Featured on the AARP website

Featured on the AARP website
CLICK the image of Andrew Wyeth's "Christina's World" (above) to see a fascinating slide show about art and Alzheimer's disease. The slideshow is part of a larger article entitled "In Museums, Those With Alzheimer’s Find Themselves Again"

"I'm Still Here" Drama Treatment featured on UK Channel 4 News

Monday, July 20, 2009

How Design Can Foster Independence in Alzheimer's Communities

The following recommendations are courtesy of John Zeisel and is excerpted from I’m Still Here by John Zeisel, Ph.D.

What Kind of Design is Best for an Alzheimer's Community?

Look for homelike environments. People living with Alzheimer’s at home are already in a residential setting. Residential quality in assisted living and similar group residences for people living with Alzheimer’s can reduce symptoms.

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What Features to Look for in an Alzheimer's Community

The following is excerpted from I’m Still Here by John Zeisel, Ph.D.

There are eight major characteristics of places that support people living with Alzheimer’s to be all they can be:

  1. exit control
  2. walking paths
  3. privacy
  4. shared space
  5. gardens
  6. homelike quality
  7. sensory understanding
  8. supports for independence and empowerment

Next I discuss the design qualities to look for in residential settings that present themselves as Alzheimer’s-competent. You can, however, take the same information and use it to look at your own home or the home in which the person lives with Alzheimer’s.

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Wednesday, July 15, 2009

Lying To Alzheimer's Patients : NPR


Talk of the Nation, May 19, 2009 · For families caring for a loved one with Alzheimer's disease, communication can be emotionally exhausting.

If the family receives bad or disturbing news, is it ever compassionate to not tell the family member with Alzheimer's about it, or even to lie about it?

Clink title like above to listen to NPR broadcast of this topic.

Neil Conan on Talk of the Nation focuses on whether or not to tell "fiblets" to people with dementia.

From my perspective, when my dad first had dementia and asked me why I didn't invite my mother to my home for a holiday occasion, I was flabbergasted. Didn't my dad know me well enough to know that I would never not invite my mother to my home? The first several times that he asked me that, and if I had seen my mother lately, I asked him, "Don't you remember, Dad? Mom died ...." Each time he was shocked, and became grief stricken.

I would think I would have known better, since I work with people with dementia. But somehow, I had no objectivity when it came to my dad. However, I learned pretty quickly something that John Zeisel talks about in his book I'm Still Here. That is, we can empathize with them that they are missing that person, and then change the subject, redirecting them which will help them ease their loneliness.

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Friday, July 10, 2009

Neuroarchitecture: the Science of Getting Your Decor in the Right Frame of Mind

It’s not preposterous to think your next resource for revamping your home is not ASID but ANFA: The Academy of Neuroscience for Architecture.

It is the mission of this think tank, and others like it, to promote and advance knowledge bridging neuroscience research to how we humans respond to our built environments.

Apparently, so much new information in this area has surfaced in the last two decades, excited architects, designers and scientists are calling it the new Renaissance in physical design.

There are even books being published on the subject, such as Inquiry By Design: Environment Behavior/Neuroscience in Architecture, Interiors, Landscape and Planning by John Zeisel, a consultant to ANFA.

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Another way of thinking about Alzheimer’s


July 8, 2009

Two days ago I finished reading I’m Still Here by John Zeisel. Zeisel is the President and co-founder of Hearthstone Alzheimer Care, which provides “residential treatment environments where people with Alzheimer’s and related disorders can flourish.” I am intrigued by the Hearthstone approach. As it happens, I live not far from a Hearthstone residence, and am hoping to visit sometime this summer. In addition to his book, Zeisel also maintains a blog.

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Monday, July 6, 2009

ARTZ, Authors and Alzheimer’s

June 25, 2009

This post owes its thanks to a conversation with Karen Kruger on Tuesday, at the first Yale Center for Dyslexia & Creativity conference. More on the conference in upcoming posts, but for now, it’s ARTZ and Authors, all related to Alzheimer’s.

ARTZ
Karen began by telling me about ARTZ, Artists for Alzheimer’s. Art as therapy has long been a useful tool for assisting people with myriad health issues, right up there in positive impact with music, dance and pet therapy. “The ARTZ Museum Partnership Program implements interactive, educational museum programs for people living with Alzheimer’s disease and related dementia.” My Dad is unable to visit a museum, but perhaps I can bring “art” to him. I see him respond to my singing of songs and playing of his favorite oldies (Frank Sinatra always hits home); perhaps art – both viewing and creating (why not finger painting!) – will also tweak a memory or provoke a positive response.

