Lifestyle Tips for Warfarin Users

Lifestyle Tips for Warfarin Users

 

 

Warfarin (brand names Coumadin and Jantoven) is a prescription medication used to prevent harmful blood clots from forming or growing larger. Beneficial blood clots prevent or stop bleeding, but harmful blood clots can cause a stroke, heart attack, deep vein thrombosis, or pulmonary embolism. Because Warfarin interferes with the formation of blood clots, it is called an anticoagulant. Many people refer to anticoagulants as “blood thinners”; however, Warfarin does not thin the blood but instead causes the blood to take longer to form a clot.

 

The formation of a clot in the body is a complex process that involves multiple substances called clotting factors. Warfarin decreases the body’s ability to form blood clots by blocking the formation of vitamin K–dependent clotting factors. Vitamin K is needed to make clotting factors and prevent bleeding. Therefore, by giving a medication that blocks the clotting factors, your body can stop harmful clots from forming and prevent clots from getting larger.

 

 

Measuring Your PT/INR

 

 

The INR is the International Normalised Ratio, a measure of how fast blood clots and this evaluates the effectiveness of warfarin in thinning your blood.

Your INR will be measured usually by pricking your finger to obtain a small droplet of blood which is put onto a special strip which can be analysed by a hand-held point-of-care device.

 

  • In people who are not taking a blood-thinning medicine, blood clots with INR of around 1.0. To reduce the risk of a stroke in atrial fibrillation the blood needs to be 2-3 times thinner than normal.
  • This means that the blood takes 2-3 times longer to clot.
  • If you have atrial fibrillation your target INR range will be 2.0 to 3.0.
  • If your blood is too thick (INR less than 2.0), then you are still at increased risk of having a stroke (caused by a clot).
  • If your blood is too thin (INR greater than 3.0), then this increases your risk of bleeding.
  • Some people attend a clinic (either at the hospital or their GP or health centre) to have their INR monitored. Other people self-monitor and/or self-manage their INR at home but this is not suitable or possible for all patients. If you wish to self-manage your INR you need to discuss this with your doctor.
  • When you first start warfarin it may be necessary to have your INR monitored every week but once your INR becomes therapeutic (in the INR range of 2.0 to 3.0) and is stable in that range, when you will only need to have INR checked every 4 to 6 weeks. Remember, it is very important to keep your INR in the recommended range of 2.0 to 3.0.

 

 

Managing Your PT/INR Range

 

To help Warfarin work effectively, it is important to keep your vitamin K intake as consistent as possible:

Sudden increases in vitamin K intake may decrease the effect of Warfarin.

On the other hand, greatly lowering your vitamin K intake could increase the effect of Warfarin.

 

 

To keep INR / PT stable and within the recommended range, it is important to:

 

  • take the correct dose of Warfarin at the same time every day
  • have your INR / PT checked regularly
  • keep your vitamin K intake consistent from day to day

 

 

To help make it easier to keep your intake of vitamin K consistent:

 

  • limit intake of foods considered “high” in vitamin K to no more than 1 serving each day
  • limit intake of foods “moderately high” in vitamin K to no more than 3 servings each day
  • report any significant changes in your diet or your weight to your doctor

 

In other words,

  • Watch how often you eat foods high in vitamin K.
  • Watch how much you eat of foods high in vitamin K

 

 

 

Watching Your Vitamin K Intake

 

Green leafy vegetables are among the best food sources of vitamin K. The average intake of vitamin K for most adults in the U.S. is 70 to 80 micrograms (mcg) per day.

The Daily Value for vitamin K, an estimate of daily need, is 80 micrograms. The Percent Daily Values (%DV), listed on the tables below, help consumers determine if a food contains a little or a lot of a specific nutrient.

It is important to limit intake of foods that provide more that 60% of the Daily Value for vitamin K to help keep INR/PT in the desired range.

