Life

Hiring Home Services or Repairs During COVID-19

September 1, 2020 Caregivers, Life

CDC offers the following tips for staying safe and slowing the spread of COVID-19 while scheduling services or repairs inside the home. This may include installation and repair of plumbing, electrical, heating, or air conditioning systems; painting; or cleaning services.

In general, the closer and longer you interact with others, the higher the risk of COVID-19 spread. Limiting close face-to-face contact and staying at least 6 feet away from other people is the best way to reduce the risk of COVID-19 infection, along with wearing masks and practicing everyday preventive actions. Before welcoming service providers into your home, consider these tips to help keep you, your family, and the service provider safe during in-home services or repairs:

Before the visit

Check with your local health department to see if there is a stay-at-home order in your state or local community that restricts non-essential activities or services. If a stay-at-home order is in effect in your community, consider if the service request is essential or if it can be delayed.
If you or someone in your home has COVID-19, has symptoms consistent with COVID-19, or has been in close contact with someone who has COVID-19, wait to schedule non-emergency services that require entry into your home until it is safe to be around others.
If you or someone in your home is at higher risk for severe illness from COVID-19, such as older adults or those with underlying medical conditions, consider not being inside the home during the service, or find someone else who can be in the home instead.
Do as much of the pre-service consultation as possible before the service provider arrives, to reduce the amount of time the service provider spends inside your home. For example, discuss the details of the service request on the phone or by email, and send pictures ahead of time.
Discuss any COVID-19 precautions the service provider is taking, including the use of masks for the duration of the service visit, any pre-screening procedures (such as temperature checks) and using the restroom during the service call.

During the visit

Do not allow service providers to enter your home if they seem sick or are showing symptoms of COVID-19.
Ask the service provider to wear a mask before entering your home and during the service visit. Also, you and other household members should wear a mask. Consider having clean, spare masks to offer to service providers if their cloth face covering becomes wet, contaminated or otherwise soiled during the service call.
Avoid physical greetings, for example, handshakes.
Minimize indoor conversations. All conversations with the service providers should take place outdoors, when possible, and physically distanced indoors, if necessary.
Maintain a distance of at least 6 feet from the service provider, and limit interactions between the service provider and other household members and pets.
During indoor services, take steps to maximize ventilation inside the home, such as turning on the air conditioner or opening windows in the area.

After the visit

If possible, use touchless payment options or pay over the phone to avoid touching money, a card, or a keypad. If you must handle money, a card, or use a keypad, wash your hands with soap and water for at least 20 seconds or use hand sanitizer with at least 60% alcohol after paying.
After the service is completed, clean and disinfect any surfaces in your home that may have been touched by the service provider.

Source CDC.gov

Diet, Nutrition, and Parkinson’s: What you Need to Know

July 1, 2020 Life, Research

Diet and nutrition have been found to play a crucial role in Parkinson’s. In a recent ‘Ending Parkinson’s Disease: Live’ webinar on Parkinson’s EU, Parkinson’s expert Dr Bastiaan Bloem, epidemiologist Dr Alberto Ascherio and Parkinson’s campaigner Omotola Thomas, considered how different foods can affect the risk of diagnosis, maintaining bowel health and more.

We share five key takeaways from their discussion.

1. Which foods can affect your risk of developing Parkinson’s?

Diet, said Dr Bloem, “is a really hot topic in the field of Parkinson’s”. Alongside exercise, diet and nutrition “are the big new kids on the block when it comes to improving symptoms, and perhaps, slowing down the progression of the disease.”

Dr Bloem and Dr Ascherio praised the Mediterranean diet, which varies by country and region, for its potential to lower the risk of developing Parkinson’s. The Mediterranean diet is generally high in vegetables, fruits, grains, healthy fats and fish, and is typically low in meat and dairy. Such a diet is rich in nutrients and antioxidants, making it “better than the traditional Western diet”, according to Dr Ascherio.

On the other hand, Dr Bloem theorised that “a lifetime of exposure to dairy” is associated with a higher risk of developing Parkinson’s, likely due to the pesticides ingested by cattle from contaminated grass.

Dr Ascherio added: “I don’t think that globally, dairy products are known to be a major cause of pesticide exposure. Dairy also has other effects like reducing the level of uric acid in blood, which we found to be related to a risk of Parkinson’s disease.”

