Caregiver Corner: Surviving the Holidays

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 Negative political ads have been replaced by holiday “needs” in a nearly-constant bombardment of commercials, while Facebook-ers debated whether or not to shop on Thanksgiving.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.

Picnic Safety

Jiuseppe M Russo RD, CD-N, Clinical Dietitian Manager, Hebrew Health Care

Getting outdoors to enjoy the beautiful weather is one of the perks of this time of year. If picnics are part of your plans, take caution with time and temperature to make sure nothing spoils your fun. Eating outdoors can be a great way to get some fresh air during your lunch break. Unfortunately, many of us tend to forget some of the basics of food safety when it comes to eating outdoors. To make sure that food borne illness does not spoil your outdoor eating, follow these simple rules.

  • Wash Your Hands-This effective step is not always so easy when you are outside. Consider washing your hands right before you head out or bring some hand wipes with you.

  • Maintain Food Temperature-Keep hot foods hot and cold foods cold. The bacteria that can make you sick enjoy warm weather as much as you do. To keep your food safe from unwanted bacteria, keep food below 40F or above 140F. Consider ice packs or hot food containers if you don’t plan to eat your food right away. If you can’t do this, remember that anything left out for more than two hours, or one hour if it is really hot out, should be thrown away.

  • Handle Leftovers Carefully-If you bring your lunch outside and have some leftover, put it in the refrigerator as soon as you get back. If you can’t get it into a refrigerator, toss it into a cooler with ice. As good as it might have been, the risk is not worth keeping it around.

Healthy Myths vs. Facts

Jiuseppe M Russo RD, CD-N, Clinical Dietitian Manager, Hebrew Health Care

Warm Weather vs. Cold Weather
Myth: When engaging in outdoor recreation, you only need to worry about drinking enough water only during warm weather sports and activities.
Fact: Outdoor winter activities require at least as much water as outdoor activities during the rest of the year. Your body loses fluids when inhaling cold winter air, particularly during days when humidity is low and air is crisp and dry.

What about Fruit Juice?
Myth: Drinking fruit juice is a good way to meet the majority of your body’s fluid requirements as long as it is 100% juice.
Fact: While it’s true that fruit juice has high water content, the calories can add up quickly making it poor choice as a hydrating beverage. Try diluting a few ounces of your favorite fruit juice plenty of water or making a spritzer by adding a few ounces of fruit juice or nectar to a tall glass of seltzer.

Bottled Water Safety
Myth: Bottled water is safer than tap water.
Fact: Most bottled waters are safe, but it depends on where the water comes from, how it’s treated and whether or not it is tainted. In fact, an estimated 25% or more of bottled water is really just tap water in a bottle – sometimes treated, sometimes not. A recent survey by the Natural Resources Defense Council found that out of 103 brands of water tested, one-third contained significant contamination. If you’re buying bottled water, choose a major brand from a store that sells a lot of water. Once you drink from a bottle, refrigerate it, and finish it within one or two days.

Reusing Water Bottles
Myth: There’s nothing wrong with rinsing out and reusing plastic water bottles.
Fact: Reusing and refilling empty water bottles seems like a responsible practice since it helps reduce wasteful discarding of plastic. However, according to the International Bottled Water Association, these bottles, made from polyethylene terephthalate (PET), are intended for onetime use. Over time, the plastic loses its integrity and develop cracks of leaks. In addition, they are difficult to wash and dry due to a narrow neck. If not properly sanitized, they could harbor bacteria. It’s true that water is not the most likely environment for bacteria to grow in, but since water bottles come in contact with the mouth, particles of food mixed with saliva could flow back into the bottle where-under the right conditions, such as warm temperatures or even room temperature-bacteria could thrive. If you want to be environmentally conscious, purchase a reusable water bottle sold in bike shop or outdoors/sporting goods stores.

Men’s Health and Dementia: Five Healthy Behaviors Which May Lead to a Dementia-Free Retirement

Compiled by Pamela Atwood, MA, CDP, CLL, Director of Dementia Care Services, Hebrew Health Care

A Welsh research team followed more than 2,200 men ages 45 and 59 for 35 years. They had two key objectives: 1) to see if there really is a relationship between healthy lifestyle, chronic disease and cognitive decline; and 2) to see how much impact changes in health activities (adopting new healthy habits) had on wellness over time. The researchers from Cardiff University were tracking health habits and monitoring for chronic conditions including dementia, cardiovascular disease, diabetes and stroke and have authored more than 400 articles in various publications since the end of last year.

So what are the healthiest habits for the men who participated in the study? They probably won’t surprise you.
♥ Exercise regularly.
♥ Don’t smoke.
♥ Maintain a low body weight.
♥ Eat a healthy diet.
♥ Keep alcohol intake low.

While the study found that few people live a fully healthy lifestyle (only 1%), they did see note some interesting findings:

How healthy do you need to be? When should you start?
The study shows that people who consistently followed 4 of the 5 habits reduced their risk of dementia by SIXTY PERCENT (60%). That is very significant. They also reduced their other chronic diseases by 70% (diabetes, heart disease, etc.). Also, start now with JUST ONE NEW HABIT. Researchers found that if the men had been urged to follow just one new healthy habit at the start of the study, the rates of dementia and other diseases would have continued to drop significantly.

What about women?
Although the study participants in this research were all men, there is no reason to think that the results would not be equally impressive for women. We have always said that what is good for the heart is good for the head. There are many research studies on smaller scales which yielded similar findings. And the results of the Welch study are often extrapolated to “people,” not just men.


Scan our code and take our dementia risk screen for free, or visit right now to learn more about memory issues or to find support for family or a friend with cognitive problems

Scan our code and take our dementia risk screen for free, or visit right now to learn more about memory issues or to find support for family or a friend with cognitive problems