Puzzles To Remember

An Unusual Request for Alzheimer's Puzzles

2012-02-06T17:27:00.002-05:00

By Max Wallack
Puzzles to Remember

Last week, I received an unusual request for Alzheimer’s puzzles.

I was contacted by a man named Robert. Robert used to live in New York City, but he currently lives in Quindio, Columbia, South America, where he teaches English as a Second Language.

Robert also works together with a group of local psychologists who do a lot of work with Alzheimer’s patients. Together, they are working on a program to integrate English as a Second Language as a therapy for Alzheimer’s patients.

Robert says, “Second language study has been proven to offset some symptoms.”

Robert is also aware of a “cluster of patients that live in the remote area of Antioquia, . . . a mountainous region North of where I live. Some of those families are heading to the states to seek treatment for the malady. It has been in the families in this area for a number of generations already.”

Robert asked if I had any resources to send to these people in Colombia.

PuzzlesToRemember and Springbok will be sending puzzles to the Institucion El Paisa Gringo (translates as American Institution for Parents) in Colombia, South America. We hope the patients enjoy the puzzles, and we wish we could do more.

Alzheimer’s Stalks a Colombian Family

Alzheimer’s Puzzles Sent to the Alzheimer’s Association’s Adult Day Centers in Ohio

2012-02-04T15:35:00.000-05:00

By Max Wallack
Puzzles to Remember

Last week, PuzzlesToRemember sent the Springbok PuzzlesToRemember to the NorthWest Ohio Alzheimer’s Association’s Adult Day Centers in Ohio. Below is the response from one of their Respite Coordinators:

Dear Max,

The puzzles arrived at both of our Adult Day Centers, and they are AWESOME! The large pieces and beautiful colors are perfect for our participants with Alzheimer’s disease. I know they will enjoy them immensely!

Traci

PuzzlesToRemember provides puzzles to facilities caring for Alzheimer’s patients. Any caregiver who would like to purchase these puzzles for someone with Alzheimer’s can view them here.

A Note of Thanks from Rock Spring, Wyoming

2012-01-31T19:11:00.000-05:00

By Max Wallack
Puzzles to Remember

Today, I received the following note of thanks from Cindy, at the Sage View Care Center in Rock Spring, Wyoming for having donated Springbok PuzzlesToRemember to that facility.

“Thank you so much for the puzzles you recently donated to our facility. I was recently appointed the coordinator over our Alzheimer’s unit, and have been desperately looking for some good puzzles for our wonderful residents to use. Your donation arrived just when I needed them the most. Thank you for taking the time and energy to include us in your efforts. There just are not words to express how appreciative I am for you and the work you do.”

I think Cindy will make a great Activity Director and Program Coordinator!

Prejudice and Alzheimer's Disease

2012-01-26T16:19:00.000-05:00

By Max Wallack
Puzzles to Remember

This past week we celebrated Martin Luther King Day. I made of point of delivering puzzles to three nursing facilities in honor of what this day has come to symbolize. I have also applied for a college scholarship, the Martin Luther King Scholarship, which is a scholarship that Boston University grants to students who get good grades, but also serve society, while respecting individual differences.

Dr. Martin Luther King said, “We may have all come on different ships, but we are in the same boat now.”

You may be wondering, by now, what any of this has to do with Alzheimer’s and/or dementia. Well, since I have been thinking about these matters all week, I have a story about Great Grams that I would like to share.

In July of 2006, we took a family trip to Hawaii, including Great Grams. I have written about many aspects of this trip previously, but I don’t think I have ever shared the events at the airport in Honolulu as we waited for our return flight home.

(As a reminder, Great Grams was about 94 at the time, and she had moderate to advanced Alzheimer’s disease.)

My family had arrived early for the flight. We were all quite tired, since many of the events in Honolulu had involved significant episodes with Great Grams.

Suddenly, Great Grams looked up and noticed several Black individuals sitting in the same boarding area. She became very upset and clearly announced that she would not be getting on the flight that had Black people on it.

My family, including myself, was entirely taken by surprise. In fact, we were shocked beyond belief. Great Grams had lived her whole life in integrated neighborhoods. She raised her family in a Boston Housing Authority apartment. Various races were certainly nothing new to her, and we had NEVER heard her express any prejudice previously.

We weren’t sure how to handle this situation. Great Grams would always perseverate; she continued to be adamant that she was not getting on that plane. We knew reasoning would not work.

After trying various solutions, we tried something that worked. We got up and changed our seats so that we were not facing the African American individuals. Sure enough, within a few minutes, Great Grams forgot all about them.

Then, something happened that made the whole incident more vivid in my memory. Some of the young African American children from this family were running around the boarding area, playing happily. Now, many of you may remember that Great Grams loved children.

Great Grams called the children over to her and began playing with them. She commented on how cute and smart they were. She was so happy! She enjoyed playing with those children for most of an hour.

Now, I think back about how much Great Grams’s dementia taught me about prejudice. She clearly demonstrated to me that prejudice is fear in its very basic state. Great Grams had never previously exhibited prejudice, but she was a very, very fearful individual.

