Here is a great dementia resource for caregivers and healthcare professionals,
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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
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Huffington Post
People living with Alzheimer's or other dementias often have mental health problems -- especially depression and anxiety disorders -- as well as dementia. Memories they have always relied on become hazy and uncertain. Knowledge and skills cultivated over a lifetime diminish. Relationships change or are lost. Ordinary activities at work, home or leisure become difficult. Eventually, other people may be needed to help manage finances, make plans, get back and forth from home, eat, stay clean or go to the bathroom. As these sources of identity, personal pride and satisfaction are lost, people with dementia can become deeply sad, fearful and/or angry. Sometimes their behavior becomes a challenge for people who care for them.
These obvious facts should be part of what drives our nation's preparation for the vast growth of the number of people with Alzheimer's or other dementias that will take place over the next two decades.
The good news is that pursuant to The National Alzheimer's Project Act (NAPA) signed into law in January 2011, the U.S. Department of Health and Human Services (HHS) has begun to develop a long-term plan regarding dementia. The planning advisory committee for this project includes a representative of the Substance Abuse and Services Administration (SAMHSA) as well as representatives of many other federal agencies. In mid-December SAMHSA brought together a small group of experts who recommended that SAMHSA speak to the critical importance of addressing mental health problems experienced by people with dementia, Hopefully, it will do so at the next meeting of the advisory committee, which will take place on Jan. 17 and 18.
That's the good news. The bad news is that there is a battle shaping up about what the nation's priorities regarding dementia should be.
Some argue that there should be one and only one priority -- investing in research to discover a cure for Alzheimer's or at least to invent medications to stop the ineluctable decline the disease brings with it. For example, in an editorial in Alzheimer's and Dementia, Zaven Khachaturian of the Campaign to Prevent Alzheimer's Disease by 2020 argues, "Ultimately, the only deliverable that counts is a credible plan of action that calls for significant and systematic increases in the allocation of resources and funds for Alzheimer's research... particularly in the discovery and development of interventions to prevent disability."[1]
Others of us believe that, however promising biomedical research is, it will probably not bring relief in time for the 5.4 million Americans who already have dementia or for the additional five to six million people who will develop dementia over the next two decades. [2] We believe that humane care to help them have the best possible quality of life is the critical goal. We see this not as competing with biomedical research but as work that is necessary in addition to it.
But even among those of us who are focused on the need for more humane and more effective services and supports, there is some dispute about the importance of mental health services.
In part, this is the result of an outmoded view about the separation of mind and body. Dementia has physical roots with mental manifestations. Many advocates for better Alzheimer's care and treatment focus on the physical roots and do not regard dementia as a mental health condition. Others of us believe that mind and body are inextricably intertwined and that both physical and mental health perspectives and interventions are needed to help people with dementia and their families to have the best possible quality of life.
Many mental health issues arise in the lives of people with dementia and their caregivers. In a recent article in the same journal that published Khachaturian's editorial, Constantine Lyketsos and others argue that "neuropsychiatric symptoms (NPS) are core features of Alzheimer's disease and related dementias." They cite "depression and apathy ... verbal and physical agitation ... [and in later phases] delusions, hallucinations and aggression" as particularly common and important to address with mental health interventions, preferably non-pharmacological interventions. [3]
Psychological understanding can also contribute to improved quality of life for people with dementia and their families even if they do not have diagnosable mental illnesses. Dementia is often thought of as an unmitigated horror, but the truth is that some people with dementia lead lives that they find satisfying. Helping people with dementia to retain a sense of self-worth and be at peace with who they are is a very important goal for them. [4]
Mental health issues also touch family caregivers who provide 80 percent of the care for their relatives with disabilities. They are at high risk for depression, anxiety and physical illnesses that contribute to burn-out. Solid research by Mary Mittelman has shown that psychological support helps family caregivers live better with the stress they face, resulting in delay in nursing home placement by upward of 18 months. [5]
If the National Alzheimer's Plan does not reflect these facts, life for people with dementia and their families will end up far worse than it needs to be. That is why I and many others are advocating that the plan establish meeting the mental health needs of people with dementia and their families as a core priority for our nation.
