of which produce side effects, such as nausea or dizziness. As a caregiver, you should make certain that they are taking their medicines on time and watch for side-effects in the case of an emergency. Review their medications and administer the prescribed dosage at the right times yourself. This will also help those who forget to take their medicines without prompting.

You may have several challenging times throughout your career as a caregiver for the elderly, but empathy and compassion will help you considerably. You will create a better job experience and help the elderly with a very difficult phase of their life.

Reference: Big Easy (Dec. 10, 2020) “6 Things to Consider as a Caregiver for the Elderly”

Is there a Blood Test for Alzheimer’s?

Independent experts are cautious of a new first blood test to help diagnose Alzheimer’s disease due to the fact that key test results haven’t been published, and the test has not been approved by the FDA. While it’s being sold under more general rules for commercial labs, they agree that a simple test that can be performed in a doctor’s office is long overdue.

NBC News’s recent article entitled “First blood test to help diagnose Alzheimer’s goes on sale” notes that more than five million people in the U.S. and millions more around the world have Alzheimer’s, the most common form of dementia. To be diagnosed with it, people will experience symptoms, such as memory loss plus evidence of a buildup of a protein in the brain called beta-amyloid.

Currently, the best way to measure beta-amyloid is a costly PET brain scan that usually is not covered by insurance. As a result, most people won’t get one and are left wondering if their problems are due to normal aging, Alzheimer’s, or another cause. However, this new blood test from C2N Diagnostics in St. Louis will try to fill that gap. The test isn’t designed for general screening or for people without symptoms. It is intended for those 60 and older, who are having thinking problems and are being evaluated for Alzheimer’s.

The test isn’t covered by insurance or Medicare, and C2N Diagnostics charges $1,250. However, it offers discounts based on income. Only a physician can order the test, and results come within 10 days. It’s sold in all but a handful of states in the U.S. and was just approved for sale in Europe.

The blood test measures two types of amyloid particles plus various forms of a protein that show if a person has a gene that increases risk for the disease. These factors are combined in a formula that includes age, and patients are given a score suggesting low, medium or high likelihood of having amyloid buildup in the brain. If the test scores the patient in the low category, it’s a good reason to look for other things besides Alzheimer’s. There are a number of things that can cause a person to be cognitively impaired, from vitamin deficiencies to medications.

The company has not published any data on the test’s accuracy, but the doctors have published on the amyloid research leading to the test. Company materials cite results comparing the test to PET brain scans, which is the current gold standard, in 686 people, ages 60-91, with cognitive impairment or dementia. If a PET scan showed amyloid buildup, the blood test also gave a high probability of that in 92% of cases and missed 8% of them, said the company’s CEO, Dr. Joel Braunstein. If the PET scan was negative, the blood test ruled out amyloid buildup 77% of the time. The other 23% got a positive result, but that doesn’t necessarily mean the blood test was wrong. The published research suggests it may see amyloid buildup before it’s noticeable on scans.

Braunstein said the company will seek FDA approval, and the agency has designated it for a faster review.

Reference: NBC News (Nov. 30, 2020) “First blood test to help diagnose Alzheimer’s goes on sale”

Could a Polar Bear Plunge Help with Dementia?

A “cold-shock” protein has been discovered in the blood of regular winter swimmers at London’s Parliament Hill Lido. The protein has been shown to retard the onset of dementia and even repair some of the damage it causes in mice, according to a report in the BBC’s recent article entitled “Could cold water hold a clue to a dementia cure?”

Professor Giovanna Mallucci, who runs the United Kingdom Dementia Research Institute’s Centre at the University of Cambridge, says the discovery could help scientists with new drug treatments that may help hold dementia at bay. The research, while encouraging, is at an early stage and focuses on the hibernation ability that all mammals retain, which is prompted by exposure to cold.

The link with dementia lies in the destruction and creation of synapses, which are the connections between cells in the brain. In the early stages of Alzheimer’s and other neuro-degenerative diseases, these brain connections are lost. Mallucci saw that brain connections are lost when hibernating animals, like bears, bed down for their winter sleep, but that roughly 20-30% of their synapses are culled as their bodies preserve precious resources for winter. When they awake in the spring, those connections are reformed.

The shock of entering cold water results in a significant increase in heart rate and blood pressure, which can cause heart attacks and strokes in those with underlying illnesses. This also creates a gasp reflex and rapid breathing, which can lead to drowning, if water is inhaled.

Don’t try a plunge without consulting a doctor.

When researching this treatment in mice, scientists found that levels of a “cold-shock” protein called RBM3 soared in the ordinary mice, but not in the others. This suggested RBM3 could be the key to the formation of new connections. Mallucci proved the link in a separate experiment which showed brain cell deaths in Alzheimer’s and prion disease could be prevented by artificially boosting RBM3 levels in mice. This was a major breakthrough in dementia research, and their findings were published in the scientific journal Nature.

Professor Mallucci contends that a drug which prompted the production of RBM3 might help slow—and possibly even partially reverse—the progress of some neuro-degenerative diseases in people. RBM3 hadn’t been seen in human blood, so the obvious next step was to find out whether the protein is present in humans.

It’s hard to get people to become hypothermic by choice, but Martin Pate and his group of Londoners who swim throughout the winter at the unheated open-air London Parliament Hill Lido pool voluntarily made themselves hypothermic on a regular basis, so he thought they’d be ideal subjects of a study.

