Archive of ‘Alzheimer’s and dementia’ category

The Aging Brain: What’s Normal and What’s Not?

In 2014, there were 46.2 million Americans over the age of 65, which represents about 14.5% of the U.S. population. By 2040, this number is expected to rise to over 81 million, and by 2060, almost 100 million. With this significant increase in the aging population comes a growing concern about the prevention and treatment of age-related diseases. One, if not the most, notable of these diseases is dementia, due to the impact it has not only on the person with the disease, but also to their spouses, children, and to the healthcare system as a whole.

By: Shannon Haragan, LPC

By: Shannon Haragan, LPC

How Do I Know if it’s Normal Aging or Early Signs of Dementia?

In the not-too-distant past, researchers believed that the brain only developed and built connections during our early years, after which, development stopped, and the rest of our lives were spent losing brain cells. Now we know that the brain can continue to generate cells and build connections throughout our life span–we call this neuroplasticity. If we keep our bodies and our minds engaged and active, we can have a healthy brain throughout our lifetime. Here is an example of truly healthy aging, at age 106, who got to dance with the President and the First Lady

Similar to any muscle in our body, however, we can apply the age-old “use it or lose it” principle to the brain, as well. As we age, we tend to naturally slow down both physically and mentally. We tend to engage less with things that are mentally and cognitively challenging. Our minds follow suit, and as a result, we may naturally experience memory lapses from time to time. So some memory loss is considered normal. But how much? What if you forget where you left your keys? Call your granddaughter by your sister’s name? Walk into a room and forget why you walked in there in the first place? Here are a few guidelines for what’s normal and what’s not:

             Normal Aging                      Signs of Dementia
Preserved independence in daily activitiesCritical dependence on others for key daily living activities
The individual is more concerned about alleged forgetfulness than close family members areClose family members are much more concerned about incidents of memory loss than the individual
The person complains of memory loss but can provide considerable detail regarding incidents of forgetfulnessThe person complains of memory problems only if specifically asked; cannot recall instances where memory loss was noticeable
Recent memory for important events, affairs, and conversations is not impairedRecent memory for events and ability to converse are both noticeably impaired
Occasional word-finding difficultiesFrequent word-finding pauses and substitutions
Person does not get lost in familiar territory; may have to pause momentarily to remember wayPerson gets lost in familiar territory while walking or driving; may take hours to return home
Individual operates common appliances even if unwilling to learn how to operate new devicesPerson cannot operate common appliances; unable to learn to operate even simple new appliances
No decline in interpersonal social skillsLoss of interest in social activities; socially inappropriate behaviors
Normal performance on mental status examinations, relative to the individual’s education and cultureBelow-normal performance on mental status examinations in ways not accounted for by educational or cultural factors


There are many different causes of dementia (Alzheimer’s is the most common), but the way the symptoms present is different for everybody. If you have a concern for yourself or a family member, talk with your primary care doctor or a neurologist. If you’re struggling with anxiety, worry or grief around a potential diagnosis, a therapist can be helpful. Though the funding is currently lacking compared to other diseases such as cancer and heart disease, important research is currently ongoing, and there is great hope for finding effective treatments to combat Alzheimer’s and other forms of dementia in the not-too-distant future. For more information, check out the Alzheimer’s Association or more info about dementia.

Caring for the Caregiver, Part 2: Managing Caregiver Stress

Part 1: Caring for the Caregiver

It’s not stress that kills us, it is our reaction to it.
–Hans Selye

Life brings with it a few guarantees: death, taxes and stress. Stress is universal, and we all experience it from time to time. A reasonable amount of stress is actually thought to be helpful: it can be a source of energy that moves us toward change. Sometimes, however, circumstances are such that the stress involved seems almost overwhelming.

By: Shannon Haragan, LPC-Intern Supervised by Lora Ferguson, LPC-S

By: Shannon Haragan, LPC-Intern
Supervised by Lora Ferguson, LPC-S

If stress is defined as the gap between our expectations and our reality, this is a constant for the Alzheimer’s caregiver. As any chronic and incurable disease progresses, new normals are a steady force that bring with them new realities that often defy our expectations. Chronic stress of this type can impact not just our emotional and mental health, leading to depression, anxiety, and more, but it also can have a profound effect on our physical well-being.

Stress and Your Physical Health

In a recent study, the stress of caregiving was found to have a significant negative impact on the physical health of caregivers. Three-fifths of all caregivers rated their physical health as “fair” or “poor” compared to one-fifth of non-caregivers. Caregivers also experience chronic conditions (including heart attacks or heart disease, cancer, diabetes or arthritis) at nearly twice the rate of non-caregivers. According to the National Center on Caregiving, the stress of caregiving also causes a decreased immune response. Studies indicate that caregivers have a 23% higher level of stress hormones, and a 15% lower level of antibody responses.

Although the perception of stress is subjective (what’s stressful to you may not be to somebody else), there are several factors that can influence our perceived level of stress in a caregiving context:

–Is the caregiving voluntary or not? Were you forced into the role because nobody else was available?
–How well have you coped with stress in the past? This is a strong predictor for how you will cope with it now and in the future.
–What was your relationship like with the care receiver before the diagnosis? If it was a difficult one, higher amounts of stress if more likely.
–What kind of support is available to you?


