Memory Care with Teresa Youngstrom
Dementia Care. How to Keep the Peace
[MUSIC] >> Hey everybody, Teresa Youngstrom here with memory care with Teresa Youngstrom. So excited you're here. We've got an amazing class planned for you today and interesting podcast. We're going to dig a little deeper this week. I know I serve a lot of professionals out there and so in the past, I did a really great CE about neurodegenerative diseases. And it would dig a little bit deeper. We're not gonna, I'm not the doctor, I'm the nurse. But we'll dig a little deeper today. I just wanna talk to you more about that. As always, if you love this program, please like and share and subscribe so we can get it a little bit further out there into the world. It's very exciting and thank you so much for your support. We've had amazing support and it's just growing to different places in the world now. And I'm so ecstatic that we're serving so many. So thank you for your help in getting that done and helping to serve so many. So let's get started. Neurodegenerative diseases, I know it sounds complicated, but honestly that's what Alzheimer's is, right? I just want to go a little deeper though because there's more to it than just Alzheimer's and frontotemporal. But we'll just talk a little bit more about the brain itself, the parts of the brain, what parts do what? And then what are the symptoms of these neurodegenerative diseases? So you'll know. We do know that with dementia, my topic, that there's more than 120 diagnosis that can give us symptoms of dementia. And so I want you to see that there's a very big picture here. And then a lot of people get a mixed picture. So you can have Alzheimer's, but you can also have something else. And the diagnosis usually comes from which part of the brain is struggling. And which one is being damaged, okay? So today let's get started. So let's talk about the parts of the brain. We've got the frontal lobe and of course that's the front part, right? The parietals are the sides, right and left. We've got the occipital, which think about the back of the brain, okay? And then way underneath, cerebellum. And that's what's way underneath. And then you have the temporal lobes, each side, all right? And these are, you know, they're symmetrical and they should be symmetrical. They should be same size on either side of the brain. And then you have your spinal cord, which some people forget is part of the central nervous system. That is, your spinal cord is a very, very important part to that. So the frontal lobe really is about thinking, okay, memory, behavior, movement. And these are just generalized guys. The brain is so complicated. But then the parietal lobes, language and touch, occipital lobe vision, isn't it wild? That's where you're vision. That's what makes your brain help your eyes see things. It's really cool. The cerebellum, which is tucked underneath, that's balance and coordination. And then we have the temporal lobes, hearing, learning, feeling in the temporal lobes. And then you've got the brain stem. And of course, breathing, heart rate, these so important temperature regulations, those come from the spinal cord. And again, these are, we could go so much deeper, but for those of you who want to just learn a little bit more about your brain, that's what we're talking about today. So neurodegenerative disorders. For those of you listening on Spotify, I'm going to just give you what's on this slide so you'll have it. Neurodegenerative disease is an umbrella term for a range of conditions which primarily affect the neurons in the human brain. So the neurons are the building blocks of the nervous system. These are the individual brain cells, okay, which include the brain and the spinal cord. Neurons normally don't reproduce themselves or replace themselves. And so when they become damaged or die, they cannot be replaced by the body. But I want to hit the pause button because I keep reading more and more research. This whole thing about whether neurons can reproduce or not, it's been two steps forwards, two steps back. I mean, as far back as the early 2000s, I was reading some articles that were saying, hey, we think we think maybe we're on to this, maybe we've got some neurons that are reproducing. And then, you know, then the study would come out again and say, oh, these were infantile brains. They were, you know, pediatric brains, and of course they've got the newer, younger neurons that they found on autopsy. But we're still working on this. And it's been, like I said, two steps forward, two steps back. I know my Parkinson's folks will tell you that you can create new pathways in the brain because you can learn to walk a different way than you did before. So maybe you can't walk the same way your brain has in the past, but what do you know? Well, now you're able to, with practice and routine, be able to train yourself to create some new pathways in the brain. So I just wanted to hit the pause button on that particular slide just for a minute when it says they don't reproduce themselves because they think we're really still figuring it out about what they do. And there are folks that'll tell you it has to do with mitochondria. You know that that is the brain of the cell. And what is the health of the mitochondria? Is that what we need to work on? Some will tell you it's the brain barrier, the gut brain barrier. You know what it has to do with your gut health? So there are lots of great studies out there. We're trying so hard to get to the bottom of this so that we can really improve on these neurodegenerative diseases because they're out there and they're plaguing your family and