2. Could you be malnourished if you have Parkinson’s?

While Dr Bloem pointed out that a regular diet should offer all the necessary nutrients, he did note that vitamin D and vitamin C can be exceptions. “Many people, particularly when you age and particularly when you’re a woman, are at risk of developing a vitamin D deficiency. There are fascinating anecdotal reports of people taking vitamin D and experiencing improved motor symptoms.”

Meanwhile, he explained, vitamin C supplements can help to prevent bladder infections in Parkinson’s patients by acidifying the urine. “Bladder infections can trigger a cascade that leads to worsening Parkinson’s symptoms.”

Dr Bloem also debunked the use of supplements like vitamin E, curcumin and Coenzyme Q190, which have been found to offer no benefits to people with Parkinson’s.

3. How can you maintain your bowel health?

Bowel problems are common in Parkinson’s patients, which Dr Bloem said can be alleviated by drinking a lot of water and eating a diet rich in fibres. People with Parkinson’s should see their general practitioner for laxatives only if all else fails. “The rule is you need to have bowel movements at least once every other day.”

Thomas added: “I have a three litre water bottle that I finish by the end of the day. It is a challenge, but I try to finish it. Because I struggle very greatly with constipation, I take three or four ounces of prune juice in the morning and that seems to help me.”

4. How should you take your Parkinson’s medication?

As food can interfere with the efficacy of levodopa medication, Dr Bloem recommended taking levodopa at least half an hour before or after a meal. In particular, he advised that protein intake be spread across the day.

“For most patients, taking your medication with a protein rich meal including dairy products and meat, can reduce gastrointestinal absorption of your levodopa. So, you need the proteins in order to keep up your muscle strength and avoid weight loss but try to spread the proteins over the day.”

Thomas acknowledged that this can be hard to do. She said: “I have a struggle spreading my proteins with my levodopa because I can’t take more than 15mg of levodopa at a time, so I’m taking it every two hours.

“That is one of those things whereby theoretically, I know what I’m supposed to do, but practically, I’m not able to.”

5. Should a dietician be part of your standard Parkinson’s care?

Yes, said Dr Bloem. “I think paying attention to the gut is part of routine clinical care at every consultation for people with Parkinson’s. Parkinson’s starts in the gut for many patients and slow bowel movements are very common, impacting the efficacy of your medication and appetite for food. It needs attention.”

While a Parkinson’s doctor or nurse can offer useful dietary advice, Dr Bloem himself recommends that his patients see a dietician at least once. “I think it’s part of standard care.”

View the webcast.

View WPA’s “Ask the Expert” video on this topic with Michelle McDonagh, RD, Froedtert & Medical College of Wisconsin

Coronavirus and treatment for Parkinson’s

July 1, 2020 Awareness, Education, Life

What do we know about the relationship between coronavirus and Parkinson’s?

Joaquim Ferreira, neurologist, Portugal: There is still scarce information regarding many clinical aspects of this infection and its potential short- and long-term complications. We know that the majority of people with Parkinson’s are elderly, and age is a risk factor for the more severe forms of Covid-19. On the other hand, we recognise that patients might be affected indirectly by the lockdown physical restrictions, the psychological impacts and the compromised healthcare.

Miriam Parry, senior Parkinson’s Disease nurse specialist, UK: We do know that people with Parkinson’s are more prone to pneumonia and infections. Parkinson’s can cause respiratory issues for some people – if you have lived with Parkinson’s for a long time, you are more likely to have breathing and respiratory difficulties. This is why people with Parkinson’s are described as being at greater risk of severe illness if they get coronavirus. As such, their caregivers need to take precautions.

Rick Helmich, neurologist, the Netherlands: We know very little, but knowledge is rapidly increasing. Parkinson patients who develop Covid-19 seem to suffer from the same symptoms as other people and to approximately the same degree. However, patients who get sick from coronavirus may suffer from a worsening of their Parkinson symptoms. This is a well-known finding that also occurs when Parkinson patients develop other non-coronavirus infections. The current pandemic also has effects on Parkinson patients that are not so visible, such as increased stress levels and less physical exercise due to the social isolation measures.

How has the coronavirus crisis affected how you and your colleagues carry out your roles, and interact with patients?

Emma Edwards, Parkinson’s specialist nurse, UK: The coronavirus crisis has meant that our face-to-face appointments were stopped with immediate effect. We knew that telehealth technology was due to be implemented in our work area over a planned period of about seven months. When the crisis happened, that roll out took about seven days! In May, I started to see some patients again in their homes. Those allocated for this type of review were people that were running into problems with their Parkinson’s that we couldn’t resolve over the phone or via the virtual clinics.

