Sometimes you have to hear a message many times before you really get it. After talking with experts like Dr. Michael Baime and reading the work of Jon Kabat-Zinn, I now see why it’s crucial for caregivers and dementia patients to do activities that protect the hippocampus region of their brain.
Research shows that the hippocampus plays an important role in consolidation of information from short-term memory to long-term memory. We have two hippocampi, one on each side of the brain. They display the earliest signs of damage when Alzheimer’s disease attacks.
The work of Baime and Kabat-Zinn has shown that a regular meditation practice can actually promote growth of grey matter in this brain region which is so essential to preserving memories. This week my regular news scan led me to another article, by Margery Rosen, stating that physical exercise has also been shown to boost the size and vitality of the hippocampus. Rosen writes in the AARP report that, “Scientists think exercise boosts the flow of blood to certain parts of the brain, spurring the release of brain-derived neurotrophic factor (BDNF) …[which] stimulates the formation of new neurons in the hippocampus….At the same time, [BDNF] repairs cell damage and strengthens synapses, or the connections between brain cells.”
The effects of exercise can be significant, even if you are older or were not physically active earlier in life. A study from the Archives of Internal Medicine found that 70- to 80-years-old women who already had symptoms of mild cognitive impairment, had better focus and decision-making skills after doing one to two hours of weight training two days a week for six months. Rosen also quotes Kirk Erickson, neuroscientist at the University of Pittsburgh and co-author of the exercise study, as saying, “This was the first time that we were able to demonstrate that you can actually increase the size of the hippocampus…People need to know that dementia is not inevitable.”
While his comment on inevitability may be an overstatement, these two research studies give us plenty of reasons to try to fit these two activities into our busy lives. It looks like 15 minutes of morning meditation — and a 30-minute walk before dinner — could drastically improve the lives we lead 20 years from now.
If you’ve ever visited a dementia care site, you’re bound to wonder how things got the way they are. Not because it’s all bad, but because many features of both day and residential care programs don’t seem to benefit the patients. Reliance on drugs leaves many people barely alert and the aesthetics of care sites are often distracting for lucid patients filled with anxiety. Family caregivers may know better ways to treat loved ones, but they can’t always manage care during the long course of the disease. Finally, better alternatives are emerging!
It’s exciting to learn that new treatment models are being used successfully in the field. In the May 20 issue of The New Yorker, author Rebecca Mead describes evolving care strategies that have provided residents with significant relief at the Beatitudes Campus in Phoenix, Arizona. Beatitudes describes its approach as one that “focuses on the comfort of the individual with dementia and empowers staff members to anticipate the needs of the resident.” Beatitudes trains professional caregivers to use a “person-directed approach to care.”
This strategy sits at the opposite end of the spectrum from most nursing homes. Even the finest, high-end dementia facilities organize everything — from administration of drugs, to deployment of staff — around the needs of the institution rather than those of the patient. Facility administrators might argue that people with dementia are often unable to communicate their needs when pressured for an explanation of what ails them. But staff members at Beatitudes engaged in deep study of their patients — and themselves — to create a service model that relies more on empathy than assumptions. Beatitudes caregivers took the extraordinary steps of spoon feeding each other and wearing incontinence diapers so they could learn what residents really experienced during a typical day.
After these experiments, lots of practices — including use of diapers — were thrown out the window. Staff members also began to realize something that most family caregivers learn early. Although words may fail dementia patients, “all behavior is communication.” This phrase is a mantra repeated by Tena Alonzo, Director of Education and Research at Beatitudes, who now uses quiet, calming methods for getting patients to disclose as best as they can what is causing their agitation.
The work of the Beatitudes Campus is based on ideas developed by British educator and psychologist, Thomas Kitwood. Not long before his death, he published his 1997 theories under the revealing title “Dementia Reconsidered: The Person Comes First.” His ideas have been influential in England and Belgium. Details will be featured in future posts here. For now, you can learn more about Beatitudes Campus care concepts by clicking here for background on their training model. May you discover some ideas that buoy you up.