Caring for the Stressed-Out Caregiver: Steps

Clearly, stress management and reduction should be important goals for caregivers and for anyone who supports a caregiver. Though there is nothing that can be done to improve the long-term outcome of a care receiver diagnosed with Alzheimer’s or other type of dementia, there are definitely things that can be done to help reduce stress in the caregiver, which ultimately helps both the caregiver and the care receiver:

  1. Learn to recognize the early signs of stress. Everybody’s different. What happens when you get stressed out? Is your sleep impacted? Your temper? Your eating habits? Are people commenting on changes in your appearance or behavior? Know yourself, and become familiar with how stress manifests for you, so you can recognize it while it’s still in a manageable stage.
  2. Identify your sources of stress–even those not associated with caregiving, as these can directly impact your caregiving abilities. The possibilities are wide-ranging and very subjective, but can range from financial stressors to the care receiver’s diminishing abilities to the negative attitudes of people close to you and much more.
  3. From this list, figure out the items you can change, and those you can’t. This one can be the most challenging, as most of us would like to believe we can change the unchangeable. Be willing to look objectively at those things you can’t change, and foster a sense of acceptance. Educate yourself on the disease and identify any unrealistic expectations you may have for the future. Focus on the things you still have, rather than what you don’t.
  4. For those items that can be changed, take action. Try to make sure each part of you is being cared for: physical, emotional, mental and spiritual. Seek out resources and be willing to accept support. Take small steps. Seek meaning in the journey.

    Those who have a ‘why’ to live can bear with almost any ‘how.
    –Viktor Frankl

Give yourself permission to take care of you. In order to better care for your loved one, you must learn to first care for the caregiver, and this includes managing caregiver stress.

November is National Family Caregivers Month! If you know a family caregiver in need of support, now is a great time to offer a word of encouragement or even to ask how you can help to reduce their stress.

(Sources: The Caregiver Helpbook, 3rd edition, AGE of Central Texas)

Caring for the Caregiver: An Introduction

Let’s start with a few sobering facts about dementia and Alzheimer’s disease: 
By: Shannon Haragan, LPC-Intern Supervised by Lora Ferguson, LPC-S

By: Shannon Haragan, LPC-Intern
Supervised by Lora Ferguson, LPC-S

— As I type these words, there are currently 5.1 million Americans living with dementia and 60-70% of those individuals have Alzheimer’s (the most common cause of dementia).

— Every 67 seconds, someone new develops the disease–and that’s just in our own country.

— By 2025 (that’s just ten years from now!), the overall number of Americans living with the disease is expected to jump 40%, to 7.1 million. By 2050, perhaps around the time you or someone you love turns 65, that number is projected to be nearly 14 million.

— For unknown reasons, two-thirds of these people are women.

— Alzheimer’s is the sixth leading cause of death in the United States, and it is also the ONLY cause of death in the top 10 that cannot be prevented, slowed or cured.

If you have a brain, you are at risk of developing the disease.

If anybody you love has a brain, you run an even higher risk of becoming a caregiver.

So here’s where the rubber hits the road. A couple of stats from

— Up to 70% of family caregivers have clinically significant symptoms of depression, and up to half of those caregivers meet the diagnostic criteria for major depression.

— Caring for persons with dementia reportedly impacts a person’s immune system for up to 3 years after their caregiving experience ends, thus increasing their chances of developing a chronic illness themselves.

Caregiving for someone diagnosed with dementia takes a significant toll, physically, mentally and emotionally. This is the first in a series written about the world of dementia caregiving, and ways that caregivers can cope with a variety of common issues, from the practical to the emotional to the existential. Though I will be focusing on dementia, primarily Alzheimer’s, much of this is applicable for caregivers for any chronic illness. The term caregiver certainly applies to those individuals living in the home and helping to provide ongoing daily care of their loved one (typically spouses or adult children), but it also refers to other family members and friends who spend time and energy invested in the health and well-being of the care receiver.


Acute illnesses are short-term, with available cures. Caregivers and families typically operate in a world of certainty, knowing their loved one’s health will ultimately improve. Chronic illnesses, like Alzheimer’s disease, offer no cures. They are long-term, and are marked by unpredictability and a future negotiating change.


Generally speaking, there are three broad stages that all Alzheimer’s patients and their families go through: early, middle and late. Each stage brings its own set of changes and transitions, varying between periods of encountering new symptoms, behaviors and emotions, and adjusting to the “new normal.” Though much of the journey of caregiving involves components you can’t control, it is crucial to discover and focus on those parts you CAN control:

Change is external and generally involves things you CANNOT control, such as:

— Roles
— Situations
— Abilities
— Care needs
— Events

Transition is internal, and generally involves things you CAN control, such as:

— Emotions/feelings
— Thoughts/cognitions
— Attitudes
— Learning
— Acceptance

Future blogs will address how to transition well, and will offer practical solutions the changes that your family encounters. Ultimately, the goal of the Caring for the Caregiver blog series is to learn how to better take care of YOU. By making yourself a priority, you will ultimately be able to better care for your loved one. Like the flight attendants tell us, we must first put the oxygen masks on ourselves before helping to put the oxygen masks on those we care for.

1 2