Helmich: For a few months, I have been working mainly from home, and all my contacts with patients were through video-conferencing and by phone. It took some time to adjust, but I am actually very happy with how it turned out now. It is amazing how much you can see and discuss via a good video connection. On the other hand, more subtle things are better seen in real life, so I am happy that we are allowed to see more patients at our hospital in the next weeks.

Ferreira: The major implications of visit cancellations for patients that were hospitalised, or doing rehabilitation programmes as inpatients, should also be mentioned. This situation forced all health professionals to be involved in facilitating communication and minimising the consequences of not seeing family and friends.

How has the coronavirus crisis affected access to treatment for people with Parkinson’s?

Helmich: This is a topic that many patients are worried about: access to health care. Many Parkinson patients are treated by a whole team of professionals, including a neurologist, a Parkinson nurse, a physical therapist, and sometimes a psychiatrist, speech therapist, or occupational therapist. Access to these health care providers has been restricted by the isolation and social distancing measures. Not all people have good access to internet, and not all treatments can be given through video conferencing. So, I believe that the care for Parkinson patients has certainly suffered from the coronavirus pandemic.

Ferreira: The coronavirus pandemic severely affected the follow-up of people with Parkinson’s disease. The regular consultations were cancelled, making it more difficult or impossible the access to physicians and other health professionals. Pharmacological prescriptions were more difficult to obtain. Sessions of physiotherapy, speech therapy and other therapeutic interventions were cancelled, and physical activity and exercise was highly reduced for many patients. Many deep brain surgeries were deferred, and patients included in research studies and clinical trials saw their consultations being moved to phone contacts or videocalls.

Edwards: Face-to-face sessions such as our Parkinson’s exercise groups, have also been postponed but luckily the staff that ran those groups produced a brilliant DVD of the common exercises they undertook in class. These were distributed out to homes at the beginning of the outbreak and were warmly received by many people with Parkinson’s.

What actions should people with Parkinson’s take at the moment?

Ferreira: The most important recommendation for people with Parkinson’s and their close friends and family is to follow the general public health recommendations that apply to the elderly population. At the current stage of the pandemic, when governments are lowering the confinement measures, the most important message is to alert everybody that this pandemic is not over and the general measures that are being recommended for the general population should be followed strictly in the next months.

Parry: When you leave the house, for any reason, you should avoid busy spaces and keep a distance of around two meters from people you do not live with, while wearing a face mask. You should also continue to follow good hygiene practices, including handwashing, not sharing crockery and cutlery, wiping down surfaces, and not entering other people’s homes. You can ask your local pharmacist to deliver medication to your home address or ask family members or friends to help.

Edwards: I would really advocate for people, if they can, to exercise. It has proven benefits not just for physical health in Parkinson’s but for promoting good mental health. I’ve been really impressed with the exercise classes available online to people with Parkinson’s whilst the group classes have been postponed.

What should people with Parkinson’s do if they have hospital and GP appointments during this period?

Parry: If you’re in the UK, please call the GP’s practice and ask for further information and direction pending the reasons for the appointments. The GP practice will be able to advice you whether it is urgent or offer you a phone or video consultation. Routine hospital appointments have now changed to virtual clinics using phone and video link consultations.

Ferreira: During this crisis, health institutions in Portugal have changed their procedures in order to implement safety circuits for those who will need to attend their routine visits or need to go to the hospital in an urgent situation.

Edwards: I would imagine as we come out of the lockdown, clinical outpatient appointments in the UK will look very different to what people are used to. Certainly, in our area, personal protective equipment will be worn by staff and visiting patients are encouraged to wear face masks. If people with Parkinson’s need advice on managing their condition and are not sure when their next review will be, they should contact their local Parkinson’s service and ask for help. Be proactive!

How can people with Parkinson’s look after their mental wellbeing?

Ferreira: All health professionals that follow patients with Parkinson’s recognise that this has been a difficult time, not just for the patients but for all around them. The most important thing for the community is strengthening support and continuing care, keeping the links between patients, their families, caregivers and health professionals.

Helmich: This is different for everyone. Some of my patients even like certain aspects about the current situation, such as a reduction in workload, deadlines, or social obligations. In general, I think it is good to try to stay in touch with your loved ones. Find a new structure for your day that works for you and develop new exercise routines. There are many online events available for Parkinson patients, such as online dancing or singing classes. So, it might be worthwhile to have a look online to see what is out there or ask someone to help you do so. Don’t be afraid to speak about your worries or fears.