 

 

Foods high in Vitamin K (more than or equal to 200% DV)

Eat no more than 1 serving per day

 

Food                                                               Serving size                     % Daily Value

Kale, fresh, boiled                                     1/2 cup                                 660

Spinach, fresh, boiled                             1/2 cup                                  560

Turnip greens, frozen, boiled              1/2 cup                                   530

Collards, fresh, boiled                            1/2 cup                                    520

Swiss chard, fresh, boiled                     1/2 cup                                    360

Parsley, raw                                                 1/4 cup                                   300

Mustard greens, fresh, boiled             1/2 cup                                    260

 

 

 

Foods moderately high in Vitamin K (60 to 199% DV)

Eat no more than 3 servings per day

 

Food                                                              Serving size                           % Daily Value

Brussels sprouts, frozen, boiled             1/2 cup                                190

Spinach, raw                                                    1 cup                                   180

Turnip greens, raw, chopped                    1 cup                                   170

Green leaf lettuce, shredded                     1 cup                                   125

Broccoli, raw, chopped                                 1 cup                                  110

Endive lettuce, raw                                         1 cup                                      70

Romaine lettuce, raw                                     1 cup                                      70

 

Iceberg lettuce, red cabbage, asparagus, and soybean oil are often reported as being high in vitamin K. They contain much smaller amounts than foods listed in the tables above. These, and other foods and beverages not listed in the tables above (including coffee and tea), may be consumed as desired.

The above food values are from the U.S. Department of Agriculture, Agricultural Research Service. 2003. USDA National Nutrient Database for Standard Reference, Release 16.

 

 

Alcoholic Beverages and Warfarin

 

 

Alcohol intake greater than 3 drinks daily can increase the effect of Warfarin. However, some medical doctors advise those taking Warfarin to avoid all alcoholic beverages. Check with your doctor about this issue.

One drink = 5 ounces wine

12 ounces beer

1 1/2 ounces liquor

 

 

Supplements and Herbs

 

Many dietary supplements can alter the INR/ PT.

Dietary supplements known to affect the INR/PT include: arnica, bilberry, butchers broom, cat’s claw, dong quai, feverfew, forskolin, garlic, ginger, ginkgo, horse chestnut, insositol hexaphosphate, licorice, melilot (sweet clover) pau d’arco, red clover, St. John’s wort, sweet woodruff, turmeric, willow bark, and wheat grass.

Much is unknown about dietary supplements. The safest policy is for individuals on Warfarin to avoid all dietary supplements unless their physicians approve. This includes any vitamin/mineral supplements that list vitamin K on the label. If they are taken regularly on a daily basis, they pose less of a problem than if taken off and on.

 

 

Vitamin E Supplements and Warfarin

 

Evidence suggests that vitamin E has blood-thinning effects. Vitamin E intakes above 1,000 International Units (IU) per day may increase the risk of excess bleeding. Research suggests that doses up to 800 IU may be safe for individuals on Coumadin®, but the evidence is not conclusive. It is best for those taking Warfarin to ask their physicians about taking Vitamin E supplements.

 

 

 

Recommended:

 

Beat Your A-Fib by Steve S. Ryan, PHD

 

 

Antiobiotics and Warfarin

 

http://img.medscape.com/thumbnail_library/dt_150401_antibiotics_pkg_800x600.jpg

 

Many antibiotics and related medications, including azole antifungal agents, heighten warfarin’s blood-thinning ability and raise the risk of internal bleeding. Some antibiotics, such as rifampin, decrease warfarin’s ability to “thin” the blood, increasing the risk a blood clot will form. People taking warfarin and antibiotics must be monitored closely. That’s why if you are prescribed an antibiotic to treat or prevent an infection, you should immediately tell the clinician who manages your warfarin.

“Monitoring is key. It is important to maintain a level of warfarin that is high enough to prevent unwanted blood clots without overly increasing the risk of bleeding,” says Dr. Tejal Gandhi, associate professor of medicine at Harvard Medical School and an expert on outpatient drug safety.

In a recent study of 38,762 Medicare patients taking warfarin, researchers found that azole antifungals and all classes of antibiotics increased the risk of bleeding within two weeks, but to different degrees (American Journal of Medicine, February 2012).

The drug classes are listed in the chart below, along with their risk of interaction (4.57 = the drug increases the risk of bleeding more than 4 times over that of a warfarin user who is not taking this particular drug).

Risk of a drug-drug interaction varies

 

 

https://www.bestonlinemd.com/wp-content/uploads/2014/03/Topical-Antibiotic-Treatment-For-Baby-Rash-That-Caused-By-Bacterial-Infections.jpg

Many patients think drug interactions are only caused by pills, but topical antibiotics are absorbed into the bloodstream and can interfere with warfarin, too.

This includes ointments, creams, and suppositories. “A common cause of a rise in the INR is antifungal cream prescribed to women with a vaginal yeast infection,” says Massachusetts General Hospital’s Lynn Oertel.