they're plaguing mine. So examples of neurodegenerative diseases include Parkinson's, Alzheimer's, Lewybody, ALS, and we're going to talk more about those, okay? Let's move forward. So common neurodegenerative symptoms, and this is the common list and then later we're going to dig a little deeper. But I can tell you that we might see anxiety, apathy, apathy, I just don't really care anymore. Whatever, I just want to sit here in my chair, I don't care. My tremors, okay, rigid muscles, sexual problems, decreased autonomic or automatic movements, okay, fatigue, so I'm more tired, insomnia, I'm not sleeping great, apparently sleep has a whole lot to do with your brain health, so make it a priority for you that you're getting good sleep, balance problems we might see, speech changes, abnormal sensations. So they feel like you have creepy crawlies, do you have tingling, you know? So it can vary for individuals, but this is kind of the most common that we see when people are kind of like, oh boy, I got to get this checked out, okay? So I'm going to stick my glasses on for this one. So symptoms of Alzheimer's, we're going to kind of go through these and break it down a little bit more. So we're just going to talk about four different neurodegenerative diseases. And so symptoms of Alzheimer's, we'll talk about Huntington's, Parkinson's and then ALS, the amiotrophic lateral sclerosis, right? So Alzheimer's, of course, there's memory loss, we all know that. And then problems could be in speech, reading, writing, understanding, there could be disorientation, time and place, poor or decreased judgment, problems with abstract thinking, misplacing things or putting them in odd places, all right? We never found my mom's upper plate to her dentures. She definitely put that one in an odd place one time and we never found it. So difficulty performing, familiar tasks. So if we look at that and compare it to Huntington's, Huntington's more psychological symptoms such as depression, memory impairment, delusions, hallucinations, sexual disorders can look like a schizophrenia, motor symptoms such as jerky arms and facial twitches. But we again can get mixed picture. And just so you know, a lot of these diagnosis, they can be misdiagnosed, okay? And they're thought to be other things. And so it's so important to dig deep and get second opinions, third opinions to really try and figure out what we have. The fact is that some of these diagnosis are only confirmed with autopsy, lewy bodies like that. And so some now we can do spinal taps or pet scans and things and get a little bit deeper into a good evaluation assessment, diagnostic, but for some of them it's very difficult. And you can get things that look like other things. And you certainly don't, if you're giving the wrong medication, if you're medicating for this and really it's that, then it's just trouble and it's a mess. So movement disorders with Parkinson's movement disorders that could be bradykinesia, akinesia, rigidity, rigidity, tremors, dyskinesia. So freezing of the gate, like you just cannot get it going. You just cannot move it forward, okay? Cannot move forward. Having behavioral disorders that include the dementia, depression, hallucination, sensory, sleep and emotional problems. Parkinson's is so hard. We want to catch it early so we can start working on these things and certainly keep working out and you got to move it or lose it with some of these disorders. Symptoms of the ALS, difficulty walking or doing the normal daily activities, tripping and falling, weakness in the legs, feet, ankles, hand weakness or clumsiness, sword speech or trouble swallowing, all right? Muscle cramps, twitching in the arm, shoulders, tongue, difficulty holding the head up and keeping good posture. So the head is hanging forward, hanging down, all right? So just to break it down into four diseases and let you see some of the symptoms. And I think you can see how some of these symptoms overlap right here and so it can make it very difficult to diagnose some of these. But we have to admit that all of these are very difficult to deal with and takes a lot of commitment to jump in and to do the research to go get the right doctors, the right therapy, the right medication and to keep researching to make sure we've got the right diagnosis for your loved one. You know, I wish I could make it all easier, but it's tough, it's hard, it's very hard. But it definitely is worth going to bat for these individuals, you know, they're counting on us and we want to give them our best. So if I want to dig a little bit deeper, let's talk about some more early warning signs because I just think it's important to not just give you those ones that are specific to those diseases, but way early, just memory loss can be a problem. But you know, memory loss, let's talk about that. So if I just missed one appointment, you know, I want to say not a big deal, aging brain, we're all going to, you know, forget something every now and then, especially if an emergency happens and then I look, you know, all my plates that I'm spinning get tossed up in the air and it's hard for me to get everything back. With a healthy brain, I should be able to get all my spinning plates back. But I would say if you've got a dementia, you've got some type of a neurodegenerative disease that's not going to happen. And the longer we progress into the disease, the more brain damage that happens, then it would be harder and harder to bring those plates back and be able to remember what you were doing, what you were talking about, what you were planning, okay? So early warning signs, memory loss certainly, recent or new