Dementia without medication

In 2013, a nursing home in Maine eliminated the use of antipsychotic drugs from their dementia ward. That same year, a New York facility went from 38% in 2009 to 11% of their patients on them.  In 2015, California reported only 15% use of the mind-numbing, fog creating meds to subdue people in memory facilities.

In 2012, the Federal Government started regulating the use of antipsychotics in nursing homes. Several studies had shown that use of these drugs caused falls, strokes and even death. Could it possibly be that geriatric psychiatrists are now beginning to see that it is not only possible, but preferrable, to care for the elderly with memory issues in more – yes, I’ll say it – humane and thoughtful ways?

Continue reading

Home nursing

Out of the thousands of books I have in my mother’s and my combined library, my eyes rested on “Beeton’s Book of Household Management.” I pulled it off the shelf and settled in with a hot cup of peppermint tea.  I glanced through this facsimile of Mrs. Isabella Beeton’s 1861 tome, which outlines observations on all things from the history of fishes to making soups, jellies and puddings, to the management of the housekeeper and domestic servants. I was particularly interested in her chapter on Invalid Cookery, and although  it didn’t shed much light on the subject – at least not much that I could use – there was a passage that I was compelled to duplicate here:

“(2416) All women are likely, at some period of their lives, to be called on to perform the duties of a sick-nurse, and should prepare themselves as much as possible, by observation and reading, for the occasion when they may be required to perform the office. The main requirements are good temper, compassion for suffering, sympathy with sufferers, which most women worthy of the name possess, neat-handedness, quiet manners, love of order, and cleanliness. With these qualifications there will be very little to be wished for; the desire to relieve suffering will inspire a thousand little attentions, and surmount the disgusts which some of the offices attending the sick-room are apt to create. Where serious illness visits a household, and protracted nursing is likely to become a necessary, a professional nurse will probably be engaged, who has been trained to its duties; but in some families, and those not a few let us hope, the ladies of the family would oppose such an arrangement as a failure of duty on their part. There is, besides, even when a professional nurse is ultimately called in, a period of doubt and hesitation, while disease has not yet developed itself, when the patient must be attended to; …”

Continue reading

Living naturally

Every once in a while I have to stop and think about how grateful I am that I was raised in a household that wasn’t guided solely by the medical community, and recent events have made me even more appreciative. I realize how fortunate I am that I do not have to adhere to the generally held beliefs and fears that prevail in today’s society about healthcare.

I suppose I see the world through a different ‘lens,’ and one that others find hard to see through because of their upbringing. A lens that advocates for clean, healthy eating and living, but other than that, assumes that the body will fix itself…or it will not. Sometimes, the best ‘remedy’ is to intelligently do nothing. Rest/sleep, water, fasting and sunshine can do a lot to promote health. And they don’t cost a thing.

Continue reading

Dementia and hallucinations

I saw a question on a favorite caregiving site about how to handle a loved one who claims to be seeing dead people.

If you are not familiar with the practice, don’t laugh, because people with dementia – especially the Lewy Body type, see strange things all the time. Once, my mother swore there were spiders or bugs all over the ceiling, and another time she recounted the conversation she had with her mother, who passed away in 1948.

She also erroneously claims that she just washed her hair, or took a shower, ate a huge meal, or walked uptown. So the issue is not whether or not what they say is real, it’s your reaction to what they say that is in question.

Continue reading

Let us cultivate our garden.

Some days are harder than others… Today was ‘one of those days’.

Sometimes I get kind of blue. I realize the inevitable will happen one day: my mother will pass, and I’ll grieve, but Life will go on and I’ll be OK. Sometimes I feel depressed because I recognize that my mother could possibly live for another ten years, and I’ll be 75 years old and still taking care of her! Then I feel guilty because of my depression about that!

I grabbed my journal and wrote furiously for about an hour. Writing has always been my way of letting off steam, clarifying feelings, setting goals and working out conflicts. I couldn’t even tell you what I said in it other than I ultimately realized that I was living in the future, worrying about things that I don’t have to deal with today.

All I really have to do is take care of today. Be in the moment. Practice mindfulness.

Yesterday, I took a book off my library shelf that I found in my attic when I moved into my home back in 1982. It was a Literary Guild Book from December 1929 and I’ve been telling myself for over thirty years that I would read it. I finally did.

The book was Candide by Voltaire. Inside the front cover was a copy of Wings, the Literary Guild of America monthly magazine, which said that the edition was “the finest piece of book-making ever achieved in the United States.” At the time, it cost twenty dollars, which would be $276.63 today. Amazing.

Even though Wings reviewed Candide as “an established masterpiece, and the “quintessence of all the books in which wisdom, wit and malice are brought to bear upon the spectacle of human life,” to me, it was at first glance absolutely ridiculous! It was like a grown-up cartoon where no matter what you do to the main character, he keeps popping back up.  But I kept reading.

The secondary characters are stereotypical and caricatures of the aristocracy, the clergy, Jews, Protestants, religion in general, the government, bankers – Voltaire leaves no one out! (Which is why he was imprisoned and banished several times in real life.) He makes fun of everyone, and even in the face of robbery, murder, floggings and worse, Candide recites what Pangloss, his philosopher teacher, taught him as a young boy, “All is for the best.” (If you truly believe that, I suppose you can rest easy, and though you still may suffer, your suffering will not be in vain.) Halfway through, I found I was actually enjoying the book.

The conclusion to the story sets everything right, as far as I’m concerned. When all the loose ends are tied and Candide and his troop are living quietly in the country, boredom strikes and makes them long for their days of excitement. Candide meets a farmer and his family who are living each day in perfect contentment, tending their fields. He reflects on their industry and the farmer’s prescription for freedom from boredom, vice and need. They do not pontificate, moralize or sermonize. They do not indulge in long political and religious discussions. They simply live and work, enjoy each others company and the fruit of their labor.

When he returns home Candide shares his insight. “Let us work without theorizing,” one of the characters says in response. “It is the only way to make life endurable.”

I like the translation of my edition, rather than the one I found on the internet. Mine reads: “The whole small fraternity entered into this praiseworthy plan, and each started to make use of his talents.”

Occasionally though, Pangloss starts to philosophize about how each event is linked with all the others for the best possible outcome. Candide interrupts him. “Tis well said,” said Candide, “but we must cultivate our gardens.”

I must remember that line.  It’s a good one.

Is it really that simple? To do the task before us without concern for the future, or fear of the outcome? To find certainty in the fact that we are doing all we can, the best way that we can, at this moment in time? is that the best possible world? Can Candide and Pangloss BOTH be right?

I am reminded of what Thich Nhat Hanh, a Vietnamese Buddhist monk, calls “mindfulness.” He says, “When we are mindful, deeply in touch with the present moment, our understanding of what is going on deepens, and we begin to be filled with acceptance, joy, peace and love.”

Sigh. I feel better already.