Did you know that dementia is not one disease, but a name for many different brain diseases?
Before the late 1800s, dementia was an umbrella term for many types of unrelated mental illnesses, and there was very little medical understanding from ancient times. The haphazard developments in medical knowledge in this field are why we have many different conditions, lumped under one word. It is an unfortunate legacy, especially when combined with the social stigma and the wrongful association with natural aging.
Today, medical research endeavor to unravel the intricate web of dementia so we can have a better understanding of these diseases, in the hope of prevention and one day – a cure. Though there are many types of dementia, the most common ones are Alzheimer’s and vascular dementia, according to the Alzheimer’s Disease Association.
1. Alzheimer’s disease
Alzheimer’s is a “type of dementia that causes problems with memory, thinking, behavioral and other intellectual abilities serious enough to interfere with daily life”, according to Alzheimer’s Association. Alzheimer’s disease makes up some 50%-70% of dementia cases – there is a clear organic process of deterioration. The early symptoms of Alzheimer’s are difficulty remembering recent conversations, names or events, as well as apathy and depression. As it progresses, symptoms include impaired communication, poor judgment, disorientation, confusion, behavior changes and difficulty speaking, swallowing and walking.
2. Vascular dementia/ Multi-infarct dementia
Previously known as post-stroke or multi-infarct dementia, vascular dementia is caused by problems in the brain’s blood supply, often after a series of strokes or bleeding in the brain. The location, number, and size of the brain injury determine how the individual’s thinking and physical functioning are affected. The early symptoms of vascular dementia are impaired judgment or ability to make decisions, plan or organize. Memory loss is not a common initial-stage symptom in people with vascular dementia as it is in people with Alzheimer’s.
3. Dementia with Lewy Bodies (DLB)
DLB is a type of “progressive dementia that leads to a decline in thinking, reasoning and independent function because of abnormal microscopic deposits that damage brain cells over time”, as per Alzheimer’s Association. Medical science doesn’t know what causes DLB, but it is specific enough – there is cognitive decline and can only be confirmed by a post-mortem brain histology that shows Lewy bodies in the neurons. People with DLB often have early symptoms such as sleep disturbances, well-formed visual hallucinations, slowness, gait imbalance or other parkinsonian movement traits. Memory loss and thinking problems are also common symptoms in DLB as it is in Alzheimer’s.
4. Parkinson’s disease dementia/ Mixed Dementia
Alzheimer’s Association explains Parkinson’s disease dementia as an “impairment in thinking and reasoning that begins in a region that plays a key role in movement”. Changes in the brain gradually spread and initially affect mental functions, including memory and the ability to pay attention, make sound judgments and plan the steps needed to complete a task. An estimated 50 to 80 percent of those with Parkinson’s eventually experience dementia as their disease progresses, according to Alzheimer’s Association. The average time from onset of Parkinson’s to developing dementia is about 10 years. If dementia develops, symptoms are often similar to dementia with Lewy bodies.
Mentioned above are only some of the common types of dementia, and up-to-date there are over nine types discovered. As different types of dementia can have similar overlapping symptoms, it may be difficult to diagnose dementia just by the symptoms alone. Take note of the signs and early symptoms of dementia. People with deterioration in cognition and personality should seek medical help upon the onset of symptoms. Alzheimer’s Disease Association offers help through programs and support services for patients and their families.
It is often said that home is where the heart is, but how do you decide where home should be as you or your loved ones age and health decline? Whether you are facing the decision personally or helping an aging parent decide where to live out the golden years, there are many factors to consider. This article will review the key issues that must be addressed when making this decision and also look at how to find resources to support your decision.
First let’s take a look at your main options: independent living/remaining in one’s own home, living with family, or moving into a nursing care facility or assisted living facility.
Independent Living/Remaining in One’s Own Home
This simply means continuing to live in your own residence or perhaps downsizing to a smaller, easier to care for dwelling, but enlisting minimal help, if any at all.
Living with Family
As they age, some people choose to move in with family members who can help care for them, or to have family move in with them.
Nursing Care/Long-term Care Facility
The care provided in a nursing home/long-term care facility care can vary and is usually most appropriate for someone whose needs exceed those that can be met by family and/or community supports.
“Often this is someone who has significant medical issues that need to be monitored and managed frequently by skilled nursing,” said Erin Frankenfield, a social worker with the Central Ohio Area Agency on Aging (COAAA). “Or, this might be someone who has significant memory impairment and requires special programming and supervision to ensure their safety is met, as well as activities tailored to their cognitive capacity. Nursing homes have some private rooms available, but those are more costly. Usually, you have a semi-private room that you share with someone else. Medicaid will only pay for a semi-private room.”