 

Most physicians are aware of the potential for warfarin-antibiotic interactions, and they discuss the risk with patients when warfarin is prescribed. Nevertheless, as a caregiver, you an be an important safety net, as there are plenty of opportunities for error:

 

  • A patient may not understand the potential significance of this drug-drug interaction, or may simply forget.  A provider who prescribes the antibiotic may fail to inform the clinician managing the patient’s warfarin.

 

  • Monitoring is advised, but the patient may not comply with INR testing.

 

  • The drug-interaction alert function in the physician’s computerized medical records system is not turned on, or the medication lists are out of date.

 

  • The patient uses two different pharmacies for filling the warfarin and antibiotic prescriptions, preventing the pharmacist from issuing a warning.

 

  • The patient receives an antibiotic sample or handwritten prescription from the physician, bypassing any computer system that might alert providers to a potential drug-drug interaction.

 

 

 

The Three Most Important Points

 

  • Warfarin is a very important drug for you. Follow the prescription exactly, and keep your follow-up appointments for blood tests such as the INR/PT.

 

  • Warfarin interacts with vitamin K in your body, so you need to keep vitamin K intake constant from day to day. It is also important to avoid herbal products and dietary supple­ments that may affect vitamin K and Warfarin unless approved by a qualified health care provider.

 

  • Post the phone numbers of your doctor, pharmacist, and registered dietitian for ready reference when you have a question or concern about Warfarin, vitamin K, and your INR / PT.

 

Sources:

US National Library of Medicine. Medline Plus: health topics. Available at: http://www.nlm.nih.gov/medlineplus/healthtopics.html.

 


Recommended: 

Beat Your A-Fib: The Essential Guide to Finding Your Cure: Written in everyday language for patients with Atrial Fibrillation by Steve S. Ryan, PhD

Many patients suffering from Atrial Fibrillation have three strikes against them:


1. Their “quality of life” has deteriorated; they are scared or frightened.

2. Many experience side effects from the common drug therapies or simply do not want to live on medication; a cure for their A-Fib hasn’t been discussed.


3. Patient information is often out-of-date, incomplete or biased toward a specific pharmaceutical or treatment; much information about new treatment options is written in the language of scientists and doctors.

 

The author, Dr. Steve Ryan, PhD, a former A-Fib patient, addresses all these issues. His book is written for the newly diagnosed patient and any A-Fib patient who doesn’t want to wade through medical texts and research journals to understand their disease.

Beat Your A-Fib helps patients and their families look beyond the commonly prescribed drug therapies that only manage the disease, but do not cure it.

 

Beat Your A-Fib: The Essential Guide to Finding Your Cure offers:

 

  • Unbiased, up-to-date information and best practices
  • Medical terms and concepts translated into everyday language
  • Non-drug treatment options including Cardioversion, RF catheter ablation, Pulmonary Vein Isolation, CryoBalloon, Cox-Maze and Mini-Maze surgeries, and AV Node Ablation with Pacemaker
  • Research-based content with a bibliography of over 150 medical references
  • ‘Lessons learned’ from A-Fib patients now enjoying lives free of the burden of A-Fib
  •  Recommended Resources and Website Links
  • Patient tools to become their own best healthcare advocate

 

This unique book helps patients research their best treatment options, steps through how to find the right doctor for their type of A-Fib and treatment goals, gives patients hope and empowers them to develop a plan for finding their A-Fib cure or best outcome.

Dr. Walter Kerwin, MD, of Cedars-Sinai Medical Center Los Angeles, California, wrote the Foreword for the book. Dr. Steven C. Hao, MD, of California Pacific Medical Center, San Francisco, California, penned the Introduction.

Dr. Steve Ryan, PhD, is a noted healthcare educator and advocate for patients with Atrial Fibrillation, and former A-Fib patient. He earned his Ph.D. in Educational Communications from the Ohio State University.

Read the reviews.

 

 

 

 

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Caregiver Guide to ALS

 

Caregiver Guide to ALS

 

 

 

 

What is ALS?

 

Amyotrophic Lateral Sclerosis (ALS), also called Lou Gehrig’s Disease or Motor Neuron Disease, is a progressive, neuromuscular disease that attacks nerve cells and pathways in the brain and spinal cord.

 

Motor neurons, among the largest of all nerve cells, reach from the brain to the spinal cord and from the spinal cord to muscles throughout the body. When these motor neurons die, the brain can no longer start and control muscle movement. At this time there is no cure for the disease; however, over the past decade, we have made amazing strides in our understanding of the brain, the nervous system and genetics. Discoveries in each of these areas bring hope to people with ALS (PALS) and their families that some day a cure will be found.