She was fearful of these individuals that appeared different from herself. Yet, she was very loving to the children, whom she didn’t fear.

Great Grams clearly taught me an important life lesson that day when I was ten. I learned that prejudice is a function of fear. I also learned that most of the agitation evidenced by Alzheimer’s patients is rooted in fear and misunderstanding.

Is this true today for the many people in our society that shun Alzheimer’s and dementia patients? Is this a case of prejudice based in fear? Are some siblings and children of Alzheimer’s patients fearful of what they don’t understand? Is it because Alzheimer’s patients appear different sometimes? Do people turn away because they afraid that they may be looking at their own future? Are they afraid they won’t be capable of doing the job of the full-time caregiver, so they just don’t try at all?

Can we look deeper and see the person that is “still there?” Can we find that happy child that is still within them? If we can overcome our fears, we will find that there remains something in there that can still be of value not only to them but to ourselves.

We all need to do this because, with the impending tsunami of Alzheimer’s disease, in the words of Dr. Martin Luther King , we will soon all be “in the same boat.”

Puzzles Delivered to Three Nursing Facilities in Honor of MLK Day

2012-01-16T18:12:00.000-05:00

By Max Wallack
Puzzles to Remember

Today, I delivered jigsaw puzzles to three nursing facilities in honor of MLK Day. These facilities received some very nice puzzles, including many of the recently donated Ceaco puzzles.

Since I have already donated puzzles to so many facilities in Massachusetts, most of my donations are now shipped to other states, but I felt it was important, as a tribute to Martin Luther King's values, to personally bring these puzzles to patients who could benefit from them.

Presentation About PuzzlesToRemember at Philips Corporation

2012-01-13T17:25:00.000-05:00

By Max Wallack
Puzzles to Remember

Today I gave a presentation about PuzzlesToRemember at Philips Corporation in Andover. Specifically, I spoke to the Ultrasound Department members.

They, and other departments, have been collecting puzzles for Alzheimer’s patients since September. They have donated almost 200 puzzles. They were very interested to hear about Alzheimer’s patients and how they benefit from working on puzzles. They were also interested in the Springbok PuzzlesToRemember, developed specifically for Alzheimer’s patients.

They plan on continuing to collect puzzles as part of their ongoing community involvement. I thank them. They are making a difference in the lives of many people.

Springbok Donates Specialized Alzheimer’s Puzzles to Fifty Alzheimer’s Facilities

2012-01-12T16:19:00.002-05:00

By Max Wallack
Puzzles to Remember

Springbok has produced four new images for their specialized line of Springbok’s PuzzlesToRemember, made specifically to meet the needs of Alzheimer’s patients. You may click on the name of the puzzle under each image to order that puzzle.

Coral Carnival

Country Mill

Crimson Road

Durango Express

As part of Springbok Cares, their program to give back to society, they are also supplying these puzzles free, this week, to fifty Alzheimer’s facilities that I have chosen.

Alzheimer’s caregivers, both in facilities and in home care, attest to the value of these puzzles as a tool to promote positive interaction between patients and caregivers, as well as a mood-lifting tool that provides the patients with a sense of accomplishment that lasts well beyond the puzzle-making session.

Alzheimer’s Patients Have Received Over 10,000 Puzzles

2012-01-12T16:01:00.000-05:00

By Max Wallack
Puzzles to Remember

PuzzlesToRemember has now distributed over 10,000 puzzles to facilities that care for Alzheimer’s patients. These facilities are located in every state, as well as Canada and Mexico.

Activity Directors frequently contact PuzzlesToRemember, requesting puzzle contributions. They often cite the scarcity of much needed activities for their patients with moderate or severe Alzheimer’s disease.

Recently, many individuals have emailed offering to donate their own puzzles. Some have only a few puzzles to donate. Others have contributed several hundred puzzles. Every puzzle has the potential to help many seniors in nursing facilities. Usually it is possible to match up the difficulty of the puzzle with a nursing ward with residents of appropriate abilities. Everyone benefits.

Those donating puzzles are even able to claim their value as a tax deduction! Contact PuzzlesToRemember@gmail.com, and you will be given a location to which to bring your puzzles as well as a donation letter for tax purposes.

Ceaco Donates 113 Puzzles for Alzheimer’s Patients

2012-01-11T18:13:00.000-05:00

By Max Wallack
Puzzles to Remember

Today Ceaco, a puzzles manufacturer who has supported PuzzlesToRemember since 2009, donated 113 new puzzles.

These puzzles vary greatly in their level of difficulty, so they will each be sent to a nursing facility unit matched for the ability of the residents. Senior citizens seem to especially enjoy animal puzzles.

More simple puzzles, like this American scene by Jane Wooster Scott, will be sent to facilities that have patients with Mild Cognitive Impairment. These puzzles have fewer pieces that are oversized and easier-to-grasp. Research shows that working on puzzles can help delay the point at which an early Alzheimer’s patient becomes no longer able to function in society.