AUTHORS
Still Alice was written by neuroscientist Lisa Genova, whose grandmother had Alzheimer’s. Lisa had the benefit of being a scientist who could understand the mental deterioration that was taking place in her grandmother’s brain, but it left her wondering how a person with Alzheimer’s felt as their cognition slipped away. From this curiosity came Still Alice. Thanks to a book journal given me by my oldest son, I’ve been writing about the books I read, and here’s what I wrote about this book back in March.

Deb S. loaned me this book. written by a Harvard PhD in neuroscience and online columnist for the National Alzheimer’s Association, it is a fictionalized yet highly informed look at one woman’s descent into dementia after being diagnosed with early onset Alzheimer’s. The woman, Alice, is a Harvard professor with three grown children and a husband, also a Harvard researcher. They have a summer home on the Cape, in Chatham. Yes, the ending is a tear jerker – Alice is alive but has lost so much of her capability to communicate. Lisa’s insights into Alice’s mindset seem spot on and I wish-I wish-I wish that I had read a book like this when Dad was in the early stages. Perhaps I could have been more helpful to him.

I did not read verbatim, and intentionally read quickly, because this topic and story – particularly this story – were too close to home. Fred and I teach at the same school. We’ve spent many glorious, soothing summers on the Cape. We have two incredible children. I cried for Alice but nestled deep down perhaps I cried for me. I could have the gene my Dad has, and that portends a future I don’t want to contemplate, certainly not until or unless it becomes apparent that I need to contemplate it.

And that is the most honest I’ve been about Alzheimer’s! This was a sad story but also somehow encouraging, because Alice had a voice. This is Alice’s story.

Karen also recommended another book, which I have ordered, I’m Still Here: A Breakthrough Approach to Understanding Someone Living with Alzheimer’s by John Zeisel. Am very much looking forward to reading it, and of course, will share my thoughts in a later post.

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Mood, memory affected by your home

July 4, 2009

Mood, memory affected by your homeAnyone fond of coming home to a chilled glass of Chardonnay to help wind down may soon be dreaming of the front door keys rather than a corkscrew. The pleasure is due to a hot new field of design called neuroarchitecture.Emerging research on how factors like light, space and room layout affect physical and psychological well-being are driving the buzz behind this new intersection of art and science.

"The premise is to consider how each feature of the architectural environment influences certain brain processes such as those involved in stress, emotion and memory," says Eve Edelstein, Ph.D., adjunct professor at the NewSchool of Architecture & Design in San Diego and a research consultant to the Academy of Neuroscience for Architecture (ANFA).

For example, light is already a well-known mood modulator -- candles, artificial sources controlled with dimmers, lots of natural sunshine. Beyond that, neuroarchitecture experts have a few suggestions about how to make the kind of home improvements that also might renovate your mood:

Decor

Surprisingly, sleek minimalist interiors may not feed the brain as much as a home or apartment that's a little cluttered, says John Zeisel, Ph.D., who serves on ANFA's board of directors and designs therapeutic environments for dementia sufferers through his company, Hearthstone Alzheimer Care, in Woburn, Massachusetts.

"Alzheimer's patients wander. However, if you provide good visual cues -- pictures and objects they're familiar with, destinations at the ends of hallways, such as kitchens, activity spaces and doors that lead out into safe and inviting healing gardens -- they stop wandering and begin to walk with purpose."

Similarly, when you look around your own place and see the evidence of who you are (the books you've read, the projects you're working on), you feel grounded.The hearth should always be the center of the home, according to Zeisel and British kitchen designer Johnny Grey, who have collaborated since Daniel Goleman, author of "Emotional Intelligence," introduced them three years ago.

"Being in the kitchen links you to hardwired feelings of comfort -- beyond getting food, there's a sense of protection, warmth, sociability, sharing stories," says Zeisel, which is why, ideally, it's both a functional and a social space where friends and family can gather, do homework, and relax.

Grey says the "sweet spot" is a location where you can cook with your back facing a wall while looking others in the eyes.