 

Amyotrophic comes from the Greek language. “A” means no or negative. “Myo” refers to muscle, and “trophic” means nourishment–“no muscle nourishment.” When a muscle receives no nourishment, it atrophies or wastes away. “Lateral” identifies the areas in a person’s spinal cord where portions of the nerve cells that nourish the muscles are located. As this area degenerates, it leads to scarring or hardening (“sclerosis”) in the region.

 

As more and more nerves and muscles are affected, the person with ALS loses the ability to move, eventually suffering complete paralysis. The muscles used for breathing, speaking and swallowing also become affected. ALS does not affect the person’s mind, senses (feeling, tasting smelling etc.), bladder and bowel function or sexual drive and function.

 

 

Who gets ALS?

 

There are 30,000 people living with ALS in the United States and approximately 6,000 Americans are newly diagnosed with ALS each year. Symptoms usually appear in individuals between the ages of 45-65, though the disease has been reported in both younger and older persons. Survival after the confirming diagnosis is, on average, two to five years.

 

The progression of ALS varies with each individual. Ten percent of those diagnosed with ALS live for ten years or more. Family caregivers, physicians, nurses, physical therapists, speech therapists/pathologists, occupational therapists and social workers all working together with the person with ALS can help ensure a high quality of life and as much independence as possible.

 

ALS occurs more frequently in men than in women. For 90-95% of all ALS cases, there is no known cause. These cases, which appear to occur at random, are referred to as sporadic ALS. Between 5-10% of ALS cases are inherited. This genetic form of ALS is known as familial ALS. Sporadic and familial ALS do not differ in symptoms or progression. ALS is not contagious.

 

 

Symptoms

 

Some patients become aware of the onset of the disease when their hands become clumsy, causing difficulty in the performance of tasks like unlocking doors or writing. Others experience weakness in the legs and may trip or stumble. Other people notice they have problems speaking or difficulty swallowing.

 

ALS may be present for some time before any symptoms are noticed. This lack of noticeable symptoms occurs because the remaining functioning nerve cells compensate for the lost or damaged nerve cells. One early symptom is generalized fatigue. As muscle cells deteriorate, patients may experience stiffness, occasional jerking of the arms or legs, or twitching (fasciculations). Often symptoms begin in the hands and feet, then travel inward toward the center of the body. One side is usually more affected than the other. Eventually paralysis may be complete, except for the muscles of the eyes.

 

 

Diagnosis

 

There is no specific clinical test that can identify ALS. Diagnosis is made by a neurologist through a physical examination, a thorough patient medical history, and neurological testing. Diagnostic testing often includes the electromyogram (EMG) to test muscle activity, CT Scan or MRI (Magnetic Resonance Imaging), and extensive blood work. Sometimes muscle and/or nerve biopsies are performed.

 

The diagnostic process involves ruling out other potential causes of the symptoms the person is exhibiting. Because there is no conclusive test, people may find themselves with a diagnosis of probable or possible ALS until further identifying symptoms appear.

 

A diagnosis of ALS can be devastating to both the individual and the family. Anger, denial, fear, and a sense of loss are common reactions. For those who have been through a lengthy diagnosis process and the anguish of not having a diagnosis, finally knowing that they have ALS may actually bring a feeling of relief.

 

 

Treatment and Management of ALS

 

 

The Physician’s Role

 

The American Academy of Neurology has established guidelines for physicians treating individuals with ALS. These are based upon the following four principles:

 

Patient self-determination and autonomy are priorities; however, the way in which care and information are delivered to the person with ALS and/or his or her family should take into account the social, psychological and cultural background of the family. For example, in some instances the patient may prefer not to know the diagnosis and/or prognosis and the family may appoint someone else as medical decision-maker.

 

Physicians should provide the family with information well in advance of the time that decisions will have to be made regarding treatment options. Everyone involved should understand that decisions may change over time.

 

Caring for a person with ALS requires a coordinated effort among many people including family caregivers, therapists, nurses, and physicians. The physician should be responsible for ensuring the coordination of care from the time of diagnosis to the last stages of the disease.

