Sunday, February 27, 2011

The Importance of Alternative Therapies in Dementia

Here is a great dementia resource for caregivers and healthcare professinals,

Here is information on being the best caregiver you can be

Here is a way for nurses administrators, social workers and other health care professionals to get an easyceu or two

Here are more interesting dementia brain boosting activities

Although no therapy has been found to reverse dementia, it is possible to slow the course and improve the quality of life for those battling with the disease. Here are some therapies that have been known to slow the decline of dementia

Pet Therapy:
As many pet owners will attest, just being around an animal can have a soothing effect. This is the idea behind pet therapy for people with dementias such as Alzheimer's disease, who are at particular risk for anxiety and depression. In this kind of therapy, the pet's human companion introduces the animal -- whether it's a dog, cat, guinea pig, or other domestic pet -- to the person with Alzheimer's and helps the interaction go smoothly and safely. These visits generally occur in nursing homes, adult day centers, and hospitals, but of course the idea can be used in the home as well.

The benefits of pet therapy include lowering anxiety and stress, encouraging communication, improving mood, and lowering blood pressure. People with a dementia like Alzheimer's may feel especially comfortable with a pet because it lets them interact nonverbally.

What you can do: The person you're caring for probably isn't capable of looking after a pet, so it's not a good idea to run out and buy her a kitten unless someone is available around the clock to provide its care. But even pet therapy that doesn't involve direct contact with pets -- bird-watching and looking at an aquarium -- seems to have positive effects. Research funded by the Pet Care Trust, a nonprofit foundation, and conducted by Purdue University, found that Alzheimer's patients provided with aquariums gained weight (indicating better nutritional intake -- people with Alzheimer's often have trouble eating adequately) and showed less aggression. Try setting up an aquarium or bird feeders outside a favorite window view.

Spiritual Activities:
Whether spiritual activities include prayer, religious services, or visits with someone who offers faith-based counsel, they have a therapeutic effect on many people with Alzheimer's disease. Spirituality and faith offer stress relief, hope, and reassurance. Some studies have found that people with probable Alzheimer's who have higher levels of religiosity show slower rates of mental decline.

What's more, religious participation usually involves regular events, rituals, or traditions. Repeated over the years, these memories tend to be wired more fixedly in the brain of someone with Alzheimer's. That's why someone with Alzheimer's may find religious or spiritual activities comforting and easy to follow. These activities also offer an opportunity to socialize and bond with family, friends, and members of the community.

What you can do: Make provisions for the person in your care to continue attending her routine religious services as long as possible. If her behavior is erratic and sometimes disruptive, see if a "quiet room" is available. (Usually used by mothers of young children, this spot is helpful for people with Alzheimer's, too.) Try going to early or midweek services where attendance is lightest.

Consider other things that may nourish her spirituality, too. For some people, that's a walk in the woods, looking up at the night sky, listening to classical music, or meditation.

Music Therapy:
If you've ever found yourself singing a pop song you haven't heard since high school -- and knowing the lyrics -- you have some idea of the power of musical memory. Someone with Alzheimer's might not remember breakfast, yet the lyrics of old favorites from 50 or 60 years ago may be at the tip of her tongue.

Listening to familiar music is both enjoyable and comforting. It can relieve stress and anxiety and improve mood. People with Alzheimer's often "open up" and start to clap and sing along. In group settings, music may prompt listeners to reminisce about their past and interact with one another. At music therapy programs in adult daycare or assisted living facilities, caregivers may arrange live performances or music with dancing, which has the added benefit of encouraging exercise.

What you can do: Select music carefully, and stick to what you know your loved one likes and enjoys. (If you're not sure, look for CDs or old LPs of tunes from her 20s and 30s, when almost everyone is most attuned to popular music. You may even be able to borrow some from the library to try them out.) Playing music during meals may improve appetite, and calmer music played before bedtime may help her get to sleep more easily and agreeably.

Some people with Alzheimer's enjoy making music. Many children's musical toys are appropriate without seeming juvenile, so look for maracas, tambourines, xylophones, or toy lap harps (zither) that offer easy-to-follow music sheets or can simply be plucked when she can no longer follow the written notes.

Art Therapy:
Both viewing and creating works of art can be therapeutic. Walking through a museum or gallery is a great way to relax a person with Alzheimer's disease while providing some exercise. Talking about certain pieces with a companion or a group on a special tour gives her a chance to converse about something in the moment without worrying about failing to remember names or facts. (And art interpretation, after all, is up to the individual, so there's also a freedom of expression.) This, in turn, can be a huge mood booster and way to increase self-esteem.