information, if you catch someone repeating themselves, what time do we have to be there? And then a few minutes later, what time do we have to be there? No, so what time do we have to be there? And so it can drive you crazy with all these repetitive questions too. And so put on your, we need all kinds of patients when working with this. We might even write it down early on. If it's early in the disease and they can still read, then we could put a sign on the refrigerator or maybe we establish a calendar, a big calendar with big writing early on where you can put the appointments on there, so no surprises. And they feel comfortable with their schedule, difficulty with familiar, but difficult tasks like managing money or doing their medications. I have seen lots and lots of crazy situations with medications. And it's interesting that sometimes in the medicine, they've just got, they have this medicine in the Monday and this medicine in the Tuesday and this medicine in the Wednesday. Instead of having in Monday, the four things they take in the morning and then the four things they take in the evening, they may just have poured all the weeks worth of that med into one slot. I think they don't use the tool accurately and that can get them in trouble. My goodness though, I found one Medi set that had as much cat food mixed in with the pills that were there. I'm not, I'm not kidding at all, okay? So, Medi set was half cat food. It really was just a situation that had been let go way too long and I think sometimes folks know that there's a problem, but they don't really know what to do. And sadly, if we don't intervene earlier on, it waits until something very bad happens like a person falls down the steps or they come outside in the wrong time of year or, you know, you find them, they fall outside and then you've got a tragedy in that way. So, but difficulty with familiar tasks, managing money is a common thing. I cared for a woman. She lived in a high-rise retirement place in town, one of the nicest places, one of the most expensive places in a high-rise and her bills were just stacked up in a pile. And I mean, a pile that was two feet tall and so, and she was getting all these late bills and all these foreclosures on things. It's like, oh my goodness, and, you know, somebody knew that was going on. She was getting food every day. She was, you know, people were popping in. It's like, okay, you see something, say something. Because we'd love to be able to help before, I mean, she wasted a lot of money just because of the improper handling. And there are companies out there, guys, that would come alongside and help repay your bills. If you're a family member willing to take up that responsibility or flip-side, no family member, she's comfortable giving that responsibility to, okay. But there are people who, that is their job and they can come in and just pay her bills for her and trust worthy companies. And so, that's a real good resource to have. You might have seen that they have a problem with word finding or misnaming or misunderstanding. Now, all of us have problems remembering a name. I don't care who you are. You get to be close to my age, which is, you know, halfway or a little more, then remembering someone's name. Yeah, that can be tough. But that's okay. As long as you know the situation, you know what you guys were planning to do. And then later, the name will come to you. Not a big deal that doesn't worry me. But if you and I did something last week, and now I'm looking at you and I have, and it's like, I don't think so, I'm not sure I've seen you before, that would be a bigger, bigger red flag. All right, I think you've got that. Let's see. Word finding, we talked about that. Getting confused, time-place, or lost while driving, oh, this is a big one. You know, you can put locators on people's automobiles, just so you can keep track of where they are, because there are a lot of folks who don't believe they have a problem bad enough that they shouldn't be driving, especially if they don't have awareness. You talked about this a lot, if you've seen any of my podcasts, that some individuals have awareness of their memory failure, their brain failure, and some do not. And those that do not are typically in denial, and they're paranoid and suspicious of you. And they are not very trusting of you either, and they're the ones who can really get themselves in a world of trouble. And so you would need help, you'd probably need counsel to come in and be able to intervene without them ending up hating you in the process, okay? There are good techniques for that, but we'd need to talk about it to see about alternatives for driving and how we can get them to put the keys down. Missing appointments repeatedly, oh my goodness, I remember a woman, it seemed like every time I went to her home to check on her, she was actually in a retirement community, independent living at this point. She still managed her calendar, and it seemed like every time I was there, she was calling up the doctor's office saying who changed my schedule? I don't know who called and made this appointment for tomorrow, can't possibly be there tomorrow. And then don't you know, by Friday, she's calling again saying, I don't know who could possibly have made this change. And we eventually were able to relieve her of that responsibility, but things like that are tough if you are not there seeing that it's going on, okay, let's see, make sure you got your POAs, okay, powers of attorney signed and documented to those are things that should happen early on. Have you done that for your kids yet? I mean, with your kids or have you done