 

A Living Will (Advance Directives, Power of Attorney for Healthcare) defining the treatment preferences of the person with ALS can be an excellent tool for communication among the person with ALS, the family, and the medical care team. The Living Will document should be reviewed every six months to reflect possible changes in preferences. This can often be a difficult topic and the physician should help by offering the family a chance to talk about it and to review it. In preparation, the physician should provide the family with information about the terminal phases of the disease.

 

Sample Health Care Directive

You can create, save and print out a legal Living Will/Health Care Directive simply and inexpensively online at LawDepot.  You can also log back in to make changes as necessary.  This service is available to U.S., Canadian, UK and Australian citizens.

See a Sample Health Care Directive

 

Helping people with ALS and their families requires empathy and sensitivity on the part of everyone involved.

 

 

Drug Treatment

 

In 1995, the FDA approved riluzole (Rilutek) the first and only drug for the treatment of ALS. Clinical trails of riluzole showed that the drug had a modest effect (2-3 months) on slowing the progression of ALS. Researchers continue to conduct clinical trails of potential new treatments for ALS. People with ALS (PALS) may want to discuss with their physician the option of participating in a clinical trial.

 

Approximately 50% of those affected by ALS may exhibit uncontrollable laughter or crying. This is referred to as psuedobulbar affect. Depression can also be a symptom. Some PALS experience Sialorrhea, drooling. All of these symptoms (depression, uncontrollable laughing/crying, and drooling) can be treated with medications and should be brought to the attention of the physician.

 

 

Living with ALS

 

While it is true that there is no cure for ALS, much can be done to help the person live with the disease. Treatment aimed at relieving symptoms can be very effective.

 

Generally, people with ALS should continue their usual daily activities, stopping before they become fatigued. They should be encouraged to set their own limits of exertion, and to plan how they will use their energy and strength. The physician will probably suggest exercises, including breathing exercises, to strengthen unaffected or less-affected muscles. These exercises are not vigorous or tiring, but are intended to help maintain mobility and prevent joint stiffness and muscle contracture.

 

There are a wide variety of assistive devices for enhancing the quality of life for the person with ALS:

 

 

Mobility

By working with physical and occupational therapists, PALS and their caregivers can identify appropriate devices to help maximize independence and reduce caregiver strain as changes in mobility occur. Braces, canes and walkers can help PALS maintain independent mobility for as long as possible.

As the disease progresses, wheelchairs, lifts and other special equipment can enable PALS and their caregivers to work as a team to keep the person with ALS connected to the world around them and to ensure appropriate care.

 

 

Communication

A speech therapist can help PALS maintain their speaking ability for as long as possible; however, the loss of speech does not mean the loss of the ability to communicate. Assistive communication devices, from simple boards to sophisticated electronic devices and computer applications, permit communication even into the latest stages of ALS.

 

 

For more communication help, see Caregivers Can Help With Aphasia

 

Rapid advances in technology have resulted in products that dramatically increase the independence of people with very limited mobility, allowing them to “speak,” operate lights and other controls, and remain contributing members of their families and communities. As of January 2001, Medicare policy was changed to include coverage of many of these communication devices.

 

 

 

Breathing

As muscles weaken, breathing becomes more difficult and less effective in the person with ALS. Individuals may find that they have problems sleeping, wake up feeling tired or wake up with a headache. Several options exist for individuals whose breathing becomes inadequate.

 

Several non-invasive options for helping breathing exist. One of the most frequently used is called a BiPAP (biphasic positive airway pressure). The person with ALS wears a mask over his or her nose at night connected to the BiPAP, which helps increase the flow of air into and out of the lungs.

 

When the person requires more help breathing than can be offered with any of the noninvasive methods, a permanent ventilator can be used. The ventilator then does the person’s breathing for him or her. This option can prolong the life of a person with ALS but it increases the need for care and the cost of care. The willingness and availability of caregivers can impact this decision.

 

Deciding whether or not to use the various types of assistive breathing devices will be one of the hardest decisions PALS and their families need to make. Preferences regarding breathing support should be discussed with the physician and included in the Advanced Directives.

 

 

Nutrition

It is important for people with ALS to receive proper nutrition and to maintain a normal weight. As problems with swallowing develop, food can be processed to make it easier to swallow. A nutritionist or registered dietitian and speech therapist or speech pathologist can help develop strategies to ensure that the person is receiving enough nutrients, calories and fluids.