Assisted Living Facility
“An assisted living facility can be an appropriate choice for someone who can live in their own private room,” Ms. Frankenfield explained. “However, there are some facilities that are specific to memory care and severe dementia patients. Also, assisted living has regular nursing care but not as intensive as that provided in a nursing facility. Assisted living facilities often provide meals, homemaking and a living space that is more ‘homey’ rather than ‘medical’ (like you would find in a nursing facility). Often, assisted living facilities will be more selective about accepting patients with extensive medical issues, partly due to the capacity of the facility to safely and adequately care for the multiple health complications of someone who has several and severe health issues.”
Making a Decision
Determining where you or a loved one should live in the autumn of life is a big decision and should not be made lightly.
“When figuring out how to choose the appropriate care setting for someone, it’s important to first determine how much assistance someone requires to complete their activities of daily living (ADLs),” Ms. Frankenfield said.
- Managing medication
- Handling environmental tasks such as shopping, laundry, cooking and cleaning
- Heavy chores
- Yard work
- Home maintenance
- Bathing, dressing, grooming
- Mobility – getting in and out of the shower/bath, up/down the stairs, in/out of bed, ambulation – getting from point A to point B
- Making phone calls
- Driving or arranging transportation
- Managing finances/legal matters
“It is also important to consider whether there are any memory deficits or ongoing issues with confusion,” Ms. Frankenfield said. “For example, are they forgetful about whether or not they have eaten or taken their medication? When they leave the home alone, do they get lost? Do they get out of bed in the middle of the night and wander?”
After taking an honest and thorough look at how much help someone requires, next, it’s important to determine if there are enough family and/or community supports to sustain that person either in their environment or in a family member’s home.
“There are options for living in the community with assistance,” Ms. Frankenfield said. “There are private pay home health companies that supply trained personal care aides to assist with ADL tasks, cleaning and running errands. Paying privately for care in the home can be costly, and choosing a company is difficult as there are a lot of companies out there. The cost of private paying for a personal care aide can range, and most companies would like someone to commit to a block of time versus an hour.”
For those who opt to remain in their own home or live with a relative, many communities provide a plethora of senior services, which could include home-delivered meals, a homemaker and/or personal care aide, emergency response pendant, assistance with obtaining durable medical equipment such as hospital beds, wheelchairs, grab bars, shower chairs, etc.
“In Columbus, Ohio, for example,” Ms. Frankenfield said, “there is a program called Senior Options, or for someone who requires a lot of assistance with personal care and is Medicaid eligible, there’s a program called PASSPORT managed through the Central Ohio Area Agency on Aging. These two programs are designed to assist people who meet certain income guidelines and who require a certain level of assistance, so they can live in the community setting with supports. COAAA also offers a lot of other resources and assistance with information about long term care, and they are always available to take calls for such information.”
To find resources in your own community, try Google searching for “resources for seniors” in your city or state, or visit the Administration for Community Living website.
“Living in the community can also be enhanced by using an adult day program,” Ms. Frankenfield said. “Usually, they provide transportation. These type of programs are convenient for a working family that needs to have their older adult family member in a safe environment during the day while the working members of the family are not able to be home with them.”
To find information on adult day programs, residents in Central Ohio can contact the COAAA. In other areas, you can conduct a Google search for your city and state plus “adult day programs.”
National Church Residences also has several programs in Columbus and throughout the United States.
Funding the Care Scenario of Your Choice
Whether you and your family choose care at home or in a facility, there will be a significant cost involved.
“Older adults and their families need to look honestly at what they can afford as far as time and money to safely and reliably support the care needs of the family member concerned,” Ms. Frankenfield said. “The cost of private pay for a nursing facility or assisted living is very expensive, and both the cost and quality of the facilities range widely. There is a useful link on the Medicare.gov website: ‘Find Nursing Homes.’ It links to different nursing facilities, including their ratings and is a good place to do research.”
There are four different sources for funding a stay in a nursing facility or assisted living facility. These are:
1) Private pay
2) Long-term care insurance
“Medicaid is state-funded insurance, and eligibility is based on income and assets,” Ms. Frankenfield explained. “If someone has several assets and would like to explore qualifying for Medicaid, they could consult an elder law attorney for assistance in determining how or if these assets could be protected.”
Regardless of the decision you make, it should not be arrived at lightly. Take your time to really consider all of the key issues and research your options so you can make the best decisions for you and your loved ones.
Self-compassion: can I be kind to myself?
As M. Scott Peck, author of the New York Times bestseller The Road Less Traveled: A New Psychology of Love, Traditional Values and Spiritual Growth said, “Life is difficult. This is a great truth, one of the greatest truths. It is a great truth because once we truly see this truth, we transcend it. Once we truly know that life is difficult-once we truly understand and accept it-then life is no longer difficult. Because once it is accepted, the fact that life is difficult no longer matters.”
Naturally, this sounds a lot easier to accept in print than reality but alongside my attempts to be more mindful on a daily basis, I have found self-compassion the most crucial and empowering in understanding and accepting that life is hard, so we should not be harder on ourselves.