that, do you have someone as your POA? You should, if I'm talking to you on this podcast, you're old enough that you should have someone, someone should be your POA. You just don't know guys when something's going to happen. So let's just take care of that. We're sending judgment, difficulty or problem solving, or difficulty with reasoning. Logic can go out the window as brain failure, as neurodegenerative diseases ensue and develop. And so my ability to logic with you is crazy. And so we have to be able to, there are great techniques on how to come alongside and join me on the journey when I'm making big mistakes, but it takes practice and it's just not intuitive. You know, that's why I got thrown out of the blankety blank house with my own mother. That's what gets me to this point here, why I share this information because this old nurse thought she understood dementia and I was wrong. And it's a completely different technique and it's so much more than just being nice to somebody, all right, because I was nice. I was always nice. Still got kicked out of the blankety blank house. So misplacing things, putting things in odd places, you know, when you start finding things in the freezer that don't belong there, things in the refrigerator that don't belong there, maybe things that go in the freezer in the drawer with the bread or something. Okay, those are things to make note of. And honestly, if you were to call me today and say, yeah, I'm worried about Bob, he's doing XYZ, I would tell you to journal that. I would tell you to take 30 days. I mean, unless he's in danger today, unless he's done anything significantly dangerous like you, you know, drove the car and was gone for five hours and said he went to the corner, you know, unless it was something really stark like that, but I would say just start keeping track and journal what's going on because sometimes they're sick or they have a virus or not feeling great and this too may pass. And so I would say just because you see one or two things, let's keep a journal. And that's helpful too for when it's time to go see a physician or that you have some documentation because it's easy to forget things in our age of when that happened or how long go and what really happened. So I would just say keep a journal and let's track some things and see if there's a real big problem or really not that big a problem at all. All right, change and mood and behavior. There's a page two here because like I said, I wanted to dig a little deeper. So cause some other symptoms, changes in personalities, maybe mom really doesn't want you around anymore. Maybe she's very impatient, get out of my blankety blank house and every time you question anything, she has a little fit about that. I think change in personality is definitely a clue that there's a problem. What kind of problem? Yeah, a million dollar question because there's a million things that it could be but it's worth noting, okay, loss of initiation, that could be a loss of initiation to go to their favorite places, maybe to go to church or go to their women's club or go to go have coffee with the guys in the morning or whatever it was that they love to do. So they withdraw from their normal pattern of activity and interest. They no longer want to go to their book club or places where they used to always love to go. How about in coordination, loss of strength, stiffness of the muscles? There's normal aging and certainly if we don't take care of our bodies, we will lose more and more of our abilities. You've got to, I'm telling you, it's use it or lose it, use it or lose it. I want to see you all in the gym or at least doing 10 minutes of stretching in your home and maybe get out and take a 10 minute walk. So so very important and we're reading more and more that for good brain health and protection of your brain, exercise is really up there near the top of the list, okay? Your nutrition, your sleep, your activities, so important. So please keep your body moving, do some stretching, keep all those parts moving. So so so very important. Let's see, how about gait changes or more frequent falls? Definitely a symptom when we see we start seeing a lot more falls. I mean, it's not unusual for someone to fall every now and then. We've all done it, but we're seeing a pattern again. Maybe you start documenting these things so that when you do see the doctor, you've got evidence as to what is really going on. So slow progressive disease in the brain and spinal cord's ability to tell the muscles what to do. So yeah, your brain and spinal cord will have more challenges telling the arm what to do, telling, you know, maybe the reflexes get slower. They may have a hard time just taking that first step. There's plenty of folks that I've danced with to get a rhythm going, to get them to then be able to take that first step, but it's just it's just a challenge now as brain cells die in different parts of the brain, then they can't talk to each other and tell each other what's going on. They can't even tell. They can't even tell your brain that your elbow hurts and all you're doing is cussing about it, but you can't even point to it or say the words that you've bumped your elbow so hard, you've got a skin tear. But yet you're complaining about that boy, do we need to be good detectives guys, not good judges, not this, not finger wagging people down, you better straighten up and not act like that. I'm here to take care of you. No, no, no, no, they deserve a lot better than that. Listen, people don't ask for these neurodegenerative diseases. It's so important for us to be able to come alongside and help them just like we