 

If the person is not getting enough food, or if choking and food inhalation become a problem, he or she may want to consider a feeding tube. The tube, referred to as a PEG, is surgically inserted into the person’s stomach. Food goes through the tube and enters the stomach directly. This can be another very difficult decision for PALS and their families. Preferences regarding the placement of a PEG should be discussed before the need arises and included in the Advanced Directives. As with all treatment decisions, they should be reviewed periodically.

 

For more help, see End of Life Feeding and Nutrition

 

 

Gathering the appropriate resources to meet the challenges of ALS can be financially difficult for many families. Both the Amyotrophic Lateral Sclerosis Association (ALSA) and the Muscular Dystrophy Association (MDA) have programs through which people with ALS can borrow assistive devices and equipment that they might otherwise not be able to afford.

 

 

Reaching Out

It is important that the person with ALS and his or her primary caregiver get the information and support they need. Financial, emotional and caregiving challenges can take their toll on PALS and their caregivers. Preparing for upcoming changes, establishing good communication with the physician and other medical team members, and pulling together a supportive community of family, friends, and social service professionals will help ensure the highest possible quality of life.

 

While the care needs of PALS can be intense, caregivers must also be aware of their own needs for respite, rest and emotional support. A diagnosis of ALS does not mean an end to enjoyment. PALS and their caregivers will find that they continue to laugh, to find joy in their lives and to gain strength from the love of their families and friends.

 

 

Best Source:

 

Amyotrophic Lateral Sclerosis – A Guide for Patients and Families by Hiroshi Mitsumoto, MD (Third Edition)

This extensively revised and rewritten new edition of the bestselling Amyotrophic Lateral Sclerosis: A Guide For Patients and Families addresses all of those needs, and brings up-to-date important information to those living with the reality of ALS.

The book is completely revised throughout and contains NEW information on:

  • Recently developed approaches to treating ALS symptoms
  • Use of non-invasive ventilators
  • Multidisciplinary team care
  • New guidelines being developed by the American Academy of Neurology for patients with ALS
  • The use of riluzole (Rilutek) to treat ALS

Amyotrophic Lateral Sclerosis covers every aspect of the management of ALS, from clinical features of the disease, to diagnosis, to an overview of symptom management. Major sections deal with medical and rehabilitative management, living with ALS, managing advanced disease, end-of-life issues, and resources that can provide support and assistance in this time of need.

 

 

Also Recommended:

 

Don’t Buy Too Many Green Bananas – Living With ALS by Delores M. Warner

This memoir was from a journal the author kept regarding the progression of ALS (Lou Gehrig’s Disease) as her husband fought this devastating disease.

She and her husband were problem solvers, and as she cared for him at home, the two of them worked out ways to compensate for his declining strength. If you know someone who has been diagnosed with ALS, they and their families will find this book provides information on resources and approaches to dealing with the physical aspects, in the story as well as the back of the book for quick reference. As well, the author writes an unflinching account providing insights into coping with such diagnosis with grace.

 

 

I Remember Running – The Year I Got Everything I Ever Wanted – and ALS by Darcy Wakefield

A little over a year ago, Darcy Wakefield was a single, 33-year-old, athletic, workaholic English professor, a vegetarian who had never had a serious health problem or injury.

Then she was diagnosed with ALS, and her world turned upside down.

I Remember Running is Darcy’s story of change and loss and challenges during her first year with ALS, as she struggles to make sense of her diagnosis and redefine herself in the face of this terminal illness.

With unflagging courage, wit, and eloquence, Darcy shares what she calls her “fast-forward” life, a life in which she applies for disability, leaves her job, and plans her own funeral as well as meets and moves in with her true love, buys a house, and gives birth to her first child in less time than it takes most of us to accomplish even one of these things.

Beautifully written and wholly inspiring, I Remember Running proves that it is possible to live a rich, meaningful life after being diagnosed with a terminal illness. This book will move readers to see the world in a different light.

 

 

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Avoid or Slow Dementia by Building Cognitive Reserve

 

 

 

Nothing can cure or slow Alzheimer’s disease—but, what if there was a way to stave off its effects on a person’s memory and cognition?

 

 

 

 

 

Cognitive Reserve

 

Scientists have discovered a biological mechanism, called, ‘cognitive reserve,’ that allows the brain to retain its functionality despite the onset of Alzheimer’s and other forms of dementia.

The concept of a cognitive reserve arose from the observations of several independent research studies. Researchers found that certain seniors with normal, or minimally-impaired, mental functioning, actually had physical signs of pronounced Alzheimer’s disease in their brains. It was concluded that something was protecting these seniors from the effects memory-robbing disease.