More on Alzheimer's disease
References:
[1] Khachaturian, Z. "Prospects for designating Alzheimer's disease research a national priority" in Alzheimer's and Dementia, November 2011.
[2] Alzheimer's Association. "Facts and Figures About Alzheimer's."
[3] Lyketsos, C. et al. "Neuropsychiatric symptoms in Alzheimer's disease" in Alzheimer's and Dementia, September 2011.
[4] Zeisel, J. I'm Still Here. Avery Press, 2009.
[5] Mittelman, M. et al. "Improving Caregiver Well-Being Delays Nursing Home Placement of Patients with Alzheimer's Disease" in Neurology, November 14, 2006.
Showing posts with label Mental Health. Show all posts
Showing posts with label Mental Health. Show all posts
Sunday, January 15, 2012
Sunday, August 14, 2011
Sleep apnea linked to 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
Seattle Post
People who suffer from sleep apnea are at a high risk of developing memory problems and dementia as they get older, according to a recent study by the University of California, San Francisco and California Medical Center.
Sleeping disorders, and sleep apnea in particular, have long been associated with dementia, but this is the first time researchers have suggested that sleep problems may actually contribute to the development of cognitive impairment as we age.
For the study, a team of scientists followed almost 300 women in their early eighties for an average period of five years. At the outset, all participants tested normal in terms of cognitive abilities. The researchers found that the women who were diagnosed with sleep apnea were twice as likely to develop memory decline and other symptoms of dementia.
Although this particular study involved only women, there is no reason to believe that the results won’t apply to men as well. The disorder affects between 10 and 20 percent of middle-aged and older adults in the U.S., according to the Agency for Healthcare Research and Quality (AHRQ).
Sleep apnea causes sufferers to literally stop breathing while they’re asleep, sometimes hundreds of times a night. The reason is blockage of the airways. Consequently, blood oxygenation levels fall lower and lower until the body wakes up and normal breathing is resumed again – but only for a while. Typically, the person does not fully awake and is not aware that this is happening.
For their tests, the researchers looked at a number of specific factors connected with sleep apnea, including oxygen flow during sleep, duration of sleep and frequency of interruptions throughout the night. The risk of developing dementia appeared to be directly linked to the amount of time the women experienced a decrease of oxygen flow – not to the hours of sleep they had or the number of sleep interruptions they went through.
“The findings indicate that people with sleep apnea should be screened for cognitive problems,” said Dr. Kristine Yaffe, professor of psychiatry, neurology and epidemiology and lead author of the report that was published in the Journal of the American Medical Association (JAMA).
Although additional research is required, the study has already been acknowledged as an important step toward a better understanding of the seriousness of sleep apnea and the need for more effective treatment. “It makes sense that good sleep is going to be protective to the brain,” said Dr. Robert Thomas of Harvard Medical School in Boston, Massachusetts, who is an expert on the subject but was not involved in this study.
The most common way to treat sleep apnea is to force oxygen up a patient’s airways to prevent blockage with the help of a device that is placed in the mouth, a.k.a. Continuous Positive Airway Pressure (CPAP). Unfortunately, not everyone gets easily used to this procedure.
The disease affects often people who are overweight or have heart- and blood pressure problems. “There is only one cure for apnea so far we’ve found, and this is weight loss,” said Dr. Seva Polotsky, a researcher at Johns Hopkins University School of Medicine in Baltimore.
Aside from the issue of effective treatment, the study also gives rise to questions about the importance of sleep for both physical and mental health. The problem is that we don’t really understand yet what sleep does for us. “There is quite a broad consensus that supports the notion that memories are consolidated during sleep. But obviously the field is still not clear about what the mechanisms for memory formation are,” said Dr. Luis de Lecea, professor of psychiatry and behavioral sciences at Stanford University in California, who studies sleep disorders and their effects on memory and other brain functions in lab animals. “The new research shows a much more dramatic effect from sleep disorders than simple memory loss. Cognitive impairment is a whole different ballgame,” he added.