Thank you, Ceaco, for continuing to help so many people, and a special thanks to Laura for accumulating these puzzles, keeping them for PuzzlesToRemember, and helping load them into my car today.

1,000 Alzheimer’s Facilities Have Received Puzzles

2012-01-02T16:23:00.000-05:00

By Max Wallack
Puzzles to Remember

Today, to celebrate the New Year, I delivered puzzles to my 999th and 1000th facility. The facility with the 1000th designation happened to be a Kindred Healthcare facility in Saugus, Massachusetts. That seemed fitting because my great grandmother spent the last weeks of her life being well-treated in a Kindred facility. Here are photos of my two deliveries.

I am also very happy to announce that Springbok’s newest PuzzlesToRemember will be available very soon. The new puzzles will include a country mill scene, a colorful fish scene, and a steam railway train. I think these images will be very memory provoking for Alzheimer’s patients, and the puzzles will be a great, activity for Alzheimer’s patients to share with their caregivers.

Important Questions About Alzheimer's

2011-12-23T15:09:00.000-05:00

Carole Larkin, from Third Age Services in Dallas TX was asked these common questions by a student at Goddard College. Her answers are very informative.

By Carole Larkin
Alzheimer's Reading Room

Q. If Alzheimer’s cannot actually be determined until viewing the brain after death, does that mean all current Alzheimer’s cases are actually only presumed?

If so, is there a proper medical term for this?

A. In my opinion, it’s kind of a cop out to say that Alzheimer’s can’t be determined until autopsy. PET scans show beta amyloid collecting in the brain, and beta amyloid is considered to be one of the main biomarkers of Alzheimer’s, by a good percentage of current researchers. You can measure Tau, another naturally produced protein and another generally recognized biomarker of Alzheimer’s disease by doing a spinal tap. Atrophy of the brain (a sign that brain cells have died in a certain area of the brain), can be seen on an MRI. Given the right diagnostic procedures, neurologists, geriatricians and geriatric psychiatrists can diagnose Alzheimer’s at over a 90% accuracy rate. The deal is that most people don’t get a “proper” diagnosis. They go to their family physician; he or she asks a few questions of the patient, throws some Aricept at the patient and says “I’m done with you. You’re on your own. Good luck.

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Q. Does there seem to be a correlation between a personality type and people who get Alzheimer’s? (Is an introvert more likely to be affected than an extrovert?

A. As far as I can tell, personality type has zero correlation to getting Alzheimer’s. It’s a biological disease not a psychiatric or psychological disease. Most current research points to beta amyloid plaques and tau tangles in neurons (brain cells) to be the biologic markers of the disease. These two are normal proteins that we have in our bodies, and that we need for our continued existence. For some reason, they go haywire and start killing brain cells. Research is trying to figure out why this happens and how to stop it or fix it.

Q. In my research, I have found that chronic stress, anger, neurosis and holding in emotions can possibly contribute to Alzheimer’s. Do you agree with this?

Absolutely not! Like I said in my answer to the last question, Alzheimer’s is a biologic disease. I can tell you though, that a person with these attributes before the disease stands a better chance of becoming a nightmare to those caring for them. Sometimes the disease works in a way that people become more of themselves. If they were nasty before, then all they become is double nasty. Some caregivers are lucky though, their person becomes the opposite of what they were before. In other words nice, for the most part. You never know which way it will work out. I’ll tell you this much; if I’m a caregiver, I’m praying for the second scenario! I find the description of chronic stress, anger, neurosis and holding in emotions far closer to describing the caregiver than the care receiver.

Q. Does retreating into one’s own head (becoming quiet, shy, withdrawn) worsen symptoms?

A. Retreating into one’s own head, as you put it, is many times a symptom of the disease itself. The disease can strike area of the brain where our ability to communicate comes from. That means that people can lose the ability to recall words they used to know, or lose the ability to know the meaning of words, thus substituting an incorrect word for another word in speaking. Also, in the beginning of the diseases people can be/are aware that they have deficiencies in their speech. Therefore, to save themselves from embarrassment, they simply stop speaking as much. That seems to be a natural enough reaction to me. Not particularly helpful in the long run, but useful to the person in the moment.

Q. Does depression worsen symptoms? If so, would antidepressants ever be prescribed to assist?

A. An excellent question! Absolutely depression can proceed or coexist with a dementia. Some research points to depression being a risk factor for dementia. I don’t know about that, but I’ve seen a number of cases where someone with dementia and depression was treated for the depression, and it helped their mood. I have also seen where doctors have treated depression instead of dementia. Those treatments didn’t help the memory issues at all, and became less effective on the behavioral issues, as more neurons died. I guess the easiest thing to say is it varies with each individual.

