Los Angeles Jewish Home

It’s 2:15 a.m. Out of a deep sleep, you awaken to clanging noises in your kitchen. Not long ago, you would have thought someone was attempting to get into the house. But with everything that’s gone on lately, you realize it is actually someone trying to get out. It’s your mom. She’s ‘wandering’ again.

Recently, you’ve noticed she is having memory problems. It’s been harder for her to recall what was just said. Now she’s forgetting the day, the date and other little features of daily life. Learning new things seems especially challenging for her, and she is starting to make up details to fill in the parts of stories she’s forgotten.

At first, it was possible to chalk it all up to getting older. After all, there are many challenges to deal with as the years advance. But things have really begun to change for the worse.

Mom can’t sleep through the night. She wakes up disoriented and confused. During the day, she believes she has appointments that have never been made. She talks about going to see friends or family who have long ago passed away or moved. She gets mad and lashes out when she is prevented from doing things you know she can no longer do.

Sometimes Mom seems depressed. It is harder and harder to take care of her personal needs, and she doesn’t seem to understand why you want her to take a shower. Sometimes she even forgets who you are.

It seems that her symptoms are coming on faster and faster, and, since she took that fall last week, things have gotten so much worse. Her doctor prescribed some medication, but it really isn’t helping.

You get out of bed and go downstairs to try to help Mom back to bed. She isn’t settled until 4 a.m. You don’t know what you’re going to do. One of these days you might not be able to get to her in time.

Mom has dementia, and now you’re worried about her safety. You need someone to help you figure out what to do next.

The preceding scenario is a composite of several we’ve heard from families caring for loved ones with various forms of age-related dementia.

At the Jewish Home’s acclaimed Auerbach Geriatric Psychiatry Unit (AGPU), we counsel families on mental health services for their senior loved ones, and provide short-term (acute) intensive treatment for seniors experiencing stressful mental or emotional challenges.

More than 50% of patients treated are suffering from acute dementia. The goal of our small, specialized hospital unit is to help restore seniors to an optimal level of functioning so they may safely return to their home or residential setting.

While most people do not need to be admitted, the staff at the Auerbach Geriatric Psychiatry Unit can help you sort through your options, gain new insights on dealing with dementia, and where to go for additional help.

If you have a loved one who is experiencing acute mental health challenges, please call the Jewish Home’s Auerbach Geriatric Psychiatry Unit at (818) 758-5042. A helpful staff member will either talk with you immediately or get back to you promptly.

Labels: Aging, Alzheimer's, Auerbach Geriatric Psychiatry Unit, Dementia, Feature Articles, For the Mind, Luke Jackson, Memory, Parents, Wandering

I was about to board my flight back to Los Angeles and turn off my cell phone — I was being thrifty with the battery since I had forgotten where I left my travel charger — when a journalist called urgently asking for a comment on Paul McCartney's recent admission that he was having trouble remembering the lyrics to some of his old songs. I envisioned him singing “She loves you — hey, hey, hey …”

“So you're trying to get me to go on record that Paul McCartney is getting Alzheimer's? I won't do that,” I said in anticipation of where the interview was going.

I flashed back to 1993 when Ronald Reagan announced that he was suffering from this devastating illness, which robs the mental life from millions of Americans. Back then, reporters kept asking me to speculate about whether Reagan might have been slipping mentally while serving as our commander in chief.

For our former president, his senior moments may have been early warning signs of further cognitive decline. In fact, an analysis of his progressive extemporaneous speech errors during debates over the years pointed to such subtle progressive deficits.

But for the average aging Baby Boomer like Sir Paul, middle-aged pauses and senior moments do not necessarily mean that rapid mental decline is inevitable. The risk for Alzheimer's disease is only about 10 percent for people age 65 or older. Misplacing keys or struggling to find a word is what we all joke about as we age.

Sure, our memory abilities are not quite what they were when we were in our twenties, but age-associated memory impairment is an expected and quite common experience of aging. Approximately 85 percent of people 65 years or older complain that they often recognize a face but can't recall the name that goes with it.

How can we tell if this normal memory loss will progress?

It's not easy, even for doctors. We often look for risk factors: age, family history, or other illnesses like diabetes or Parkinson's that predispose someone to neurodegeneration. If your memory challenges symptoms begin to interfere with your everyday life, if others start commenting on them, or if you find yourself worrying about them, it may be time to discuss it with your doctor.

Because of the general fear and denial about Alzheimer's disease, many people ignore early symptoms. That's not always a great idea, since the earlier you get help, the better your chances of staving off future symptoms. Clearly, it's easier to protect a healthy brain than to try to repair one once damage has set in. We don't yet have a miracle cure for Alzheimer's disease, but there are treatments that improve symptoms and keep people functioning better, longer. In general, earlier intervention translates to better outcomes.