Zeisel explains why: "After a busy day, if your kitchen design makes you face away from family or company, wondering what the noises and bustle going on behind you mean your brain is more likely to continue to produce adrenaline and cortisol, the hormones associated with anxiety, fear, and stress.

"But when you face into the room and can see what's going on, you feel safer and more in control; then oxytocin, the bonding hormone, and serotonin, associated with relaxation and enjoyment, have a greater chance of being released."

Better yet is a kitchen in which you have a view of the door where people enter, a window onto a landscape and a fireplace.Windows

A yard is nice, but if you don't have one, big windows or a balcony also offer an emotional lift. "Just being able to see how the weather is and knowing what's out there relaxes people and makes them feel more in control," says Zeisel.

'Soft geometry'

Grey suggests the use of curves instead of hard edges on counters, furniture, and cabinets to help nurture contentment and well-being.

"The reason has to do with your peripheral vision and is linked to a primitive part of the brain called the amygdala," he says. "If you were to walk down a dark, narrow tunnel lined with sharp rocks, you wouldn't be able to think about anything except avoiding getting hurt. But if the same tunnel were lined with linen upholstery, you'd feel safe to daydream."

Everything need not be rounded --"that gets very tedious," Grey says. "But if the key pieces and places are curved, that makes the body relax."

Original art

Decorating with a signed painting or one-of-a-kind sculpture not only puts your unique fingerprint on your place, it transmits a sense of authenticity and trust, says David Lewis, PhD, research director of Neuroco, a British neuromarketing company that uses EEGs (which measure electrical activity in the brain) and other techniques to understand consumer behavior.

A room of one's own

Lack of privacy is stressful, Zeisel says. Even if you can't have your own room, it's important to find ways to guarantee yourself solitude (make a time when the bathroom is yours so you can put on makeup alone, find a corner away from the family traffic to read).

Rearranging

"One of the keys to a home that elicits a lot of happiness and positive emotion is that it changes to some extent," says the University of Wisconsin's Richard J. Davidson, PhD.

Even an environment that makes our spirits soar -- an incredible view, for example -- tends, over time, to grow stale. We get used to it. Davidson isn't suggesting turning your place upside down, but if you get the bug to move things around a bit or play with the lighting, you might find your own interior gets a lift toward the sunnier.

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Wednesday, July 1, 2009

Cognitive Camouflage — How Alzheimer’s Can Mask Mental Illness

By Michael B. Friedman, LMSW; Gary J. Kennedy, MD; and Kimberly A. Williams, LMSW
For The Record
Vol. 21 No. 9 P. 24
April 27, 2009

It’s not unusual for mental illness, particularly depression, to occur in the early stages of Alzheimer’s disease. But accurate diagnosis and treatment can improve cognitive function.

An Alzheimer’s disease (AD) diagnosis is usually greeted as a death sentence—and with good reason. The disease grows progressively worse and currently cannot be reversed or even stopped, although it can be slowed in some cases. In 2006, it was the sixth leading cause of death, according to the Centers for Disease Control and Prevention (CDC).......

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Hopkinton facility offers unique method of dementia care - Waltham, MA - The Daily News Tribune

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Zeisel Comments on Alzheimer's Research News

Fact, Fiction or Roller Coaster Ride? by John Zeisel

“Fast Food Causes Alzheimer’s Disease”

This headline appeared recently in many newspapers throughout the world. I receive them daily because I have logged the term “Alzheimer’s” intro my Google Alerts file— http://www.google.com/alerts—along with “I’m Still Here”, Hearthstone, my name, and my wife’s name. This means that every day before I wake up there are a selection of headlines in my inbox about Alzheimer’s from around the world. I also receive similar articles daily as an email in the Alzheimer’s daily news from http://ewarner@agelessdesign.org/ the website developed and managed by Mark and Ellen Warner.

Click on the titles below to see the entire articles.

Fast Food Causes Alzheimer's Disease, Makes Population Stupid
Natural News.com - Phoenix, USA—They develop signs of Alzheimer's disease. That's what Swedish researchers
discovered in recent findings published by the Karolinska Institute’s ...

Junk Food Diet Associated with Alzheimer's

KARK - Little Rock, USA—Abnormal tangles in the brain associated with Alzheimer's disease were found in mice
that were fed junk food for nine months. A new study indicates diets ...