Q. At what point does a patient lose the ability to understand that they have Alzheimer’s?

A. excellent question! Some people never understand that they have Alzheimer’s or another dementia. It’s called Anosognosia (a lack of ability to know that they have a disability). The portion of the brain that controls our awareness about ourselves is damaged by dying neurons. Biologically they can’t know that they have a cognitive illness. That’s different than denial. Denial is a purposeful thought process that rejects something they inherently know to be true. Some people do know and are aware that something is wrong with their thinking processes. They may not know exactly what it is, but they know that something is not right, that they are different than other people. Some people will say “I have Alzheimer’s” some will say I have memory problems” or any one of a number of similar things. It’s really depends on the individual. I can say that if someone understands that their thinking is impaired, it happens fairly early in the diseases. Sometimes the knowledge stays with them months or years, sometimes not. It depends upon how fast the disease proceeds and which portions of the brain become impaired.

Q. Are visual cues (photo albums, trinkets, memory books) recommended as memory aides? Might these cues become upsetting to a patient in later stages and be taken away?

A. Very early in the disease visual cues are useful to a certain extent, but as the disease goes on their usefulness begins to fade. That is because of two reasons: one, the mental connection of the object to the memory related to it begins to fade and two; the meaning of the object itself may become not understandable to the person. For example; a souvenir of a boat may represent a cruise that the person has taken, but if the person no longer understands what a boat is, then they would not be able to make the mental jump to a memory of their own that happened on a boat (cruise). Some individuals may become perturbed if they were reminded by an individual that they were on a boat like this, and they didn’t remember it, but much more often they wouldn’t believe the other person when they said that they had on the boat. Their thought process would go something like this, “I’d remember if I were on a boat that looked like this. Since I don’t remember it, it couldn’t have happened. Therefore this other person is lying to me.” The thought that they couldn’t remember events doesn’t enter their minds. (More of the lack of self awareness thing.) The objects may not be upsetting, they just may be ignored, it’s the other person insisting that they did something that they know (in their minds) that they did not do that needs to go. The person is the antagonist, not the thing. That said simplifying a person with dementia’s surroundings is a good thing later on in the diseases because too many things to look at could cause visual overstimulation which then becomes confusing to the person and may result in agitation or anger as a behavior displayed to others.

Q. When a patient does not recall a person, is it recommended to introduce yourself, even if the result might be upsetting the patient? (i.e.: “I am your wife.” Or “I am your son/daughter.

A. I think that it all depends on the individual with the dementia. Some people would not be upset learning for the first time (to them) that they had a son or daughter or husband or wife or aunt or uncle, and so on. Others will get very upset being told that they have any of the above because they may think that they are a different age than they really are (usually younger) and they couldn’t be married or have any children because the are too young (if they thought that they were twelve for instance). Or perhaps they know that they know you, but they are just not sure of how they know you, or if you have a relationship to them. You could start by simply stating your name, as in; Hi, I’m Emily and I’m a person who (likes) loves you very much. That way, you skirt around the relationship issue while making them feel good, because someone feels warmly toward them. It’s about respect for the individual, and not pointing out their deficiencies. It’s not like they can do something to fix their memory loss, so why point it out to them? All it can do is hurt their feelings.

Q. caregiving, is there an increased amount of concealing things/telling “little white lies” patients to keep from upsetting them? Do you have any examples?

A. I suppose they could be called “lies”, but to me, they are told because the person telling the person with dementia loves that person and doesn’t want them to be hurt. We can’t change the bad things that happen to people, but we can soften the blow to people who love them and would get upset, anxious, cry and grieve every time they were told of the bad event. I call that “compassion”, not “lies”.

The classic example is of course the person with Alzheimer’s or a related dementia asking where a spouse or sibling or child is, and in fact the person has died (sometimes many years ago). Telling them the “truth”, i.e. the person is dead could cause the person with dementia immediate grief, as if their loved one had died that second. Deeper into the diseases (say early mid-stage) when the person cannot record and keep new information, they may ask twenty times a day, “where is {so and so}”; how cruel would it be to tell them twenty times that {so and so} is dead, so that they grieve twenty times a day? Now it’s a different story if they didn’t like the person who is dead. You see? It’s all about sparing someone who is very vulnerable feelings that hurt.

Carole Larkin MA,CMC,CAEd,QDCS,EICS,
is a Geriatric Care Manager who specializes in helping families with Alzheimer’s and related dementias issues. She also trains caregivers in home care companies, assisted livings, memory care communities, and nursing homes in dementia specific techniques for best care of dementia sufferers. ThirdAge Services LLC, is located in Dallas, TX.

Dreyer’s Donates $250 to provide puzzles to Alzheimer’s Patients

2011-11-27T19:54:00.002-05:00

By Max Wallack
Puzzles to Remember

This week PuzzlesToRemember received a $250 donation from Dreyer’s. The money was used to ship out the puzzles that were collected by Philips Corporation. About 12 Alzheimer’s facilities are receiving boxes of puzzles for their patients to enjoy.

This is the meaning of microphilanthropy: each person/company doing just some small thing within their capabilities builds to make the world a much better place.