Of course, treating sleep apnea does not prevent all age-related decline of cognitive functions. But these latest results could change how the medical profession views the importance of sleep for both physical and mental health in general. The hope is that early diagnosis and effective treatment of chronic sleep disorders could at least help to slow down the spreading development of dementia as the average life expectancy continues to rise.
Timi Gustafson R.D. is a clinical dietitian and author of “The Healthy Diner –
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
Seattle Post
People who suffer from sleep apnea are at a high risk of developing memory problems and dementia as they get older, according to a recent study by the University of California, San Francisco and California Medical Center.
Sleeping disorders, and sleep apnea in particular, have long been associated with dementia, but this is the first time researchers have suggested that sleep problems may actually contribute to the development of cognitive impairment as we age.
For the study, a team of scientists followed almost 300 women in their early eighties for an average period of five years. At the outset, all participants tested normal in terms of cognitive abilities. The researchers found that the women who were diagnosed with sleep apnea were twice as likely to develop memory decline and other symptoms of dementia.
Although this particular study involved only women, there is no reason to believe that the results won’t apply to men as well. The disorder affects between 10 and 20 percent of middle-aged and older adults in the U.S., according to the Agency for Healthcare Research and Quality (AHRQ).
Sleep apnea causes sufferers to literally stop breathing while they’re asleep, sometimes hundreds of times a night. The reason is blockage of the airways. Consequently, blood oxygenation levels fall lower and lower until the body wakes up and normal breathing is resumed again – but only for a while. Typically, the person does not fully awake and is not aware that this is happening.
For their tests, the researchers looked at a number of specific factors connected with sleep apnea, including oxygen flow during sleep, duration of sleep and frequency of interruptions throughout the night. The risk of developing dementia appeared to be directly linked to the amount of time the women experienced a decrease of oxygen flow – not to the hours of sleep they had or the number of sleep interruptions they went through.
“The findings indicate that people with sleep apnea should be screened for cognitive problems,” said Dr. Kristine Yaffe, professor of psychiatry, neurology and epidemiology and lead author of the report that was published in the Journal of the American Medical Association (JAMA).
Although additional research is required, the study has already been acknowledged as an important step toward a better understanding of the seriousness of sleep apnea and the need for more effective treatment. “It makes sense that good sleep is going to be protective to the brain,” said Dr. Robert Thomas of Harvard Medical School in Boston, Massachusetts, who is an expert on the subject but was not involved in this study.
The most common way to treat sleep apnea is to force oxygen up a patient’s airways to prevent blockage with the help of a device that is placed in the mouth, a.k.a. Continuous Positive Airway Pressure (CPAP). Unfortunately, not everyone gets easily used to this procedure.
The disease affects often people who are overweight or have heart- and blood pressure problems. “There is only one cure for apnea so far we’ve found, and this is weight loss,” said Dr. Seva Polotsky, a researcher at Johns Hopkins University School of Medicine in Baltimore.
Aside from the issue of effective treatment, the study also gives rise to questions about the importance of sleep for both physical and mental health. The problem is that we don’t really understand yet what sleep does for us. “There is quite a broad consensus that supports the notion that memories are consolidated during sleep. But obviously the field is still not clear about what the mechanisms for memory formation are,” said Dr. Luis de Lecea, professor of psychiatry and behavioral sciences at Stanford University in California, who studies sleep disorders and their effects on memory and other brain functions in lab animals. “The new research shows a much more dramatic effect from sleep disorders than simple memory loss. Cognitive impairment is a whole different ballgame,” he added.
Of course, treating sleep apnea does not prevent all age-related decline of cognitive functions. But these latest results could change how the medical profession views the importance of sleep for both physical and mental health in general. The hope is that early diagnosis and effective treatment of chronic sleep disorders could at least help to slow down the spreading development of dementia as the average life expectancy continues to rise.
Timi Gustafson R.D. is a clinical dietitian and author of “The Healthy Diner –
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