I do believe that we are often our best and worst critics, and at times we may take tough love a bit too far when we are too quick to judge and even condemn ourselves for our thoughts and actions. The result – a somewhat downward spiral emotionally and spiritually that yields no good for anyone. Let’s face it, everyone has different stressors in life but that is no reason for us to forget to be kind to ourselves.
I have observed that while many people openly promote consideration and compassion for others, more can be done to start with ourselves by being less unkind in our choices of words used and be slower to label our actions and inner thoughts. Even though we think that others don’t hear them, our minds and bodies are conditioned by the way we frame our thoughts so let’s do ourselves a favor and practice some self-kindness. This could take the form of simple steps such as:
- Saying something kind to yourself each day when looking into the mirror or walking on the way to work or home.
- Penning a few encouraging words in a journal or in the notes section of your handphone and reflecting on them afterward in between breaks.
- Keeping a ‘happy box’ of memories comprising compliments and kind words others have shared about you over time and looking through them once in awhile. This may seem a tad bizarre but it does wonders for your soul (provided it does not become self-infatuation). I am an old school so I keep a physical box of cards and handwritten notes sent to me over the years for old times’ sake. Recently, I’ve progressed to snapping pictures of them before they fade away and that way I get to keep them handy on my phone too. If you prefer, you can start by keeping screenshots of encouraging and kind text messages that someone sent as well.
‘Mindfulness is practiced non-judgementally’
“Expectations just keep getting higher, you just need to manage them.” I first heard this comment 17 years ago and it keeps resonating with me because there is no denying this, especially when people are involved or should I say especially when the family is involved.
Where expectations exist, judgment almost follows immediately – it is such a reflex instinct that seeps into our daily lives without us even paying close attention to it.
I struggle the most with this aspect of mindfulness because I am prolific in judging everyone around me and I genuinely believed that others were doing the same to me so it’s just the way the world worked. However, as time passed, this habit became toxic and I needed to do something about it, fast.
This whole business about expectations spiraling was a double-edged sword and it hit me only after I lost a loved one in my life. Suddenly, I blamed everyone around me for not showing enough help, concern, and support during this lowest point in my life and I criminalized them for what they did or did not do and even what I assumed they thought. Secretly, I had become a travel agent for guilt trips and it became so painful facing them when I had so much bitterness. It also did not help when other family members joined the ride adding spice to make things worse.
Eventually, it took me close to three months to ease out of the pain and talk to a friend about all this judgment I was inflicting on my family, my friends and myself. I realized that:
- Expecting anything from anyone can do more harm than good: in general, I found this a handy reminder. It is always so much more meaningful and gratifying to receive offers of help or concern when you don’t or least expect it. Instead, setting expectations on friends and family may get you more disappointed and worn out. I am certain that I have let people down before so why should I judge them more than I was ready for?
- The beauty of the earlier point is the fact that you can apply it to yourself as well: as long as you feel genuinely happy doing something for someone else, go right ahead and if you don’t, then free yourself from the fear of being judged by others. This is truly liberating as it gives you the option to respond rather than living up to expectations, imagined or otherwise.
- Being open in using the disclaimer “please don’t judge me for xxx” can be a useful lead in conversations with others. This has become a common catchphrase among close friends when we share certain stereotype views or deep-seated beliefs that most people are generally not comfortable discussing openly. I have found that this gives people a sense of assurance as a conversation starter and if anything, it encourages an open dialogue, tilting the attention more towards safe sharing rather than hasty judgments.
‘Mindfulness is knowing what is on your mind’: especially when you’re stressed
“How am I supposed to know what’s on your mind?”
I have known many people who wished they could read minds – but alas that special power continues to elude us. But we could start with something more tangible by getting to know our own mind a little better ☺ Knowing one’s mind takes more than intuition to simply decipher matters of the mind as we evolve over time. To make things more challenging, stress complicates and often clouds our minds. Some of the ways I have tried to obtain greater clarity of mind are:
- Putting the “ME” in Meditating: I have to admit that I fell asleep rather often as I tried meditating so I needed to find another way of spending this alone time with myself. So, I adapted it and chose to verbalize my thoughts in a quiet space on my own. This was a lot more useful to concentrate on my key thoughts and developing a comfort level to speak my mind.
- Seeking my center: now and then, I need some time away from everyone just to be alone and be with my thoughts while doing simple activities. For some of my friends, trekking does wonders as the natural setting is so serene that it conditions them to spend time with their own minds and focus on getting from one point to another. For me, it’s a hybrid between window shopping and people watching. For some strange reason, these two activities provide an ideal context for me to calm down and collect my thoughts as I observed who and what was around me.