Here is a photo of someone enjoying her life just a little more because of Dreyer’s and Philips:

Philips Healthcare Donates 148 Puzzles

2011-11-17T15:30:00.000-05:00

By Max Wallack
Puzzles to Remember

Philips Healthcare in Andover MA has taken on collecting puzzles for PuzzlesToRemember as an important project. Yesterday, they donated 148 puzzles. They have also publicized the cause on their internal website, and employees from many departments have been contributing.

In January, I will have the opportunity to visit their company and give a presentation about PuzzlesToRemember and, possibly, about some of the Alzheimer’s research I am doing at Boston Medical Center. The Philips employees have decided to continue collecting puzzles, showing their commitment to help patients who can benefit from this activity.

Below is a photo of the puzzles Philips Corporation donated yesterday. Even the soccer ball can be useful as tossing a ball around the room is often used as a physical therapy exercise for Alzheimer’s patients.

Empire State Building Celebrates Alzheimer’s Month

2011-11-07T20:20:00.000-05:00

By Max Wallack
Puzzles to Remember

Here is a beautiful photo of the Empire State Building lit up in purple to celebrate National Alzheimer’s Month. In the words of a three-year-old whose grandmother has Alzheimer’s:

"All the people who forget, like grandma, are being remembered by the people who are able to remember!"

Springbok Puzzles Donates Springbok PuzzlesToRemember for Alzheimer's Patients to 11 Adult Day Care Centers

2011-10-23T19:52:00.001-04:00

By Max Wallack
Puzzles to Remember

Last week, Springbok Puzzles, at their own expense, shipped their specialized Alzheimer’s puzzles to eleven additional Adult Day Care Centers.

These puzzles continue to receive outstanding reviews from Alzheimer’s caregivers and Alzheimer’s facilities. They provide a sense of calm, well-being, and accomplishment that stays well beyond the puzzle making session.

The holiday season is approaching. There are several Springbok PuzzlesToRemember that would make wonderful gifts for someone with Alzheimer’s Disease. Below are a few examples. Click here to order any of these puzzles.

Philips Andover Employees Help PuzzlesToRemember

2011-10-23T19:30:00.000-04:00

By Max Wallack
Puzzles to Remember

The employees at Philips in Andover MA are collecting puzzles for PuzzlesToRemember.

Andover is the global headquarters for Philips Healthcare and U.S. headquarters for Philips Electronics North America. The Andover location employs about 2,600 people.

Philips’ employees pride themselves because

“ Most are involved in creating, engineering, marketing, and manufacturing imaging and information solutions designed to improve the health and wellbeing of people around the world.”

Thank you, Philips. I look forward to coming to your offices in January and speaking to you about PuzzlesToRemember.

Wandering: Try these tips to prevent wandering out of the house by your loved one

2011-10-09T19:08:00.000-04:00

By Carole B. Larkin

1. If there is a securely locked high fence around the whole perimeter of the property, let your loved one go outside, in good weather. Go outside with them.

2. If there is no secure fence or there is other danger to allowing them to go outside at will, try these approaches:

A. Remove from site triggers that would make the loved one or person with dementia think of going out, such as coats, umbrellas, shoes, purse, etc.

B. Tell your loved one or person with dementia frequently where they are and why, in a calm tone of voice. Reassure them with words like, "XXX will return in an hour to be with you" or "Your family knows where you are".

C. Don't confront or argue with the person, walk with them and redirect to another part of the house or to an activity. Use humor if possible.

D. Purchase childproof doorknob covers, or deadbolts to put on the door above the loved one or person with dementia's eye level, or slide bolts on the top or bottom of the door. These items will never be used when the loved one or person with dementia is alone in the home, only when someone is with them.

E. If you don't want to do any of the above, place warning bells above the
outside doors, or activate the house alarm system, or get a monitor that
goes on the loved one or person with dementia (such as a toddler monitor) or
a pressure mat alarm, so at least you know when your loved one or person
with dementia has left the house.

F. Try putting a full-length mirror on the inside face of the outside door.
Sometimes people don't recognize themselves and think someone is standing
there and turn around and go back.

G. Try putting a black throw rug in front of the outside door. To some
people, it looks like a hole in the floor and that they won't attempt to
cross it.

H. You might try to hide the outside door by putting a curtain in front of
it, or maybe by making sure it is the same color as the surrounding walls,
that way it may not be seen by the loved one or person with dementia.

I. Put a big sign on the outside door saying "Stop" or "Do Not Enter" or
"Danger- Do not Open".

J. Sew ID labels in the loved one or person with dementia's clothes, or get
a special Medic alert bracelet for the loved one or person with dementia, if
they have a history of escaping the house. Also they need to have a current
picture and a piece of unwashed clothes (for tracking dogs) handy to give to
the police, in case the loved one or person with dementia does escape.

K. If the loved one or person with dementia escapes while you are in the
bathroom , grab your cell phone, and run out side, look around the whole
block the house is on. Cover the whole block, if not found, call 911 and
tell them that a person with dementia has escaped the house and is lost. Try
to convince them that this person needs to be found immediately, they need
their medicines badly.