Edwards: Being able to connect with others has been a challenge during the lockdown, but as restrictions are eased, I really encourage people to meet others again, albeit in a safe way. For many during coronavirus, that has been via online forums like Zoom or having a socially distanced chat over the garden fence to family and friends. I’m also a massive advocate for mindfulness. It’s a way to be fully present, having an awareness of where we are and what we are doing and feeling, without being overwhelmed by what’s going on around us.

Parry: It is normal and expected to feel a range of emotions during this pandemic including fear, increased anxiety, anger and sadness. There is guidance on looking after mental wellbeing during this time from mental health charity Mind, as well as support on the Parkinson’s UK and Parkinson’s Foundation websites.

What is the advice for those living with a vulnerable person?

Parry: Visitors and people who provide care for those with Parkinson’s should protect them and reduce their risk by staying at home as much as possible. They should work from home, if they can, and limit contact with other people.

Ferreira: It is a good principle to assume that everybody who we are in contact with may be infected, even if they don’t present any suspected symptoms. No one can be sure that they are not infected or do not have a risk of infecting others. This is even more relevant for health professionals, caregivers, family members and those that have close contact with vulnerable populations.

Edwards: I knew from the moment I re-started my home visits that I had not fully been picking up the impact that the coronavirus and subsequent lockdown has had on care partners. It was harder to pick up the subtleties of care partner stress on the telephone or even on the telemedicine appointments. I’m certainly more mindful that we need to continue to address this area as digital medicine becomes more accessible for people with Parkinson’s and potentially less contact is had with partners or carers during these interactions.

Helmich: Be aware that vulnerable people are sometimes less able to cope with new or threatening situations. Be patient if your loved ones are anxious, worried, or experience a worsening of their symptoms.

Do you think the coronavirus crisis will have a long-term impact on people with Parkinson’s?

Ferreira: The limitations induced by the Covid-19 pandemic are here to stay and we need to be prepared to adapt for the next months.

Parry: The Covid-19 pandemic could potentially have a long-term impact on the physical and mental health of people with Parkinson’s, and many studies are currently taking place looking at the effect of this pandemic.

Edwards: I think lots of clinicians were hoping that we could eventually use technology in how we review our patients, and this crisis has pushed that to the forefront. I like being able to offer our patients a wider range of ways that they can access information and advice – from virtual clinics to wearing digital technology – but also being able to offer more traditional face-to-face home visits if needed.

Need to know

Emma Edwards: I’m a mental health nurse in the UK – however for the last 10 years I’ve worked as a Parkinson’s specialist nurse in the community. I had worked in a large rural area for many years, but more recently have moved to a post in a city. Due to the lockdown on clinical work environments, my dining room is currently my office!

Joaquim Ferreira: I am a neurologist mainly working in the field of Parkinson disease for the past 25 years. I am also professor of neurology and clinical pharmacology at the University of Lisbon, Portugal. More recently, I founded CNS, Campus Neurológico Sénior, which is a movement disorders centre focused on the multidisciplinary care and rehabilitation for Parkinson’s patients.

Miriam Parry: I work as senior Parkinson’s Disease nurse specialist (PDNS) at King’s College Hospital NHS, Parkinson’s Foundation Centre of Excellence in London, UK. My role is to provide a holistic approach to care and seamless service to people with Parkinson’s and their family and carers, providing ongoing support, educating and empowering patients to become experts in their condition. Above all, I aim to engage people with Parkinson’s with King’s rich research portfolio on offer, as without it we would not have the knowledge and the care pathways that we do.

Rick Helmich: I live in Nijmegen, the Netherlands and work as a neurologist and neuroscientist at the Radboud University Medical Centre. I specialise in Parkinson’s, and in my research at the Donders Institute, I use brain imaging to help understand symptoms and phenomena I see in my patients. Lately I’m intrigued by the effects of stress on patients with Parkinson’s, both the causes and the consequences.

Information from Parkinsonlife.eu.

“You’re superhuman up there”: Parkinson’s in space

July 1, 2020 Life

Journeying into space is an incredible feat – it’s even more impressive when you’ve been diagnosed with Parkinson’s.

Michael ‘Rich’ Clifford found out he had the condition in 1994. Two years later he undertook his third journey into space on the US Atlantis shuttle.