What is the research basis of the headline: “Fast Food Increases the Risk of Alzheimer’s?” Did the researchers randomly assign elders to eat or abstain from McDonald's, Wendy’s, Burger King, KFC, and so on; following these elders for years while controlling for other potential influences—weight, exercise, alcohol intake, crossword puzzles and Sudoku, among others; and then saw a difference in the onset of Alzheimer’s? No not quite. They selected several mice genetically modified to carry the APOe4 gene—the gene that increases the likelihood among people for Alzheimer’s—and fed them lots of sugar, fat, and high cholesterol mouse food for 8 months. Among these mice, those who were fed these horrible diets—much like the director-actor in the film “Supersize Me” fed himself fast food for months—developed (surely among other maladies) a higher degree of plaques and tangles in their brains.

University of Sidney—Sydney researchers have made a breakthrough that will lead to a greater understanding of the causes of and treatments for neurodegenerative diseases.

At present neither Alzheimer's disease nor Frontotemporal dementia can be cured. Therefore, it is important to model the human diseases in animals to determine what is causing them and to develop a cure for these debilitating diseases.

Dr. Lars Ittner and Professor Jürgen Götz from the University of Sidney have succeeded in developing a mouse strain of Pick's disease, a form of Frontotemporal dementia, which reproduces, for the first time, Parkinsonism (resting tremor, muscle rigidity, bradykinesia, and postural instability) in a mouse model.

"The mice even show a reduced footstep length that is reminiscent of Parkinson's disease," said Götz. The researchers could also show that a single dose of L-Dopa (which is used to treat Parkinson's patients) caused a marked improvement in the mice.

The researchers are convinced that with their unique model of Pick's disease, FTD-associated Parkinsonism and memory impairment, they will be able to contribute to the finding of a cure of these diseases. For full story go to: usyd.edu

My gosh! Poison genetically engineered mice with sugar, fat, and cholesterol and they get sick. What a surprise! I wonder if the researchers also assessed the impact of these diets on the mice’s livers, kidneys, hearts, skin and other organs. If so, they probably would have detected similar damage.

This is not meant to put down the results of this important research; rather it is a comment on the reporting of such results. There is little question that high fat-sugar-cholesterol diets are bad for mice and people alike. Such results, however, would not make news. Alzheimer’s medical treatment research makes news. So we hear, almost every day that some research has either found a potential cause—fast food—or that what we thought might be a potential cure is not—Ginkgo Biloba, an herbal supplement recent research has found to have no effect on memory

Alzheimer's: Herbs don't do it Monroe News Star - Monroe, LA, USA
The GEM study showed that 240 milligrams of ginkgo daily had no effect on the onset of dementia or development of Alzheimer's. Ginkgo supplements are among ...

Ginkgo Biloba Shows No Benefit in Dementia, Alzheimer's Disease Medscape - USA

Describe the effect of Ginkgo biloba on Alzheimer's disease. Disclosure: Susan Jeffrey has disclosed no relevant financial relationships. ...

or Flurizan, a Myriad Genetics developed drug that was tested at a cost of $100 million

Reuters—Flurizan failed to help patients in a pivotal clinical test.

Flurizan, an experimental drug for the treatment of Alzheimer's disease, failed to help patients in a pivotal clinical test.

"We are disappointed that Flurizan failed to achieve significance in this study, and we will now discontinue development of this compound," Myriad President and CEO Peter Meldrum announced.

The Danish pharmaceutical group Lundbeck lost $100 million in the testing and development of the drug.

In North America alone there are over 5 million people in various stages of Alzheimer’s and other dementias. Assuming an average of five people who love and care for each person, there are at least 30 million waiting for positive news about a cure or delay for Alzheimer’s. Then there are the millions of baby boomers just reaching the age when they are really worrying about getting old and sick. We are probably talking about 50 million people in North America in this situation. Similar numbers— actually a little bit higher—are faced with the same situation in Europe. With 100 million people in North America and Europe desperately hanging on every news article about Alzheimer’s, newspapers and news agencies like Reuters, CNN, and The New York Times news bureau all need to be more responsible about reporting “Alzheimer’s news.” Of course being careful might not sell as many newspapers or ads on internet news services. But what is more important—selling newspapers or reporting news about Alzheimer’s in a responsible way that avoids playing with 100 million people’s emotions like bouncing balls.