L. If the loved one or person with dementia doesn't recognize his or her
home as where they live, they may want to leave to go "Home". They may be
thinking of a home they lived in previously, such as in their childhood.
Instead of telling them that this is their home, talk about the home they
are thinking of. Reminiscing about it sometimes lessens their urge to leave.

M. If they still want to go "home" tell them you will walk with them, and
take a walk with them or tell them that you will drive them there, and take
them out for a drive. It may help if you stop to get a treat, an ice cream
cone, or snack. They probably will have forgotten about the other home by
the time you get back, and may even recognize where they live now as home.

Carole Larkin MAG, CMC, CDP, EICS,
is a Geriatric Care Manager who specializes in helping families with Alzheimer’s and related dementias issues. She also trains caregivers in home care companies, assisted livings, memory care communities, and nursing homes in dementia specific techniques for best care of dementia sufferers. ThirdAge Services LLC, is located in Dallas, TX.

Nestlé UK and Ireland Donate Over 350,000 Pounds to Their Alzheimer's Society

2011-10-08T13:56:00.000-04:00

By Max Wallack
Puzzles to Remember

Nestlé UK and Ireland donated over 350,000 pounds to their Alzheimer's Society. Nestlé chose the Alzheimer's Society as their "Charity of the Year, 2011".

For the past 12 months, Nestlé UK and Ireland's employees have conducted many fundraisers. These have included bicycle challenges, marathons, quiz nights, football tournaments, raffles, and treasure hunts. Some even participated in a sky dive!

Paul Grimwood, CEO and Chairman of Nestlé UK and Ireland, said:

"I am proud that Nestlé employees have smashed our target. The money will help fund the Alzheimer's Society's National Dementia Hotline and valuable research into finding the cause and a cure for dementia which affects over 750,000 people in the UK."

You can read more here.

Alzheimer's Dilemma: I Don't Want My Grandchildren to See Me Like This

2011-09-18T18:39:00.000-04:00

By Max Wallack
Puzzles to Remember

As an editor for both PuzzlesToRemember and the Alzheimer’s Reading Room, I get some interesting questions, but none has been so difficult to answer as the question above.

This question has been on my mind for almost a week. I can imagine that this subject alone could be the focus of an entire course in medical ethics. Below are my thoughts. I am interested in learning what you think about this issue.

If an early stage Alzheimer’s patient, still capable of making rational decisions, said they did not want to see their grandchildren, for whatever reason, I would try to abide by that decision.

I don’t think this would be good for the grandchildren. I would try to explain the decision to the children by saying the grandparents' brain is overwhelmed right now, and can’t bear to deal with any additional emotions -- even the love of the grandchild.

However, if an early stage Alzheimer’s patient, capable of making rational decisions, said they did not want to see their grandchild later, some time in the future, I would not react in the same way. I think each person should be allowed to change his/her mind.

What is good today, may not be what is best tomorrow, and this is especially true for Alzheimer’s patients.

My plan would be to ask the Alzheimer’s patient at the time when the visit would take place. If, at that time, the patient beamed at the idea of seeing the grandchildren (which, in my opinion, would be very likely), I would consider the patient to have made a different decision, under different circumstances.

Often Alzheimer’s patients who can no longer speak, light up when they see their loved ones. I remember how overjoyed great grams was when she saw me.

In Alzheimer’s World, we have learned that the truth is not always the best medicine. Not allowing the interaction between two people who need and love each other because of a desire to keep an old promise, just isn’t the way things work best in Alzheimer’s World.

In Alzheimer’s World, there is only today, and the today of both the grandparent and grandchild would be best served by allowing them to interact.

It could be harmful to the grandchild if they are not allowed to see the grandparent. I think it would be very frightening to a child to think that the grandparent was so bad off that it would be too horrible to see them.

The imagination can be even more frightening than the reality, even in this horrific disease. Perhaps even more devastating would be thinking that the grandparent didn’t want to see them. I think it would be easier to accept that someone can’t know me because they are very ill; than to accept that someone who loved me, no longer wants any involvement with me.

There is no question that this is a very difficult moral dilemma.

I am interested to see how others feel about this subject.

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What’s the Difference Between Alzheimer’s Disease and Dementia

Original content Max Wallack, the Alzheimer's Reading Room

Alzheimer’s Foundation of America is Sponsoring the National Brain Game Challenge

2011-09-18T18:18:00.000-04:00

Merl Reagle, whose puzzles are syndicated in over 50 newspapers, has created a special series of challenging puzzles for the Alzheimer’s Foundation of America.

By Max Wallack
Puzzles to Remember

The Alzheimer’s Foundation of America (AFA) presents the inaugural National Brain Game Challenge, an exciting online game of skill created by renowned puzzle master Merl Reagle. Designed for novices, puzzle buffs and anyone else up for a challenge, the contest sends the message—in a fun way—that it’s never too early or too late to embrace brain health.