Gary Small, M.D., professor of psychiatry and director of the UCLA Longevity Center, likens cognitive reserve to, “having an extra mental battery.” He says that a person with a high amount of cognitive reserve can compensate, somewhat, for the brain damage caused by disease and old age.

 

 

Hope for a damaged brain

 

As a person’s brain ages, several things begin to happen that can negatively impact their ability to think and remember, according to Small.

Brain cells begin to die, neurotransmitters don’t work as well as they did when the person was young, tissues shrink, and protein deposits begin to build-up, interfering with communication between cells (Alzheimer’s disease).

One by one, the biological ‘batteries’ powering a person’s thoughts and memories begin to wear out.

And, in the elderly, dementia is often irreversible.

There are instances where a senior may exhibit signs of mental impairment due to drug interactions or low levels of certain nutrients. These can sometimes be remedied by switching a prescription, or tweaking a diet. But, there is often very little that can be done for a senior who starts losing their memory due to ailments, like Alzheimer’s disease, vascular dementia, or Lewy Body dementia.

This is why the concept of cognitive reserve is so promising—its protective effects are thought to be capable of being harnessed by anyone, no matter what the reason for their cognitive impairment.

 

 

Building up and tearing down

 

Collecting diplomas is one of the main ways a person can build solid base of cognitive reserve. According to Small—the amount of education a person has, particularly from the undergraduate level and up—helps fortify them against symptoms of memory loss and confusion.

 

 

The Alzheimer's Prevention Program: Keep Your Brain Healthy for the Rest of Your Life by [Small, Gary, Vorgan, Gigi]

 

But those who decided to forgo getting their master’s need not worry. Education is not the only way to fortify the brain against memory impairment.

Small says learning new things and doing mental exercises to help remember names and faces can also help beef up a person’s cognitive reserve. In his book, “The Alzheimer’s Prevention Program,” Small describes one such exercise: LOOK, SNAP, CONNECT.

Designed to help a person remember and associate names with faces, this exercise instructs people to concentrate on a new acquaintance’s name (LOOK), take a mental snapshot of their name and face (SNAP), and then synthesize the mental pictures to link the acquaintance’s name and face in their mind (CONNECT).

 

Sue Maxwell, M.S.W., director of Older Adult Services at Lee Memorial Health System, feels that simple lifestyle changes can also help a person’s mind become less susceptible to dementia. “Pretend you’re in a world where there are no paper and pencils—you have to remember things on your own,” she says.

Research has also linked being socially active to having a larger cognitive reserve.

There are certain things experts believe may hinder or deplete a person’s mental power cache.

Chronic stress and a sedentary lifestyle are proven brain-drainers. Scientific evidence indicates that stress may as much as double a person’s risk for developing Alzheimer’s.

 

 

A healthier brain at any age

 

When it comes to cultivating a healthy brain, “It’s never too late, and never too early to start,” Small says.

There are benefits to starting sooner, but evidence indicates that people can still enhance their brain functioning even when given a short period of time. According to Small, dramatic improvements in cognitive ability have been seen in people in their 60s, 70s, and 80s who adopt a program to stave off dementia.

Doctors even recommend that people who already have signs of cognitive impairment should try to stay as mentally active as possible.

 

 

Every little bit helps

 

What constitutes a mentally engaging activity will vary, depending on a person’s level of cognitive impairment.

Small says that any type of stimulation helps, and a caregiver may have to adjust an activity’s level of difficulty to fit a senior’s capability. For example, if your elderly loved one enjoys reading, but can no longer handle adult books due to their dementia, they may need to downgrade to a children’s book.

 

Here are a few examples of easily-modifiable activities that may be good for seniors with Alzheimer’s:

 

1. Stick to simple pleasures – Keeping things simple and straightforward is often the best course of action when coming up with activities for people with Alzheimer’s. Going to a local park to feed the birds and fish is an easy task that may be very fun for a person with Alzheimer’s.

 

 

You can also take turns reading a favorite book aloud. This can be an easy way to encourage a senior to exercise their mind while giving them the pleasure of reading a beloved book.

 

2. Listen to music – Research has shown that listening to music can help a person with Alzheimer’s remember events, people, and places from their past. Additionally, music can be a way to get a senior moving through dance or song.