- Penning it all down into words: this works for me since I’m a journal enthusiast so it all comes down to putting my thoughts into words, especially when I am stressed. It helps me develop a comprehensive discussion with my thoughts while considering some realistic solutions to reduce the stressors. More importantly, it makes for really authentic reading on hindsight.
Is Mindfulness the Way To Go?
I believe it is and after seven months of living in moments of mindfulness, I am a lot calmer and appreciative of this state of awareness. Given my personality and passion for life and people, mindfulness takes me a step closer to helping myself before I attempt to help others as an educator, communications practitioner, and just a fellow human being.
So go ahead, have fun on this journey of awareness and be mindful of how you evolve as a person.
If you are still keen to find out more about mindfulness, you may want to check out these resources as well – I know I will be!
Quit Telling Me to Keep Calm….I’m Mindful of It!
I’m hardly a fan of these ubiquitous ‘Keep Calm’ posters, just because you see them almost everywhere and almost anything goes after the first two words. Or maybe it is because I have an aversion to the words “keep calm”. The reason is simple.
It gets personal, almost always when people around me start telling me to be calm when I’m about to explode or implode. The well-meaning colleagues, friends and loved ones around me have been sensitized to my moods, dislikes and can easily spot how my temper gets ignited. I am not going to deny it – my temper is not high (but it is seeing better days now). And the toughest part of it all is that I am caught between showing my anger and concealing it, simply because I worry about how others view and judge me. So either way, it seems like I faced a losing battle for a long time.
Sometime last year, my close friend Erin mentioned that she was pursuing a Masters of Science in Studies in Mindfulness and I was a little too polite to express my inner thoughts of “why on earth would anyone study a subject like that?” I kept my opinion to myself and heard more from her about the practice of mindfulness and realized that she was very committed to it.
Seven months ago, she invited me to attend a session on mindfulness, and I am glad I kept an open mind despite not knowing what to expect from it. It introduced the key concepts of mindfulness and explained the stereotypical views attached to the practice of mindfulness. There, I decided to give it more thought, and before I knew it, there seemed to be an exponential growth in articles, media coverage and talk about mindfulness everywhere I looked. If you’re keen on finding out more about how to practice mindfulness and its benefits, you would be pleasantly surprised to know that there are many options available in Ohio. Just check out the three possible resources links here:
- Mindfulness Based Stress Reduction classes in Central Ohio
- Mindfulness Guidance and Training
- Mindfulness Meditation
Mindfulness: A Matter of Myth and Fact
It became clear to me that mindfulness as a practice was gaining currency in education, mental wellness and the corporate spheres where thousands of articles were written recommending best practices maximizing the value and benefits. But the underlying premise seems to radiate from oneself. I am certainly no scholar or trainer in mindfulness, so the focus of this article is merely to share how mindfulness has helped me in being kinder to myself by intentionally keeping an open mind regarding how I manage my thoughts, emotions, and actions, especially in coping with stress and relating to others.
I started by finding out as much as I could about mindfulness and cleared up some of the previous misconceptions that I had, such as:
- Myth: mindfulness is synonymous with religious practices, fact: it is widely practiced across the secular world.
- Myth: mindfulness is all fluff and worthy of attention only if you have too much time on your hands, fact: practicing it does, in fact, save you more time, headache and heartache.
- Myth: mindfulness is a flavor of the month and a passing phase, fact: it has been around for as long as 2500 years.
- Myth: mindfulness can be a perfect panacea to all your problems, fact: there is no such thing – mindfulness is a valuable tool to complement stress and problem-solving techniques (medical or non-medical).
According to Jon Kabat-Zinn, founder of the Mindfulness-Based Stress Reduction program, “mindfulness” is defined as “awareness that arises through paying attention, on purpose, in the present moment, non-judgementally,” says Kabat-Zinn. “It’s about knowing what is on your mind.”
As I read this quote, a few keywords jumped out at me, and I thought it fitting to describe my experience with mindfulness based on them.
Keeping Yourself In Mind
- ‘Mindfulness is awareness…on purpose.’Being aware is simply a state of being conscious about something, being informed or attentive. Achieving awareness of purpose suggests a keen intent to direct that sense of awareness. In other words, taking the effort (and time) to be meaningfully conscious of facts, events, people or anything in our surrounding.As an educator and communications practitioner for the past two decades, I have met countless individuals who could have benefitted so much, just by increasing their awareness of the things and people around them. These people include 50-year-old team managers as well as 17-year-old youths who face challenges being mindful of their environments and their struggles with stress. Often, awareness is the last state of mind they want to embrace because it’s hard work and the truth sometimes hurts. Almost always, these individuals genuinely believe that they are aware of the problems they face but are very reluctant to consider their options in solving these issues and making small changes. I know because I’ve been there.It’s no mean feat being aware of your authentic self- perhaps because we doubt that we know ourselves well and we struggle to accept all of ourself. As part of this state of purposeful awareness, I have chosen to discuss two sub-components of consciousness, namely self-awareness and self-compassion as these two aspects seem vital to opening up to oneself before practicing mindfulness.Self-awareness: try walking in someone else’s shoes?