Anyone who wishes to participate can sign up at http://www.alzfdn.org/challenge/. There is a $25 registration fee which will give you online access to the puzzles beginning at 3 p.m. ET on September 25. On September 28, the Alzheimer’s Foundation will announce the winners. There will be a $5000 grand prize, as well as other prizes.

According to the Alzheimer’s Foundation,

"The educational and fundraising event is aimed at boosting awareness of lifestyle choices that promote brain health; alerting the public about AFA as a resource for support services and information about memory concerns, successful aging and caregiving; and raising funds for AFA’s programs and services nationwide.

It stems from research that suggests that regular mental workouts may help reduce the risk of Alzheimer’s disease—an incurable brain disorder that is increasing in incidence nationwide and primarily affects the older population."

I recognize the value of this kind of mental activity, not only to reduce the risk of Alzheimer’s Disease, but also as a valuable therapeutic treatment for those with the disease. That’s why PuzzlesToRemember exists.

You have to be 18 years old to sign up, so, unfortunately, I won’t be competing.

BestAlzheimersProducts Donates Puzzles to PuzzlesToRemember

2011-09-04T18:22:00.000-04:00

By Max Wallack
Puzzles to Remember

I want to thank Holly at www.BestAlzheimersProducts.com for donating 24 nice puzzles to PuzzlesToRemember. Her company thought this group of puzzles was a bit too complicated for Alzheimer’s patients, so I agreed to find them a home where they can help elders with early mild cognitive impairment.

BestAlzheimersProducts was founded by caregivers to help other caregivers. Their reason was that

"One of the first things we learned when we started caring for Bernice was that she was less moody, more energetic, more communicative and happier when we kept her active."

BestAlzheimersProducts provide “cognitive and sensory stimulation and . . . inspire conversation and socialization.” They also have a growing inventory of Aids for Daily Living and safety products.

I, personally, am very proud that BestAlzheimersProducts has chosen to carry the Springbok’s PuzzlesToRemember. They can be seen here. I receive constant feedback about the value of these puzzles.

Clementoni Donates Puzzles for Alzheimer's Patients

2011-08-29T18:52:00.000-04:00

By Max Wallack
Puzzles to Remember

Today, I received some beautiful puzzles from Clementoni’s Museum Collection. The puzzles are 1000 piece puzzles depicting the painting “Coronation of Napoleon” by David. They are beautiful, high quality puzzles. They are really too difficult for most Alzheimer’s patients, so I will have to put lots of thought into where they might do the most good. Perhaps they would be well used at a Senior Center where patients with Mild Cognitive Impairment meet regularly. It would also give these individuals an opportunity to appreciate some beautiful art.

Do You Really Get to Choose the Facility for a Dementia Patient?

2011-08-25T21:14:00.001-04:00

By Max Wallack

Great Grams (Gertrude Finkelstein) and Max Wallack
No matter how hard you try to keep a dementia or Alzheimer’s patient at home, eventually the day may come that it is not possible.

We had planned that that day would never come for Great Grams.

She had spent about a week in a major teaching hospital because of leg pain. The doctors tried a great number of medications. Nothing really seemed to help. I suspect the pain was really caused by some of her faulty wiring in her brain.

However, while she was in the hospital, the doctors realized just how much she had deteriorated mentally. She was choking on food and rarely communicated.

However, Great Grams had a compulsion to run, and she was going to run every chance she got. They had to hire a “sitter” to stay in the room with her. Even the sitter couldn’t handle her. When Great Grams saw a young child visiting someone, she was running to play with them. Eventually, they used diapers to tie her to the chair.

Great Grams had been on Reminyl. Her own doctor had told us that when a person who is on Reminyl stops taking the drug, they decline rapidly, quickly losing all the abilities that the drug had help maintain.

During that hospital visit, some physician decided that the Reminyl wasn’t doing her any good because she was in such poor condition. So, he stopped the drug. That was really the beginning of the end for Great Grams.

Great Grams came home with us soon after. She had been put on hospice home care. Included was a 24 hour nurse available by phone. The nurse was called many times those first few nights.

Great Grams wouldn’t sleep. We rented a special bed with sidebars. You would think that would work on a small 93 year old woman, wouldn’t you? Nope. All that did was make a higher surface from which Great Grams could fall on her climb out.

Grandma was exhausted. Grandpa slept on the floor at the door to Great Grams room just to keep her inside for a few hours so Grandma could rest.

After a few days, hospice took her off their list, saying they couldn’t handle her. They suggested maybe she had another urinary tract infection, and we should take her to the local hospital. Great Grams “agreed” to go, even taking off her rings and handing them to Grandma. She must have understood at some level.

Of course, the hospital did find a urinary tract infection. They always found one whenever they tested Great Grams. They kept her for several weeks. But, she did not improve. The doctor there, who had seen her only a few months earlier, was shocked at her deterioration. (No Reminyl).

In that hospital, she climbed out of the high bed frequently, and fell on the hard tile floor. Eventually, they also tied her down.