In webcast conversation with Dr Ray Dorsey, co-author of Ending Parkinson’s Disease: A Prescription for Action, the former astronaut outlined his experience working with US space agency NASA, spoke about his exposure to pesticides – and shared what his symptoms were like in space.

“It was an easy decision to fly”
“When I got diagnosed with Parkinson’s I thought it was over and NASA asked me what I wanted to do,” Clifford told Dorsey. “I said, ‘You mean it’s up to me?’ and they said, ‘Yeah, we consider you still qualified for flight.’ I said, ‘Well, I’ll go fly again.’ And it was as easy as that.”

“It was special, because I’d done a lot of preparatory work on that – all the EVA [Extra-Vehicular Activity] simulations and validation of the positions and equipment we were going to use – so it was an easy decision to fly.”

Asked if he noticed his Parkinson’s symptoms during the seven-day period in space, Clifford said: “I felt my right-hand tremor one time, but it was very mild… I think it showed more in space. I could feel it more. When we re-entered for landing, I noticed with the pull of g-forces, my hands would go down, and it was much easier to work with.”

Lifting heavy equipment, weighing over 150 pounds, was significantly easier: “I could have just dragged it along with my fingernails – it was neat. You’re superhuman up there.”

Parkinson’s and pesticides
Growing up in Utah, US, Clifford had no family history of Parkinson’s. However, he told Dorsey, he was exposed to pesticides through a high-school job cutting grass and while working as a private pilot: “I didn’t know it was dangerous. I didn’t like the way it smelled, but it was just a job.”

Then, working as a gas station attendant Clifford encountered trichloroethylene (TCE) – another substance that has been linked with Parkinson’s.

“In the shop we would get grease spills all the way and would clean it up. I didn’t realise there was a nasty chemical in it, but it was efficient for cleaning up the grease. I did that for about three years.”

“We should be getting rid of these chemicals,” he told Dorsey, who has written about the impact of pesticides in his book. “It’s going to take somebody pushing it, like you are, to get this done.”

“Just because you have Parkinson’s, you don’t have to give up”
When he was first diagnosed, Clifford didn’t tell the rest of his crew that he had the condition. However, he decided to announce it publicly in 2011 – 17 years after his diagnosis – to “get the issue out on the table”.

“I thought it was time to reveal it. I felt it was a good thing for the community for me to announce I had Parkinson’s,” he said.

He was then encouraged by his doctor, whose son was a film producer, to share his story in a movie. ‘The Astronaut’s Secret’, a documentary released in 2014, covers Rich’s experience working with NASA while living with the condition.

Rich hopes his story inspires others with the condition: “Just because you have Parkinson’s, you don’t have to give up.”

Article from Parkinsonslife.EU.

How to Deal with Cabin Fever

June 1, 2020 Awareness, Caregivers, Life, Support Groups

Cabin fever is often associated with being cooped up on a rainy weekend or stuck inside during a winter blizzard.

In reality, though, it can actually occur anytime you feel isolated or disconnected from the outside world.

Indeed, cabin fever is a series of emotions or symptoms people experience when they’re confined to their homes for extended periods of time. This may be due to a variety of circumstances, such as a natural disaster, lack of transportation, or even social distancing for pandemics like COVID-19.

Recognizing the symptoms of cabin fever and finding ways to cope may help make the isolation easier to deal with. Keep reading to learn more about how to do this.

What is cabin fever?

In popular expressions, cabin fever is used to explain feeling bored or listless because you’ve been stuck inside for a few hours or days. But that’s not the reality of the symptoms.

Instead, cabin fever is a series of negative emotions and distressing sensations people may face if they’re isolated or feeling cut off from the world.

These feelings of isolation and loneliness are more likely in times of social distancing, self-quarantining during a pandemic, or sheltering in place because of severe weather.

Indeed, cabin fever can lead to a series of symptoms that can be difficult to manage without proper coping techniques.

Cabin fever isn’t a recognized psychological disorder, but that doesn’t mean the feelings aren’t real. The distress is very real. It can make fulfilling the requirements of everyday life difficult.

What are the symptoms?

Symptoms of cabin fever go far beyond feeling bored or “stuck” at home. They’re rooted in an intense feeling of isolation and may include:

restlessness
decreased motivation
irritability
hopelessness
difficulty concentrating
irregular sleep patterns, including sleepiness or sleeplessness
difficulty waking up
lethargy
distrust of people around you
lack of patience
persistent sadness or depression

Your personality and natural temperament will go a long way toward determining how cabin fever affects you.