One of the things that typically irk me when feedback (usually negative) is provided, is when the accompanying comment is “please don’t take this personally because it’s not.” My internal response to that used to be “HOW CAN IT NOT BE PERSONAL WHEN IT IS ABOUT ME????” yes, in full SCREAMING UPPERCASE.
It was hard, and I needed to calm down, I just didn’t need to hear it coming from someone else. So I asked myself:
- If hearing from someone else was so difficult, could I take it coming from myself? Well, I would never know unless I tried it. So I did – and it took some time being mindful that this was when my sense of empathy kicked in, both for others and more importantly, for myself. I wanted to intentionally consider the reasons and feelings of others when processing my emotional responses before taking any action.
- Am I able to walk in someone else’s shoes and see their view? To do that, I needed to get comfortable in mine for starters. So I would honestly explore my emotions and actions and whether there were certain emotional minefields triggered with the feedback. After all, that knowledge would only be transparent to me, based on my experiences, upbringing, and beliefs.
- Can I be humble enough to consider the reasons that the specific feedback was shared, to begin with? If I considered the intention and behavior of the sender (of the feedback) and I was able to see that the motivation was to build me up rather than tear me down – it became a lot clearer that I was better off moving forward rather than moping around. The litmus factor that helped here was to consider the sender’s relationship with me (either professionally or personally) to help discern their intentions either over a period of time or from a one-time session.
To be continued…..
The medical journal American Family Physician reports that falls are the leading cause of injury-related emergency department visits and the primary cause of accidental deaths in adults ages 65 and older. In fact, according to the National Council on Aging, approximately one in three adults ages 65 and older falls every year. It is no surprise that fall prevention in the elderly has become a priority for most caregivers.
“Injury from a fall is definitely a concern as we age,” said Timothy Kirkpatrick, MD, an emergency department physician. “The core becomes weaker, balance degenerates, reaction time slows, vision dims, and we cannot compensate quickly when off-balance. Falls can have serious repercussions, including hip fractures and head trauma.”
Some signs that you are or a loved one is at risk of falling include an unsteady gait or a gait that includes a lot of shuffling. You also want to pay attention to how many steps can be taken without assistance. This may be the primary step to assess any fall-related risks for injury prevention in the elderly.
“It’s important to have your vision checked frequently, including assessing for potential cataracts and macular degeneration,” Dr. Kirkpatrick said.
He continued: “You also want to be aware that certain medications can make you dizzy. Pain medications, especially if new to you, can make you loopy, fatigued and less aware of your surroundings. Pay careful attention to how you feel any time you start a new medication such as antibiotics, blood pressure medications or blood thinners, or any time the dosage of one of your medications is adjusted. Even some over-the-counter medications can affect how steady you are on your feet, such as antihistamines like Benadryl or medications marketed as sleep-aids.”
Additional risk factors, according to the United States Centers for Disease Control and Prevention, include:
- Lower body weakness (one sign of this is needing to push with your hands when standing up from a chair)
- Vitamin D deficiency (that is, not enough vitamin D in your system)
- Foot pain, numbness in your feet or poor footwear
- Needing support – such as from a cane or walker – when walking
- A history of falling – people who have already fallen once are more likely to fall again.
- Home hazards or dangers such as
- broken or uneven steps,
- throw rugs or clutter that can be tripped over,
- no handrails along stairs or in the bathroom, and
- dimly lit doorways, steps and stairwells.
Most falls are caused by a combination of risk factors. The more risk factors a person has, the greater their chances of falling.
Dr. Kirkpatrick recommends taking the following actions to help the risk of a fall or injury from a fall:
- Remove throw rugs.
- Provide good lighting.
- Remove or secure carpet and treads on stairs.
- Ensure all cords are out of the way/never crossing a footpath.
- Refrain from rearranging furniture, as people are more likely to bump into or trip over things if the layout they are familiar with changes.
- Eliminate clutter – keep kids’ toys picked up, and don’t stack things like magazines and papers near a doorway or stairway where they might be knocked over into the footpath.
- Install hand rails where needed – ensure they are secure and don’t wobble by bolting them into studs rather than anchoring into drywall.
- In the winter, ensure all outdoor walkways are kept thoroughly shoveled and well salted.
- Get rid of any glass-topped tables
- Install non-slip tread strips or bath appliques on bathtub and shower floors.
It is important to note that some fall-related injuries actually occur when people are struggling to get back up from a fall, Dr. Kirkpatrick said, and can even occur without a fall.
“When a hip breaks,” he said, “it is often not the fall that breaks it but the act of getting back up or twisting/turning when standing, and hips can even break from the simple action of getting up from a seated position. To reduce the risk of breaking a hip, chairs for the elderly shouldn’t be too soft and deep, and of course they should not be unstable. Also consider installing handrails to help get off the toilet or out of the shower.”
