Cultivate Your Creativity Now to Cope with Stress Later

Pamela Atwood, MA, CDP, CLL, Director of Dementia Care Service, Hebrew HealthCare

An article in the January 11 Hartford Courant inspired this blog post. “Can the Arts Heal” by Fredrick Kunkle of the Washington Post reviews research on arts and wellness. There are many challenges: poorly designed studies without controls, sample sizes too small to prove relevance, and limited funding for something that is not quantifiable. Regardless, there’s a strong body of research that the arts help people cope. What’s missing is the big question – will the arts help YOU cope when YOU need it? The answer may be “no,” unless you cultivate creativity now.

Chances are good that YOU will end up with some sort of disability in late-life. We’re good at keeping people alive longer, but they live with chronic conditions such as severe arthritis limiting mobility, impaired vision from glaucoma or macular degeneration, Alzheimer’s disease or other cognitive impairments, diabetes, or movement disorders such as Parkinson’s or MS. The key to SUCCESSFUL AGING is adaptation. The arts help you adapt and maintain a quality life.

As I look at my friends and those younger than me (I’m a Gen-Xer, kid of the 80s), I see more reliance on little boxes of technology. The technology might be helpful as we age, but let’s face it: aging services are often the LAST to get new technology. The arts are timeless and readily available. Music, dance/movement, art, cinema/drama, poetry require little outlay of cash. But if we don’t cultivate our ability to use the arts to help us NOW, then it will just be “an activity” later in life.

Here’s what I mean. The article had a picture of a gentleman with paranoid schizophrenia who paints murals. The ability to paint reduces his need for medication – maybe eliminates it. He said, “The paintbrush and the art give me an outlook and a feeling of serenity and peace, love and joy. The paintbrush is the treatment for all else that has failed.” But if he didn’t LOVE painting, it would just be busy-work and he would still need lots of medications to treat his symptoms.

I once saw a resident who looked bored, and I asked her if she wanted to draw (I’d seen her drawing in the past). Her response was “Drawing is what they have us do when they don’t know what to do with us.” Ouch. I don’t think that was true, but at the very least, that was HER perception (and perception is reality, especially to those with dementia).

So what will YOUR future look like? Will you see the arts as “just an activity” in your boredom-filled days, something offered between the primary activities of meals and personal care? Or will you look forward to free time, trying to figure out if you have enough time to finish crocheting the afghan for the new grandbaby, or eagerly waiting for the paint to dry on your ceramics, or allowing the songs you sing to bring memories of what you can no longer see? CULTIVATE YOUR LOVE OF THE ARTS and it could free you from the confines of your age-related conditions. Make time for them every day now, and they will help you cope with the changes of aging. Adaptation is the key to successful aging, and the arts will help you adapt and live a life worth living. If you don’t know where to start, begin by reading our other blog articles on Zen Tangles, Timeslips creative writing, Poetry and Life Enrichment. Also, check out for more information on the arts and creativity throughout life.

Zentangles For Wellness

Zen is a Buddhist-based philosophy of meditation and intuition. Commonly, it is thought of as profound state of calm and enlightenment. By definition, it is a noun. In recent popular culture, it has been used as an adjective to describe an enlightened or peaceful quality.

Zentangle is a structured form of doodles. They are based in intuition and, when practiced, create a meditative state. “Zentangles” is a registered trademark and certified instructors (CZT) are in several communities. For disclosure, I am not a CZT. I am self taught with several different books available on the subject.

Although there is structure, there is no right or wrong way to do Zentangles. This fact makes it a natural failure-free activity to do with persons with dementia.zentangle heart

Creativity has many positive benefits. Research (including Ebersole & Hess, 1998) done over the past several decades has verified that creative expression helps:

  • Create balance and order
  • Give a sense of control over the external world
  • Make something positive out of a loss, bad experience or depression
  • Maintain your sense of integrity
  • Help resolve conflicts
  • Make thought and feeling clear
  • A greater sense of well-being and personal growth
  • Improve relationships

The design above was posted by

Request your free copy of “A Guide to ZenTangles for Dementia Care” today at


Words, Image and Ideas: Pathways through Dementia

Pamela Atwood, MA, CDP, DCCP, CLL, Director of Dementia Care, Hebrew Health Care

CAN PEOPLE WITH ADVANCED DEMENTIA READ? Ask clients about their previous interests and older adults answer “Well, I used to like to read.” Has this favorite hobby been lost along with their memory of what they had for breakfast? Hebrew Health Care loves evidence-based practical activities for people with dementia and their families – we HAD to share this resource with you, so we’ve invited Susan Ostrowski to guest-author an article for you. Email us your feedback at

Memory-challenged adults may not speak well or comprehend language easily; maybe they can’t manage their hygiene independently. It is easy to assume that their ability to read has atrophied as well.

If we put a large print single word in front of a memory-challenged adult, and she can see it, there’s an excellent chance that she can read it, i.e., sound out the word and comprehend it. If we put a phrase or a sentence or even a small paragraph, printed in big, black letters, on a bright white piece of paper – would she read it? Most likely, yes.