The emotional impact of the illness is huge. We may joke about our memory lapses, but behind the humor is anxiety and fear. I have spent a good part of my career studying and caring for patients and families who have had to cope with this tragic mental struggle. And although I'm an expert, I initially refused to accept the fact that the illness was causing subtle personality changes in a close friend and mentor. I looked for almost anything else that could explain his symptoms — a possible medical condition, a depression, or maybe a drug side effect — but I eventually had to face the fact that his mind was drifting away and I couldn't stop it.

When Sir Paul McCartney was 16, he wrote “When I'm Sixty-Four.” Now that he's 67, I'm not too worried that he may not remember a few of his old lyrics – chances are that his senior moments won't progress too quickly over the years. I, on the other hand, wish I could remember where I left my cell phone charger.

Originally posted on Huffington Post. Copyright Gary Small, M.D.

Dr. Gary Small is a professor of psychiatry and director of the UCLA Center on Aging at the Semel Institute for Neuroscience & Human Behavior. His research, supported by the National Institute of Health, has made headlines in the Wall Street Journal, New York Times, and USA Today. Scientific American magazine named him one of the world's leading innovators in science and technology. Dr. Small lectures throughout the world and frequently appears on The Today Show, Good Morning America, PBS, and CNN. He has written five books, including The New York Times best seller, The Memory Bible.

Labels: Aging, Alzheimer's, Feature Articles, For the Mind, Memory, Small

Studies are proving that cognitive exercise enhances memory and reduces the risk of Alzheimer's disease and other forms of dementia. Now, new software programs are helping to keep a generation of older American minds young and fit.

At the forefront of this innovative technology is the Dakim Power Cognitive Fitness System. Currently in use at the Jewish Home, Dakim (pronounced day-kim) is a highly interactive, touch-screen computer designed to challenge, stimulate, and entertain while exercising the mind.

Ease of Use

One of Dakim's strengths is its user-friendliness. As a plug-and-play system, pre-loaded with software, access is immediate.

"It's appearance is less intimidating than a desktop computer," notes Dan Michel, CEO of Dakim, Inc. Michel invented the system to help his father, who suffered from dementia. "We worked hard not to have the unit look like a work station computer. There is no keyboard, no mouse. It's a touch-screen system that literally speaks to you."

The computer has a built-in camera which takes your picture when you first register. The very next session, it greets you by name. (Dakim even remembers birthdays.)

Once users get into their workout, a variety of interactive exercises awaits them. Dakim comes loaded with brain games, some of them designed to make the user feel like a contestant on a game show. With its Internet connection, the machine automatically downloads new exercises almost daily to keep cognitive training fresh and interesting.

Creative Programming

The secret to successful programming, says Michel, is to keep the games challenging enough to be stimulating – not too tough to discourage, nor so easy that players will be bored. The level of difficulty rises as the user becomes more proficient.

Programming is based on the latest research into cognitive science and the emerging field of brain fitness. Chief scientific advisor on the project is Dr. Gary Small, professor of psychiatry and bio-behavioral sciences, and Director of the UCLA Center on Aging.

Each Dakim session takes about 20 minutes to complete, and every session works all six cognitive domains. These include short-term memory, long-term memory, language, calculation, visuospatial orientation, and critical thinking. But we haven't even mentioned the most important part.

It's a Lot of Fun!

In one short-term memory game, you view movie clips from the 30s and 40s. Then you are asked to remember things like where a particular scene took place, or what the dialogue was about. Users get hooked, and keep coming back for more.

"It's fun, self-directing, and exciting," says Jewish Home CEO-President, Molly Forrest, who took Dakim for a test drive and had a ball. Best of all, users are independent. "You don't need anyone looking over your shoulder to talk you through the program."

Encouraging seniors to move aggressively into the information age is a priority at the Jewish Home. "It makes sense for myriad reasons," Forrest notes. "Technology is opening the door for all of us to engage our minds, improve our memory, and reach out to the world."

Research confirms that regular interaction with programs like Dakim are more than just entertaining. The Bronx Aging Study, conducted by the Department of Medicine at the Albert Einstein College of Medicine found that seniors who regularly engage in mentally stimulating activities can significantly reduce their risk of dementia.

"Cognitive fitness is an essential element of a healthy lifestyle," notes Forrest. "It can improve our health and preserve our independence as we age."

For an online introduction to the Dakim system, and additional information on the benefits of cognitive fitness for seniors, visit www.dakim.com.

Kathleen Doheny is a Los Angeles-based journalist who also writes for WebMD.com, healthday.com, Weight Watchers, the Los Angeles Times and other publications.

Labels: Alzheimer's, Cognitive Exercise, Cognitive Fitness, Dakim, Doheny, Feature Articles, For the Mind, Memory