Category Archives: Interviews with experts

Guest interviews help readers figure out how to solve care dilemmas.

Forty Winks to Fight Dementia

A gift doesn’t excite me much, unless it’s something truly heartfelt or desperately needed. This week I got an incredible gift of the second type: two nights of deep, restful sleep. I never thought sleep would mean so much to me.

Between the Pond and the Woods

Don’t horse around! Get some sleep!

I have written about sleep research before, but sleep is much more meaningful when you actually get some. This week I was having a surgical procedure, so I forced myself to bed early to help my body prepare — and then recover. My sister was back on caregiver duty so I wasn’t doing extra labor for my mom. It’s impossible to put worry out of my mind for two whole days, but I tried to minimize it. Two nights of deep sleep really took the edge off my anxiety.

A New York Times article by Maria Konnikova quotes sleep researcher Maiken Nedergaard as saying, “Sleep is such a dangerous thing to do, when you’re out in the wild. It has to have a basic evolutional function. Otherwise it would have been eliminated.” Konnikova suggests that in the era when humans were living out in the natural world, sleeping would have put us at risk of “death-by-leopard-in-the-night”, something caregivers might understand. We know that when loved ones get agitated or hallucinate at night, they can create chaos that seems as dangerous as any untamed animal. But we put ourselves in danger, too, when we fail to rest our brains.

A range of studies have turned up data showing there is greater risk of Alzheimer’s disease in older adults with insomnia. The National Heart, Lung and Blood Institute has also published research linking lack of sleep to spikes in the hunger hormone ghrelin which may lead to overeating and weight gain. It’s no wonder that caregivers often end up fighting so many personal health problems — dementia can make sleep a rare commodity.

If you’re sleeping badly on a regular basis, here are some ideas that may help you get better rest. Try at least one of them, as a gift to yourself.

  • Leave all iPhones, laptops or electronic devices outside your bedroom. Nothing ruins my sleep plans like a late night email … which leads me to web surfing….that never ends when it should.
  • Set and enforce a real schedule for going to bed and getting up in the morning. Try to stick to it for at least three days and see if you rest better.
  • Resist TV for thirty minutes before you close your eyes. Televisions give off light that lowers levels of melatonin. If you need a distraction before bed, try music instead.
  • If anxiety is keeping you awake, use paper and a pen to banish it. Write your fears and worries in a small notebook for no more than 15 minutes. Then close the book (literally) and put your problems away. In most cases, there is nothing you can do to resolve thorny issues at 11 pm, so give yourself permission to stop fretting and start sleeping. You can always go back to the worry wheel tomorrow.

Sleep is essential because it appears to be the period when our brains clean themselves of accumulated waste. This garbage includes amyloid, a protein linked to the development of Alzheimer’s disease. In the NYT article, Dr. Nedergaard offers a metaphor for the role sleep plays in our lives. She tells us to consider a fish tank, “If you have a tank and no filter, the fish will eventually die.” When we sleep deeply, our cerebral cleaning system has a chance to filter the trash out of our brain so we can resume healthy lives in the morning.

It is so rare for me to sleep long and deeply twice in one week. But today I really feel the difference. The wound from my surgery is not throbbing the way it did after the procedure. My thinking is very clear and my mood is good, despite the fact that it’s a grey, rainy day. I know that the problems that tortured me last week still need solutions. But a clear mind can solve problems way better than a tired one. If you want to give yourself (and your family) a real gift, do something tonight that increases your odds of getting forty winks.

Dementia and Diet

When my mom first got a dementia diagnosis, I knew just one way to protect her health: cooking nutritious food. Since dementia has no known cure, my meals were steeped in desperation and love. Yesterday, in a cooking class with an Ayurveda doctor, my ideas about food and healing were confirmed.

Between the Pond and the Woods

Since my mother is tiny and always hungry, I never doubted that good food would help her. But I also believed that feeding her well was a way to transmit compassion. Dr. Shekhar Annambhotla, yesterday’s Ayurveda teacher, fully agreed. “Cooking”, he said,  “is love. You put all of your love into the pot and you share that love with others.”

People in the class raved about his food. Men, women, young, old, vegans and carnivores enjoyed each dish. Local pub crawlers liked the meal as much as the yoga students in the room. As he cooked, the doctor explained how his recipes reflected the principles of Ayurvedic medicine, a health system used in India for thousands of years.

Though I’ve read many articles on Ayurveda, it always seemed too complex for me and nearly impossible to practice. But the class, sponsored by Jim Thorpe Yoga, taught me a lot. First of all, changing to a 100% Ayurvedic life WOULD be hard. However, it’s not that difficult to adopt a 10% approach and build toward 20% if the dietary shift makes you feel good. In fact, the doctor suggested that people take simple steps at first because changing too fast makes it hard to sustain the new habits we’re trying out.

His main advice to me was to eat my biggest daily meal at lunch. My weight’s gone up ten pounds since my mom got sick. Though I walk a lot and practice yoga, age has slowed my metabolism. Shekhar noted that if I eat a bigger meal at mid-day, I’d have enough daylight left for a brisk walk to aid digestion and burn calories. This sounds like something I could achieve without losing my mind or emptying the fridge. The doctor also warned us to avoid lecturing loved ones if they don’t want to change. Preaching may be hard to resist, especially if you start feeling health benefits you’d like your family to share. Caregiver efforts to improve their health can be viewed, instead, as one way of “putting on the oxygen mask before assisting others.” Our well-being will shine through the improved care we offer.

The impulse to preach nearly ruined a chat with my beef-loving boyfriend. When I raved about the delicious Ayurveda food, he asked for a list of ingredients. Coconut oil, he said, was full of saturated fat, very bad for you. (Of course he loves fries and hamburgers!) Then my Internet research pulled up this great New York Times article about coconut oil. It explains the difference between bad coconut oil — the partially hydrogenated stuff full of trans fats — and virgin coconut oil, which has no trans fats and lifts good cholesterol.

Today’s Internet feast of research and opinions makes it nearly impossible to find one health practice approved by all. I would not buy Ayurvedic “medicines” made in other countries. But I do think it’s wise to embrace basic Ayurvedic ideas like cooking your own food and adding more fresh vegetables to each meal. It actually seems a lot like what my grandmother did in the old days, when restaurants were for special occasions and home-made food nourished families through tough times. Is anything tougher than dealing with dementia?