It is possible to reduce the risk of breaking a hip as described above and to modify the overall risk of a fall/fall injury by developing or improving good self-care habits.
Dr. Kirkpatrick recommends eliminating or reducing alcohol consumption, and exercising regularly to improve balance and strengthen the core. The CDC especially recommends Tai Chi to improve balance. You also can talk with your doctor/advise your loved one to talk with his or her doctor about fall prevention.
Remember the last article about taking a break?
Some people say it also helps to take a break from the modern daily diet, and skip a meal or fast from time to time – but you would have to be careful about the thousand and one things that fasting is supposed to do for you. It is said that temporarily “starving” yourself can be beneficial to your health. So we explore the many health claims, and ask the million dollar question: is fasting good for you?
Let’s focus on the primary form of fasting being advertised – or condemned – on the Internet. This is Intermittent Fasting. This involves fasting in the very short term – as short as skipping one meal every two days, and up to 20 hours at a time, no more than 36 hours. There are many “patterns” for intermittent fasting – from skipping random meals to the “Warrior Diet” of feeding within a 4-hour window daily.
This is not the same as religious or “dry” fasting though – this is a nutrition-oriented fasting that involves constant hydration. Participants also take care to forego vigorous exercise or operating heavy machinery.
TAKE NOTE – there are many types of people who should not engage in fasting at all! If you are anorexic, pregnant, diabetic… We certainly do not recommend fasting! Some individuals with other conditions might also need professional medical supervision to fast safely.
Weight Loss and Metabolism
This is a sensitive one. This is not meant to be a fat-shaming or body-shaming exercise. It is supposed to promote health, and certainly, some people can have better fat tolerances than others. The point is that too much sugar can cause metabolic problems resulting in diabetes and many other related complications. Body fat has a role in this because the way food gets stored as fat also affects the way we burn energy. It seems to make perfect sense – fasting means less food, therefore less fat, right? Not so simple.
One way that fasting is supposed to help is by resetting certain hormone levels or resetting the body’s sensitivity to them. This theory is based on the idea that the body is built for alternating cycles of “feast and famine” – we are not biologically designed to eat regularly the way modern culture has imposed. An article argues that fasting helps to normalize your body’s sensitivity to leptin and insulin.
What’s leptin? It is the hormone that makes you burn fat. If it could be manufactured in laboratories, many people would become incredibly wealthy. But it cannot be manufactured yet, and improving the way the body responds to its own naturally-produced leptin is the next best thing. Fasting is supposed to improve the body’s response to leptin. But you know who else is heavy and wants to cut down fat? The bodybuilder. And bodybuilders manipulate leptin not by increasing their body response to leptin, but by increasing their leptin levels… through eating more. They do this on their “cheat days” because their regular exercise patterns burn a ton of calories, and result in leptin levels dropping. This makes sense – the body is getting leaner, working harder and burning lots of fat, so why should it be producing more fat-burning hormones?
Another related hormone is ghrelin, which makes you feel hungry – regular unnatural food intake supposedly interferes with the way ghrelin is supposed to work, and fasting apparently helps reset that too. Again, bodybuilders are sensitive to manipulating ghrelin levels – and fasting is not a mainstay of bodybuilders.
Improved Brain Function?
There have been claims that fasting boosts the brain by increasing levels of brain-derived neurotrophic factor (BDNF), and this helps create more stem cells. Also, fasting triggers ketosis once the blood sugar and liver glycogen run out. Ketosis is a process that converts fats into ketones, which can be used to fuel the brain. This sounds good, but ketosis can be dangerous and even fatal depending on your physical condition. So why are some websites promoting ketosis with little to no caution?
The Problem With Half-Information
These issues are the tip of the iceberg. The proposed benefits of intermittent fasting look like a wish list of “live longer”, “look better”, “feel better” and “no more pimples!” changes. However, many of the conclusions are drawn from animal studies that do not necessarily relate to human effects. More importantly, they do not account for differences in energy flux – that is, how differences in activity level can affect the many factors (e.g., hormone levels) that supposedly lead to the benefits of fasting. Guess who else experiences a lot of energy flux? Athletes and bodybuilders. They consume and burn a lot more calories than normal people do, but whether they appear fat or not, depends on a great many other factors, including the nature of the sport they practice.
Of course, there are other claims (weight loss generates a lot of interest!) that say fasting long enough will make the body burn up fibroids and bacteria and other unimportant stuff hanging around the body, thus improving health – this is the autophagy theory that is very closely related to the “detox” theory. But I am not sure how true this is.
We’re not scientists here, but if you decrease your caloric intake, why would the body metabolism increase to cause weight loss? Wouldn’t the body react to the drop in calories and… store more fat?