For most memory-challenged adults with functional vision and functional language, reading is an intact, preserved skill. Then why are conventional newspapers, magazines and books so difficult for adults with dementia to process?

The answer lies in the format of typical published reading material.

Typical published material consists of condensed small print, low visual contrast and extraneous visual stimuli. These are major impediments to reading for seniors with dementia. However, if we present written language with large, bold font on white paper with wide margins and extra space between the sentences, they can usually read it.

To increase the readability of a text for this group of seniors, the following elements must be present:
-minimal visual distractions (which compensates for attention deficits),
-sharp visual contrast (decreases eye strain),
-spacious lines of print (compensates for visual tracking difficulties),
-short, direct syntax (lessens the burden on working memory),
-contextual photographs (prompts and maintains interest).

And here’s the exciting part: these lifelong readers generally do not require diluted vocabulary or juvenile subject matter. When presented with child-like material, they show little motivation to read. They can process sophisticated words and subject matter that are reflective of their spoken language. Generally it is only the presentation of the reading material that has to be modified.

Caregiver Corner: Surviving the Holidays

Originally posted on Geriatrics: Our Mission Is Our Passion:

Pamela Atwood, MA, CDP, Director of Dementia Care Services

Holidays represent opportunities for togetherness, love, laughter and sharing with family and friends. In reality, they can be stressful times for everyone. They can be completely overwhelming to caregivers, and often represent loss, sadness and disappointment. Keeping these survival tips in mind will help caregivers make the most of this holiday season.

Be realistic
Know your limits, and the limits of your loved one. Adjusting expectations will help caregivers, family and friends. Activities often need to be simplified and minimized to reduce stress levels. If you usually serve 20 people, serve only 5 this year. Or instead of making all the food, have guests bring the holiday dishes that mean the most to them. Caregivers can expect the normal tensions of the season, plus the stress of caregiving responsibilities. Let others know what they can do for you – and then…

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Cyber Monday Gift Ideas for Seniors

by Pamela Atwood, MA, CDP, CLL

Happy Thanksgiving. In case you haven’t noticed ~ the holidays have started. Negative political ads have been replaced by holiday “needs” in a nearly-constant bombardment of commercials, while Facebook-ers debated whether or not to shop on Thanksgiving. I think shopping for me would be much more pleasurable if I had a good sense of what each person on my list really wanted. As I was thinking last Friday of the “deals” I was surely missing as work trumped Black Friday, it struck me that you might like a list of ideas for those on your list who are elderly or living in Assisted Living or Nursing Homes. For a complete list of ideas and resources, visit and scroll down to “Your Personal Consultant.”

Hobby & Leisure – there are great resources available for everything from adapted puzzles to games and reading. The puzzles should always be age-appropriate (not childlike), and suitable for the current ability – from 4 or 6 pieces to 50 pieces. Magnetic puzzles with stands are great for those with neck problems. For reading, my newest resource is based in solid research from a physician and speech/language pathologist: This product has adapted graphics and photos, plus reading content tailored to various abilities — people with advanced dementia may still be able to read! Games which spark memories, use contrast and easy to manipulate materials are available at, and

Cognitive Fitness – books, activity cards, games and software are available in all shapes and sizes. offers the Whole Brain Workout series. Resources throughout the web offer products such as “Connect: Memory Enhancing Game” which can be used in a number of ways to improve neuronal flexibility for all abilities.

Physical Fitness – being confined to a wheel chair does not mean you should quit being active. Some of the best exercise videos are now available at very little cost. Enjoying yoga, aerobics and stretching and strengthening is now possible in your own living room or day room. Check out, and the award winning PBS special

Quality of Life – No one should have to watch garbage television, wonder where the family is or be isolated because of changes in communication. A communication book, talking photo album or alternative TV program would improve quality of life for all., and can provide ideas for any gift giving budget.

If you order through Amazon, sign up for AmazonSmile and add Hebrew Health Care as your charity: a % of your total will be donated so your gift is twice as nice.  Thank you, and Happy Holidays!


Waiting in the Green Room

Pamela Atwood, MA, CDP, DCCP, CLL, Director of Dementia Care, Hebrew Health Care

As I sit here in the Green Room at Fox Channel 61, I am aware of how little we think about brain health. People take it for granted.

Sitting across from me is a young man dressed in his AAA shirt. He watches the news on the TV. Maybe he is trying to remember the answers to his pre-created questions. Or maybe this is old hat to him; he is recalling his experience during Hurricane Irene, which the newscasters remind us was 3 years ago.

Next to him are two women from the local children’s museum. No one but me notices they have small animal cages at their feet, protective towels covering the “guests” who will appear before me (a hedgehog and a snake). They discuss the details of their lives. Kids’ schedules, first days of school, other work projects. Their attention goes to the Green Room TV over a story of famous faces drawn into lattes, unaware if their cognitive functions deciphering the espresso art.