Working on an art project can help release emotions in a safe, healthy way. If done in a group setting, art also generates conversation and encourages bonding among participants. Using different tools, a person with Alzheimer's practices hand-eye coordination: If fine motor skills are declining and painting or drawing is difficult, she may enjoy the tactile work of sculpting or simply painting with a larger brush.

What you can do: Don't worry if the person you're caring for was never very "artsy." Provide safe, nontoxic, easy-to-use materials and encourage her to spend time with them. (Even crayons and pages torn from coloring books work. Offer adult coloring books or nonjuvenile images if she's sensitive to this.) If you're unsure how to proceed on your own, look into adult daycare programs, where art therapy is often used and attendees enjoy feeling like they're learning a skill or creating something.

Visit your local museum together often. Weekday mornings are least likely to be crowded. Between the large collections and her short-term memory, this is one outing that can seem new every time for quite a long while.

Storytelling is another therapy that taps into creativity. A caregiver or other companion presents the patient with a picture or series of pictures and invites her to construct a corresponding storyline. As in art therapy, communicating about an image doesn't require remembering anything, which can be an intimidating and uncomfortable aspect of other conversations. Storytelling exercises creativity, gives emotional release, and provides caregivers with interesting insights into the life and mind of the person with Alzheimer's.

In storytelling therapy, as in art therapy, the key is letting the person with Alzheimer's take the lead once the activity is introduced. The companion simply helps the story along by asking basic open-ended questions. Sometimes the story is written down.

What you can do: Find a coffee-table book with large images. At a relaxing, quiet time, when there are no distractions to interrupt or confuse your family member, sit down with her and look at the book together. You can also use postcards, calendar images, or a magazine. (Avoid celebrity or historic photos, which cause the person to get stuck trying to remember the "right" details.) Say, "Let's make up a story about this funny picture," or "I wonder what she's thinking about. What do you think?" Avoid asking questions that might feel like tests. ("What's that?") Stress the fact that there are no right or wrong answers. Offer open-ended prompts to help move the story along.

Reminiscence Therapy:
Different from storytelling, which doesn't specifically involve memories, reminiscence therapy invites a person with Alzheimer's to exercise her long-term memory by encouraging her to share positive recollections from younger days. Especially in the earlier stages of the disease, she may still remember with astonishing clarity events and people from childhood and young adulthood. Old photo albums, mementos, and music are common tools used to generate this type of conversation.

Focusing conversations on these more solid memories can improve her mood, encourage verbalization, and raise self-esteem.

* What you can do: Keep the atmosphere relaxed so she doesn't feel like she's being given a memory quiz. When children and grandchildren are involved as listeners, a person with Alzheimer's may feel especially proud to be able to share pieces of family history. As a bonus, you may learn things about her you didn't know or may be moved to record new and familiar tales on tape or paper to preserve them.

Massage Therapy:
Perhaps one of the most unexpected therapies for someone with Alzheimer's disease is massage therapy. In all people, the healing power of touch is well documented. It can trigger the relaxation response, lower blood pressure, and reduce the pain of chronic diseases. Few studies have been done on massage for Alzheimer's patients, but so far it's been found to reduce episodes of wandering and other agitated behaviors associated with anxiety. Massage can also help people with the disease sleep better, ease muscle pain and tightness, and ward off depression. Massage therapy is sometimes combined with aromatherapy (see below).

What you can do: Ask the person you're caring for if she'd like to try it. Someone who's apprehensive or has never had massage may want to start with hand, foot, or back rubs. Massage therapy only works when the person feels at ease with it. She may be very sensitive to touch or may feel uncomfortable with a stranger or even a family member touching her in this way. Be sure that if you hire a professional massage therapist, she knows that her client has dementia. Realize that you don't have to sign her up for a full body massage in order to harness the benefits of the power of touch: Hug her, hold hands, touch her gently when you talk to her.

The use of essential oils from flowers and other plants to treat physical and mental disorders has a long history dating back thousands of years. Certain scents appear to work directly on connections in the brain to create associated responses. Scented oils can be applied directly to the skin (in diluted form) during massage, burned to release their scent into the air, or placed in bathwater. Some nursing facilities use aromatherapy to calm residents. This therapy hasn't been well studied with Alzheimer's, and as the disease progresses the sense of smell is often impaired, so it's unclear whether people with advanced Alzheimer's can benefit from it.

What you can do: The relaxing and stimulating powers of scents may be worth trying at home if you find the idea appealing. Even familiar scents like chocolate chip cookies or pine needles can trigger happy memories

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