would hope that they would help us if the table is turned. Okay. Sadly, there's lots. There are more symptoms, but I just want to dig a little deeper with you into some of these symptoms. So you have a broad view of things to look for or maybe just to notice and then journal it to see if it's really a problem or if it was just a bad day. We can all have a bad day. I mean, look at COVID has thrown a wrench into all kinds of things and caused people to have secondary issues. And so it's just worth noting if you see changes and then it's worth journaling so that we have evidences in order to give a good history of what's really going on. So I thought if we had time, looks like we do that I would just break it down into two different diseases. So let's bring that one up big so they can see this slide. So if we break it down into just two different neurodegenerative diseases, if we go Alzheimer's versus Parkinson's, Alzheimer's, cognitive, memory loss, deterioration in the thinking and planning functions, Parkinson's, cognitive, well, loss of executive function, including planning, decision making and controlling emotions, but hit the pause button. In Alzheimer's or Parkinson's is the forgetful thing first or is the physical thing first? I mean, what do we see first? I mean, I would say that these work a little bit differently. It is definitely different parts of the brain that are struggling. And so the symptoms are different. But in general, it to me seems like Alzheimer's, even though they're both neurodegenerative diseases, they both are affecting neurons, brain cells, but they're different parts of the brain. But Alzheimer seems to start more of a forgetful thing and then it can progress to a physical thing where you can't even tell your body parts what to do and you start to maybe shuffle your feet, you can't see very far, you lose peripheral vision, blah, blah, blah. But then on the Parkinson's side, I think we see physical symptoms first and then it can progress into a Parkinsonian type of a dementia with loss of executive function, including the planning, decision making and controlling the emotions. So I just think it was a good compare and contrast with these two diseases because they seem to start and progress in the opposite directions of each other. Alzheimer's physical, you know, in mid-stage is when we see problems with slowing down and rigidity and tremors possibly, things like that, shuffling, things like that. But for the people with Parkinson's, we tend to see tremors early on, don't we? Stiffness, slow movements. Inside the brain, like I said, two different parts of the brain are being attacked. It's the hippocampus for the Alzheimer's folk. What does the hippocampus do? Well, the hippocampus should be sticky and that's where short-term memory should come in and stick there. And then at night when they sleep, they should go back to long-term memory and stay there. But the hippocampus gets damaged. And it shrinks and then it's not doing its job. So those short-term memories, they just don't go anywhere. They come in and they're gone. But now if we go over to inside the brain on the Parkinson's folks, you see their problem is with that substantia nigra. And the problem there is the dopamine production, okay? And so they have, at least that's our theory at this point in time and we're supplementing dopamine to keep them working. And then if they develop Lewy body, well, then that just complicates it even more. Then Lewy body, they tend to settle into the neurons and kill the neurons too. So it's hard no matter how you look at it. But I just think it's interesting to take two different neurodegenerative diseases and look how they work and how they affect the human body and how one seems to start off with more of a cognition and then it progressed to a physical thing and one starts off more physical and progress to more of a memory and a cognition thing. So we're about out of time. Oh my gosh, you guys, time goes so fast when I'm trying to spend time with you. But ultimately, we need to bring these folks joy in the moment. It's not easy, it's not easy for you. And remember, I've always said that you're going to have to get help. You're going to have to bring help in when you're caring for someone because doing this alone, if we don't get any help at all, we really increase the risk of us getting sick or developing something. You know, the anxiety can really wreak havoc on our bodies. You know, we're developing a cancer or anxiety, we're pulling in, we're not eating right, we're not going to our, we're not following our normal routines that keep us, our mental health, good. And so I just want to warn you, you will have to bring in help and we can help you at a better approach to memory care. Okay, so I hope that was informative for you. Neurodegenerative diseases, there's a lot of them, a lot of them and there are a lot of symptoms. But when you see symptoms to journal at first and see if you've really got something or if it was just a bad week, it's okay, all right. But then if you do have something, then let's get to a doctor early on because sometimes that the medicines that we can take and help stretch that out, we can get start doing therapy, we can start doing things to really fend off the detrimental symptoms of these diseases. But I also want you to try and protect yourself from ever getting these diseases, right? By exercising, eating right, getting lots of sleep, take care of your mental health. Okay, I'm Teresa Youngstrom with a better approach to memory care. You're going to go in there and like, subscribe and share and never forget you guys that you got this. [MUSIC]