Next to me sits a grandmother and her teenage grandson. He created YouTube videos when they were driving around after school – fun things like his “friend” Miley Cyrus who broke her leg while working, but is doing much better, or a story that he got a girl pregnant, which his grandmother knows is his way of teasing her to get a reaction (she’s unaware that Miley is a celebrity). She takes none of his nonsense. The videos have gone viral. They are excited to see the story teaser on TV. I tell him how lucky he is to have his grandma and get their autographs to their delight. When they ask what I do, they give me the response everyone does… “Oh”.

It’s something people take for granted, cognitive wellness. Whether it’s remembering driving tips for the busiest weekend of the year, or executive functions for organizing your day, or learning about YouTube and being creative with the special relationship we can have with our elders. And people are speechless at the thought of losing it. They do not realize there are things we can do to MINIMIZE those risks.

There are so many people to reach with this message, and so many competing messages grabbing their attention. Please visit and click on the Dementia Risk Screen. Don’t let your answer be “Oh” when faced with the concept of losing cognitive health. Empower yourself to do all that you can – challenge your brain to remember simple lists, reminisce about facts of our past history, create projects and think about the individual steps, look for familiarity in places you’d least expect it, tell creative stories, learn about new things and keep social ties strong, especially relationships with those you love. All of these things help keep your brain healthy.

Exciting Alzheimer’s Research Updates

Pamela Atwood, MA, CDP, CLL, DCC-T, Director of Dementia Care Services, Hebrew Health Care

Rates of Dementia Decreasing with Simple Steps

The news from the Alzheimer’s Association International Conference in Copenhagen last week was encouraging. Rates of Americans getting dementia are decreasing, as are rates in other “rich” countries. Why? We are controlling our risk factors.

Last year, Hebrew Health Care published the Dementia Risk Screen: eight of the 11 risk factors are modifiable. The news this week confirms you can minimize your risks!

Research conducted at Boston University has analyzed rates of dementia through several decades. The Framingham Study indicates that an individual’s risk of getting dementia is 44% lower than it was, and that the average age of onset is now 85, compared to 80 in the 1970s.

The primary reason: improved health overall. Smoking rates have dropped. Heart disease rates are improving. Numbers of strokes have declined. The study indicates the following steps will continue to improve the numbers:
o Stop smoking
o Control blood pressure
o Manage weight
o Keep cholesterol levels within normal limits
o Exercise

In other countries, the numbers are improving as well. However, there are new health rates which may limit the excitement. Higher obesity and diabetes rates may further increase the risks of dementia. Quoted in an article by MSN News, Dallas Anderson, Chief of Epidemiology at the US National Institutes of Health said, “It may be what we have now is a sweet-spot (as people with these health issues are still young). They’re not in the dementia range yet, but what is going to happen (with them) in the pipeline?”

Take the Dementia Risk Screen at Listen to the podcasts to learn what you can do to minimize your risks starting today.

New Ways to Diagnose AD Being Developed

Three other breakthroughs were announced this week: a smell test, a blood test and an eye test.

Blood test – Kings College in London reported research conducted over the past decade to develop a test for diagnosis of AD. The studies indicate 87% accuracy. The test detects 10 proteins in the blood, and indicates onset of AD in the following 12 months.
“Why would I want to know?” responded one of my colleagues. “I think most people would NOT want to know,” said a caregiver when we discussed it at a support group meeting.

Most of these tests are being developed FOR research. Many researchers are concerned that drug targets fail because by the time the experimental agents are tried, the disease has taken too much of the brain to be effective.

The target for the blood test is people with mild cognitive impairment (MCI), the vast majority of who develop Alzheimer’s in 5 years following diagnosis.

Although this is exciting, there is no blood test for dementia ‘around the corner’, according to published reports. These are small studies. And with more than 10% of people being misdiagnosed, more work, on larger scale studies, is needed.

The other two tests – smell test and eye test – are correlation studies. At the AAIC press briefing, there were lots of discussions about these two studies. The smell test is about people who have MCI, they experience changes in their ability to smell, and that correlates with the transition to Alzheimer’s. For the eye test, proteins detected correlate with amyloid proteins in the brain. However, there are still a significant number of researchers and experts who question the amyloid THEORY as the protein responsible for plaques and tangles. These tests are based on theories of what causes Alzheimer’s. Also it is important to note that just because you have a change in your sense of smell does NOT mean you have AD. Many conditions affect taste and smell.

New Protein Identified in Alzheimer’s Plaque

There were hundreds of studies shared at AAIC. Another interesting one hails from Mayo Clinic in MN. Researchers have identified a new protein which may be another piece of the “plaque” puzzle. The research compared people who died with Alzheimer’s – some who had symptoms, and some had not. Of the 372 people, more than 200 had this new protein, in addition to amyloid protein. One theory is that perhaps the protein is a byproduct of the disease. The protein has been identified as critical in ALS/Lou Gehrig’s disease and other neurological conditions. More tests will be conducted.

There is still no known CAUSE of Alzheimer’s. Unfortunately, there is still no known cure. However, the research reported at the AAIC last week is encouraging for the ongoing efforts to find the answers which plague us.