The tests showed that a significant number of the swimmers had markedly elevated levels of RBM3. All of them become hypothermic, with core temperatures as low as 93.2^⸰F. A control group of Tai Chi participants who practice beside the pool but never actually swim, showed no increase in RBM3 levels nor had they experienced very low body temperatures.

The risks associated with getting cold outweigh any potential benefits, so cold water immersion isn’t a potential dementia treatment. The key is to find a drug that stimulates the production of the protein in humans and to show that it really does help delay dementia.

Reference: BBC (Oct. 19, 2020) “Could cold water hold a clue to a dementia cure?”

Can Bad Thoughts Bring on Dementia?

There is recent research that has shown a link between repeated patterns of repetitive negative thinking (RNT) and signs of dementia. This study suggests a link between the key signs of dementia, the buildup of proteins in the brain and cognitive decline, and RNT.

Medical News Today reported in its recent article entitled “Link between dementia and repetitive negative thinking identified” that this study was published in the journal Alzheimer’s & Dementia. The study set forth the foundation for future research to consider how the link may function, and if psychological therapies that treat RNT can inhibit Alzheimer’s and other dementias.

The CDC explains that dementia is a term that represents a variety of diseases characterized by cognitive decline, which includes trouble remembering, thinking or making decisions that adversely affect a person’s everyday life.

The most common type of dementia is Alzheimer’s disease. This is a degenerative disease, which means it worsens over time. It’s not yet known exactly what causes Alzheimer’s disease. The CDC says that there are likely several factors involved. There is currently no cure for Alzheimer’s.

Prior research has suggested that psychological factors, like depression and anxiety, may also have a connection to Alzheimer’s. This has led researchers to develop the concept of cognitive debt as a risk factor for Alzheimer’s disease, which they believe is acquired by RNT. A large part of RNT are processes of rumination — repeatedly thinking about the past — and worry, being concerned about the future.

The research examined the participants’ RNT, depression, anxiety and cognitive decline levels for up to four years. They also measured the levels of tau and amyloid proteins in the brains of 113 of the participants. Scientists think that the buildup of these structures is key to the development of Alzheimer’s.

The authors of the new research discovered that the higher a person’s RNT, the faster their cognitive decline. They also found these people were more likely to have significant deposits of tau and amyloid proteins. However, although the research found a link between depression and anxiety and cognitive decline, they did not find a connection between depression and anxiety and the buildup of tau and amyloid proteins.

According to the lead author of the study Dr. Natalie Marchant of University College, London, United Kingdom, “[d]epression and anxiety in mid-life and old age are already known to be risk factors for dementia. Here, we found that certain thinking patterns implicated in depression and anxiety could be an underlying reason why people with those disorders are more likely to develop dementia.

“Taken alongside other studies that link depression and anxiety with dementia risk, we expect that chronic negative thinking patterns over a long period of time could increase the risk of dementia. We do not think the evidence suggests that short-term setbacks would increase one’s risk of dementia.

“We hope that our findings could be used to develop strategies to lower people’s risk of dementia, by helping them to reduce their negative thinking patterns.”

The study’s authors say that it’s probable that RNT contributes to Alzheimer’s in some way, possibly elevating an individual’s stress levels. However, they couldn’t discount the possibility that early signs of Alzheimer’s could lead to RNT.

Reference: Medical News Today (June 11, 2020) “Link between dementia and repetitive negative thinking identified”

Can Exercise Help with Dementia?

A new study shows that even when your memory starts to fade, you can still do something about it by adding aerobic exercise to your lifestyle, reports News Atlas’ recent article entitled “Aerobic exercise shown to improve memory in those at risk of dementia.”

The study concentrated on the long-term changes to cerebral blood flow that comes from aerobic exercise in patients already presenting with age-related mild cognitive impairment. Thirty subjects with an average age of 66 who did not regularly exercise but had signs of memory impairment were divided into two groups.

One group was asked to do several aerobic exercise sessions each week for 12 months, and the other group performed stretch and balance sessions aimed at strengthening their upper and lower body while keeping heart rates low. MRI scans calculated cerebral blood flow in all participants at the beginning and end of the year-long study.

After a year, the aerobic exercise group showed increased cerebral blood flow to the anterior cingulate cortex and adjacent prefrontal cortex, relative to the stretching group. Memory tests conducted at the start and end of the study also showed a 47% improvement in the aerobic group, while the stretching group had only minimal improvements. The study suggests a direct correlation between improvement on the memory test scores and increases in cerebral blood flow to these key areas of the brain.

While the number of people studied was small, the results are consistent with a large volume of prior research affirming the value of exercise in maintaining cognitive abilities in older age. Aerobic exercise appears to confer the greatest cognitive protections, especially in those most at risk of Alzheimer’s disease.

The researchers note that the group of patients that were recruited in the study all reported little to no regular exercise prior to the trial. The novelty of this particular trial is that it offers signs that aerobic exercise can confer cognitive benefits, even when started at an advanced age, after memory decline has already started, and those cognitive benefits may be mediated specifically by improved blood flow to specific regions of the brain.

The study was published in The Journal of Alzheimer’s Disease.

Reference: News Atlas (May 24, 2020) “Aerobic exercise shown to improve memory in those at risk of dementia”

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