This is why some of the more reputable websites or articles are written by actual doctors with something to lose, either flat-out denounce the benefits of fasting or insist that it be done very carefully as part of a general exercise and diet plan.
So, just how beneficial is intermittent fasting for the body? It may be advantageous, but I would take a lot of what is written on the Internet with a pinch of sodium… and potassium.
Please also be careful before you start fasting – as with any new regimen, whether fasting, diet or exercise, try to be gentle and ease your body into it, and keep your potassium levels up with a banana or two. Shock therapy isn’t for everyone. If you want a more detailed look at creating a fasting plan for yourself, this article is pretty useful, and also sheds light on many problems with health claims floating around the Internet.
Moreover, all that is just the natural stuff. There’s lots more virtual ink spilled over whether fasting helps you spiritually, emotionally, and psychologically – but that would make this article far too long.
Until then, take care of your eating patterns, don’t forget to exercise, and do enjoy the intermittent breaks!
It is important to take a break to rest and relax, not just regularly, but also after intense periods of high-keyed activity.
At the most basic level, rest is a fundamental component of a healthy lifestyle. It rejuvenates you in both body and mind, and regular rest also helps you regulate many other things, such as mood and body rhythm. If rest is irregular or insufficient, you can be negatively affected not only psychologically, but also physiologically.
Routine rest is an important regulator. Daily sleep. Week-end breaks. Annual holidays. And a once-in-several-years’ sabbatical. Let’s take a look at the real reasons why rest is important for your health.
The most important one is the daily (or nightly one). Regular sleep has been suggested to improve attention and learning. It promotes memorization of things you have learned, through a process called “consolidation” that happens during sleep. Not only is new information consolidated, they are also reorganized and restructured with a higher emotional reinforcement that increases creativity.
It has also been suggested that getting just enough sleep – not too much and not too little – prolongs your life, decreases fatigue and increases athletic stamina.
Conversely, insufficient sleep could be dangerous. Research suggests this can lead to increase in inflammatory proteins such as C-reactive protein, which in turn can lead to a host of other complications and disorders. Pediatric studies also suggest a lack of sleep in children is what causes hyperactivity, inattentiveness and impulsive behavior.
A UCSF study cited by the New York Times shows that rats exploring new areas needed downtime to consolidate their new experiences in order to learn and map out the new area. This is the extension of the nightly consolidation we need from sleep.
Even a short walk – for 20-30 minutes, can help you clear your mind. There are other physiological forces at work, involving sleep, memory and new brain cells, that help you rebuild during a short walk.
There are more cited health benefits of regular and sufficient sleep, e.g., it helps you maintain a healthy weight, but surely what was mentioned above is more than enough. Moreover, a couple of years ago, scientists discovered one new reason for sleep – our body uses sleep time to flush out waste products from the brain. Little wonder that sleep is crucial for all living organisms – at least those that aren’t dysfunctional!
What about weekly breaks? Most places have a weekend culture, and this is linked to religious cycles. There are the Jewish Sabbath and the Christian day of rest, and many other civilizations had their time cycles that roughly corresponded with one week, and includes a special day set aside for rest, and other non-work activities.
However, the weekend has probably become more important now than before, due to the advances of technology – the internet and mobile communications do not rest. They keep us plugged in 24 hours a day, seven days a week. This is where downtime is needed. A 2010 study published in the Journal of Organizational Behaviour shows that weekend breaks are necessary to replenish resources, in addition to nightly sleep.
What about the health effects of annual vacations, then? Or taking a year-long sabbatical from work?
There is some controversy over this one. Some argue that the health benefits are real. Others argue the benefits disappear within a short time. You may come across some Internet articles touting benefits that are quite dubious. For example, this one article in the Daily Mail lists food variety and getting enough sunlight as a benefit of going on a holiday. The problem is, these are things you need on a daily basis, and not for two weeks a year. A recent article by the Daily Mail claims that holidaying health benefits last for several months. The UK’s National Health Services, however, claims this is exaggerated. The NHS article doesn’t really say there are no health benefits, but it is a VERY USEFUL article to read for different reasons – it educates people on how to read and analyze online claims.
What’s going on?
Well, take a closer look and you see that these articles mostly do not deal with the more subtle, and probably the more important, benefits of annual vacations. They build unique positive experiences that last a lifetime. They give you breathing space to think about priorities and directions in life, the sort of higher-order thinking that tends to get shelved aside as low-priority stuff amid the hustle and bustle of the daily grind.
And that is where life-changing decisions are seeded, and later bear fruit. How can that be bad?