 

 

3. Cook and clean – You can turn mundane, daily tasks into activities that a person with Alzheimer’s can help with. Even if they just help with measuring ingredients, having a senior help you cook a family recipe can be a fun way for both of you to spend some time together. An elderly loved one might also be able to help you do things around the house like dusting or folding laundry.

 

 

4. Work up a sweat – Exercise provides countess benefits to all seniors, regardless of whether or not they have Alzheimer’s. Workouts can consist of everything from talking a walk around the block to taking a yoga-for-seniors class.

 

5. Play a game – While you probably don’t want to start a game of Risk with your elderly loved one, it’s possible to make an entertaining, personal game out of things lying around the house. Sorting through old family photos is a good way to help an elderly loved one remember special events and people from their past. You can even turn a routine trip to the grocery store into a scavenger hunt where you and your loved one search for particular items on a list.

 

Recommended: Match the Shapes For Dementia and Alzheimer’s

 

  • Designed specifically for people with dementia – age appropriate, not childish. No mention of “dementia” or “Alzheimer’s” on the product or packaging
  • 36 brightly colored tiles draw people’s attention
  • Colored templates help the person be successful
  • Tested with people at various stages of dementia to ensure that it is well-suited, and enjoyed
  • Full instructions detail how to present the activity to ensure that the person feels a sense of satisfaction and accomplishment

 

 

6. Volunteer – Devoting time to helping other people can provide immense satisfaction to both you and your elderly loved one. Volunteering can involve something as simple as collecting things like school supplies, toys, canned goods, etc., and taking them to a local shelter or food bank. Seniors who can’t leave the house could help by sorting, wrapping, or taking inventory of collected goods.

 

These activities will require varying levels of patience on the part of the caregiver. A loved one with Alzheimer’s will not be able to perform tasks perfectly, if at all, and seniors are likely to get frustrated is an activity is too difficult. It will take constant trial and error to create and modify activities to meet an elder’s shifting capabilities.

The existence of cognitive reserve is not yet a well-researched concept and no one is sure of exactly how effective it is at warding off dementia in the elderly. Existing evidence suggests that having an extra cognitive stash is beneficial. But, the advantages can vary from person to person, and generally diminish as their dementia progresses.

Still, Maxwell says that there are proven things people can do to protect their aging brain.

The key, according to Small, is coming up with a plan and sticking to it.

A combination of a healthy brain diet (full of antioxidant-rich fruits and veggies and fish as well as nuts that contain omega-3 fats), exercise, stress management, and mental stimulation will help a caregiver and their elderly loved one preserve their cognitive capacity.

 

Recommended: Genius Brain Power

 

Why Genius Brain Power Is Your Ultimate Self Mastery Tool Kit

The highly advanced entrainment technology used in the Genius Brain Power system is far more effective than offerings in much higher priced products, mainly because other companies use a very old type of Brainwave Entrainment that was discovered 150 years ago, called binaural beats.

Those less effective binaural beats send differently pitched frequencies into each ear to get your brain to “do math” and entrain to the difference between the two pitches.  Binaural beats were a great discovery, but many people don’t respond very well to this method of entrainment. 

 

Genius Brain Power uses a far superior, much more modern brainwave entrainment technology.

 

Brain Wave Entrainment Increases Intelligence

 

Utilizing computer generated, rhythmically pulsed beats (known as Isochronic beats), Genius Brain Power easily guides your brain into optimal frequencies for rocketing your IQ, deep relaxation, peak mental efficiency and much more…

The biggest of many advantages Genius Brain Power (GBP) has over binaural beats is that the brain doesn’t adapt to GBP’s rhythmic tones over time and ignore them, like it does with binaurals. This means GBP will continue to give you results for years, so you can keep improving your brain without having to buy more products.

Rhythmic frequencies are the basis of how the brain operates, so your brain is guaranteed to respond to Genius Brain Power’s pulsed brainwave rhythms. 

With these audible, computer generated pulsed tones, the brain is safely, gently and effectively guided to entrain to your most optimal brainwave frequencies.  These tones need to be audible, so you will hear them along with the music in the Genius Brain Power package.

 

Brainwave entrainment lights up your brain

The main thing you should remember here is that rhythm is one of the most basic functions in the human brain, so everyone’s brain responds to rhythm, including yours.

The brain’s natural response to “follow” or “entrain” to certain types of rhythms, coupled with my years of experience creating brainwave entrainment audio tracks has led to this breakthrough technology that I could only be  called “Genius Brain Power” because no other description really comes close.

 

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