Then, the hospital decided they could no longer keep her, and that she was too ill to be cared for at home. They said we had to get her out of there within a few days, or the bill of almost a thousand dollars a day would be ours to pay.

A few days later, an “opening” happened in a dementia ward in a facility in a neighboring town. We were told we basically had no choice. Great Grams would be sent there in an ambulance.

Grandma went over to see the place. She had read about nursing homes. One thing she had read was to make sure there was no urine odor.

When Great Grams went to the dementia ward, she was almost knocked off her feet by the stench of urine! When the nurse showed Grandma what would be Great Grams’ bed, Grandma saw a small insect crawl across it. It was a nightmare!

HOWEVER, first impressions can be wrong. It turned out that the odor had been caused by a defective bathroom toilet which was being repaired. Insects were never seen again.

And –MOST IMPORTANT OF ALL- the nurse in charge of the unit was a man with a huge heart! He treated each patient as if they were his own mom. He had eyes “in back of his head” and was aware of where each patient was and what they were doing.

Each afternoon, he would put on Sousa marches and march in the halls with each patient who could do it. His staff took their cues from him and treated the patients with respect.

They made every attempt to avoid restraints. They even put mattresses on the floor on both sides of Great Grams’ bed for when she got up at night.

Every day, after breakfast, chairs were all lined up around the nurses’ station so the patients could sit and be entertained by watching the nurses come and go. When one patient had a visitor, it was a visitor for all the patients.

We still hoped to take Great Grams home. The head nurse told us that the hospital had “warned him” that we still felt that way.

However, Great Grams continued to decline rapidly. She couldn’t and wouldn’t eat. Soon, we had to give permission for restraints because she kept falling and falling. The head nurse was very, very kind to her. She couldn’t have been in a better place.

It didn’t matter that the rug was old. It didn’t matter that the nurses’ station was all scuffed and banged up. It didn’t matter that the physical therapy was in the basement of this old, old building which had once been a factory.

It mattered that the people who cared for Great Grams were very kind.

The last time I saw Great Grams, a few days before her death, she was restrained in a chair sitting near the nurses’ station, watching everything. She played tug of war with me -- pulling me toward her so strongly that I really could barely free myself. Then, she would pull again. She was still communicating with me.

American Express Gives Its Support to PuzzlesToRemember

2011-08-24T18:42:00.000-04:00

By Max Wallack
Puzzles to Remember

I want to take this opportunity to thank American Express for its ongoing support of PuzzlesToRemember. Several employees at American Express have pledged to make monthly donations, and American Express is matching those donations.

I receive many donated puzzles, and they all have the potential to bring feelings of joy and fulfillment to Alzheimer’s patients. However, I also rely on companies with heart, like American Express, to supply the funds that it costs to ship the puzzles to where they can do the most good.

Thank you again!

Alzheimer's Dilemma: I Don't Want My Grandchildren to See Me Like This

2011-08-20T19:57:00.000-04:00

By Max Wallack
Puzzles to Remember

As an editor for the Alzheimer’s Reading Room, I get some interesting questions, but none has been so difficult to answer as the question above.

This question has been on my mind for a while. I can imagine that this subject alone could be the focus of an entire course in medical ethics. Below are my thoughts. I am interested in learning what you think about this issue.

If an early stage Alzheimer’s patient, still capable of making rational decisions, said they did not want to see their grandchildren, for whatever reason, I would try to abide by that decision.

I don’t think this would be good for the grandchildren. I would try to explain the decision to the children by saying the grandparents' brain is overwhelmed right now, and can’t bear to deal with any additional emotions -- even the love of the grandchild.

However, if an early stage Alzheimer’s patient, capable of making rational decisions, said they did not want to see their grandchild later, some time in the future, I would not react in the same way. I think each person should be allowed to change his/her mind.

What is good today, may not be what is best tomorrow, and this is especially true for Alzheimer’s patients.

My plan would be to ask the Alzheimer’s patient at the time when the visit would take place. If, at that time, the patient beamed at the idea of seeing the grandchildren (which, in my opinion, would be very likely), I would consider the patient to have made a different decision, under different circumstances.

Often Alzheimer’s patients who can no longer speak, light up when they see their loved ones. I remember how overjoyed great grams was when she saw me.

In Alzheimer’s World, we have learned that the truth is not always the best medicine. Not allowing the interaction between two people who need and love each other because of a desire to keep an old promise, just isn’t the way things work best in Alzheimer’s World.

In Alzheimer’s World, there is only today, and the today of both the grandparent and grandchild would be best served by allowing them to interact.

It could be harmful to the grandchild if they are not allowed to see the grandparent. I think it would be very frightening to a child to think that the grandparent was so bad off that it would be too horrible to see them.

The imagination can be even more frightening than the reality, even in this horrific disease. Perhaps even more devastating would be thinking that the grandparent didn’t want to see them. I think it would be easier to accept that someone can’t know me because they are very ill; than to accept that someone who loved me, no longer wants any involvement with me.

There is no question that this is a very difficult moral dilemma.

I am interested to see how others feel about this subject.