So get as much REM sleep as you can to stave off heart disease, stroke, depression, and infections. Meanwhile, I’m going to plan my next holiday…
Are you suffering from ongoing joint pain? Do you have joint swelling and/or stiffness, tenderness or pain when touching a joint, problems using or moving a joint normally or warmth and redness in a joint? If you answered yes to some of these questions, you might have some type of arthritis. If any one of these symptoms lasts more than two weeks, see your regular doctor or a rheumatologist. If you have a fever, feel physically ill, suddenly have a swollen joint, or have problems using your joint, see your doctor right away.
Arthritis – The Basics
- Arthritis actually is not a single disease but an informal way of referring to pain or disease at the joints, which are places in the body where bones come together. There are more than 100 different types of arthritis and related conditions.
- Arthritis affects people of all ages, sexes and races and is the leading cause of disability in America. More than 50 million adults – 1 in 5 people over the age of 18 – and 300,000 children have some type of arthritis. It is most common among women and occurs more frequently as people age.
- Common arthritis joint symptoms include swelling, pain, stiffness and decreased range of motion. Symptoms may come and go. They can be mild, moderate or severe. They may stay about the same for years, but may progress or get worse over time. Severe arthritis can result in chronic pain, inability to do daily activities and make it difficult to walk or climb stairs. Arthritis can cause permanent joint changes. These changes may be visible, such as knobby finger joints, but often the damage can only be seen on X-ray. The parts of the body that are most often affected include the hand, spine, hip, and knee. Some types of arthritis also affect the heart, eyes, lungs, kidneys and skin as well as the joints.
There are steps you can take to help manage your arthritis symptoms. The United States Centers for Disease Control recommends the following:
- Chronic Disease Self-Management Program (CDSMP): an effective self-management program for people with chronic health problems, including arthritis, diabetes, lung and heart disease. Developed by Stanford University, the program is held in community settings and uses workshops led by people who have personal experience with chronic disease. The CDSMP provides techniques for dealing with problems associated with chronic disease and addresses appropriate exercise and medication use, communicating effectively with family, friends and health professionals, nutrition and how to evaluate new treatment options. You can learn more about the CDSMP, or visit Better Health Workshop to find a program in your area.
- Be active
- Research shows physical activity decreases pain, improves function and delays disability.
- The CDC recommends that people with arthritis undertake 30 minutes of moderate physical activity at least five times a week, or a total of 150 minutes per week. The 30 minutes can be broken down into three 10-minute sessions throughout the day if needed.
- Details about the types of physical activity appropriate for individuals living with arthritis can be found here.
- Watch your weight
- Research confirms that maintaining a healthy weight can limit disease progression and symptoms.
- For every pound lost there is a four-pound reduction in the load exerted on the knee joint.
- A loss of just 5% – 12 pounds for a 250-pound person – can help reduce paint and disability.
- See your doctor
- Early diagnosis and professionally guided management is critical to maintaining a good quality of life, particularly for people with inflammatory arthritis.
- Disease-modifying drugs are beneficial for RA and other inflammatory arthritis conditions and are available only through a doctor’s prescription.
- Protect your joints – the article available at the following link has great information about proper body mechanics, self-help devices and how to make activities of daily life easier and scroll down to the sub-head of “Self-help skills.” This particular webpage by University of Washington Orthopaedics and Sports Medicine, even contains a link to exercise videos for people with arthritis.
The Arthritis Foundation reports that there is no sure way to prevent arthritis but asserts that you can reduce your risk and delay the potential onset of certain types of arthritis. If you have healthy joints right now, do all you can to maintain mobility and function and avoid the pain and disability associated with arthritis.
All of the more than 100 types of arthritis have their own risk factors, individual features, behaviors and circumstances associated with the disease. Some risk factors cannot be changed – such as being female or having a family history of arthritis. In contrast, some risk factors are considered to be modifiable. They are the behaviors and circumstances that can be changed in order to reduce risk, delay onset or altogether prevent arthritis. Here are just a few examples of arthritis and related diseases and associated modifiable risk factors:
- Osteoarthritis – maintain a healthy weight.
- Rheumatoid arthritis – do not smoke.
- Gout – eat a healthy diet that is low in sugar, alcohol and purines (a chemical found in meat and seafood).
In some cases, preventing a prior incident can significantly reduce the risk of arthritis. Avoiding sports injuries through proper equipment, adequate training and safe play can prevent injuries that may lead to osteoarthritis in a few years or several decades later.
Whether you or a loved one is coping with arthritis now or wishing to modify your risk factors, education is key.
Shonda is a dedicated and hard-working STNA for Caregiver USA. She loves having the opportunity to be the best part of someone’s worst day. She has worked in the health care field for over ten years. Shonda worked in a hospital setting for about six years. She realized that she wanted to provide more one-on-one care so she transitioned to home health. Her future goal is to become a Registered Nurse. In her free time, she enjoys spending time with her two daughters! Caregiver USA is very appreciative of Shonda and everything she has and will accomplish for herself.
For more information about Caregiver USA services visit http://www.CaregiverUSA.com or call 614-408-9939.