Some people can weather the feelings more easily; they may take on projects or dive into creative outlets to pass the time and ward off the symptoms.

But others may face great difficulty with managing day-to-day life until these feelings pass.

What can help you cope with cabin fever?

Because cabin fever isn’t a recognized psychological condition, there’s no standard “treatment.” However, mental health professionals do recognize that the symptoms are very real.

The coping mechanism that works best for you will have a lot to do with your personal situation and the reason you’re secluded in the first place.

Finding meaningful ways to engage your brain and occupy your time can help alleviate the distress and irritability that cabin fever brings.

The following ideas are a good place to start.

Spend time outdoors

Research shows that time spent in nature is time well spent for mental health.

Not only does spending time outdoors boost your cognitive function, it may also help:

improve your mood
alleviate stress
boost feelings of well-being

Depending on your reason for isolating, be sure to check all local regulations and avoid any spaces that are closed for safety or health reasons.

If getting outdoors isn’t an option, you could try:

opening up your windows to let the outdoor breeze in
adding a bird feeder outside your window to bring birds closer to your living space
ordering or buying fragrant, fresh-cut flowers and placing them where you can see and smell them throughout the day
growing herbs or small plants on a windowsill, patio, or balcony

Give yourself a routine

You may not have a 9-to-5 job to report to while you’re isolated, but a lack of routine can cause disruptions in eating, sleeping, and activity.

To keep a sense of structure, try to create a daily routine that consists of work or house projects, mealtimes, workout time, and even downtime.

Having an outline for your day helps you keep track of the trajectory of your hours and gives you mini “goals” to hit throughout the day.

Maintain a social life

So you can’t go to the movies or meet your friends for dinner. But you can still “meet up” with them — just in a different way.

Use real-time video streaming services, like FaceTime, Zoom, or Skype, to chat with your friends, colleagues, and loved ones. Face-to-face chat time can keep you in contact with the “outside world” and make even your small home feel a whole lot bigger.

Connecting with others who are in a similar situation can also help you feel that you’re not alone. Sharing your thoughts, emotions, and challenges with others can help you realize that what you’re feeling is normal.

Connecting with others may even help you find creative solutions to an issue you’re grappling with.

Express your creative side

Did you play a band instrument in high school? Were you once interested in painting? Do you have stacks of vacation photos you once promised yourself you’d put in a scrapbook? Is there a recipe you’ve always wanted to try but never had the time?

Use your time in isolation to reconnect with creative activities that you’ve had to put on hold because life got too busy. Spending time on creative activities keeps your brain busy.

Keeping your mind occupied and engaged may help ward off feelings of boredom or restlessness and make the time pass more quickly.

Carve out some ‘me time’

If you live with others, feelings of cabin fever may be intensified by the nearness of other individuals.

Parents have responsibilities to children; partners have responsibilities to one another. But that doesn’t mean you shouldn’t have any time on your own.

Give yourself time “away” from others to relax. Find a quiet place to read a book, meditate, or pop in some earbuds for an engaging podcast.

If you’re feeling stressed, you may even want to tune in to a podcast on mental health or anxiety.

Break a sweat

Research has shown that people who exercise regularly are less prone to anxiety than people who don’t exercise. That’s because physical activity lowers your body’s stress hormones, such as cortisol.

At the same time, exercise causes your brain to release endorphins. These neurochemicals can boost your mood and overall feeling of well-being.

If you can’t get outside, you can do a strength training workout at home using just your body weight or simple equipment, like dumbbells or resistance bands.

Or you can put together your own routine by focusing on a few basic but effective exercises, such as:

pushups
squats
burpees
lunges
planks

If you need a more structured program, there are plenty of online exercise options on YouTube and through various exercise apps.

Chill out

Not every minute of every day you spend at home has to be planned. Give yourself some time to rest. Look for constructive ways to relax.

Mindfulness, deep breathing, and relaxation exercises may help you maintain your emotional health and balance feelings of isolation or frustration.

When to Get Help

Cabin fever is often a fleeting feeling. You may feel irritable or frustrated for a few hours, but having a virtual chat with a friend or finding a task to distract your mind may help erase the frustrations you felt earlier.

Sometimes, however, the feelings may grow stronger, and no coping mechanisms may be able to successfully help you eliminate your feelings of isolation, sadness, or depression.

What’s more, if your time indoors is prolonged by outside forces, like weather or extended shelter-in-place orders from your local government, feelings of anxiety and fear are valid.

In fact, anxiety may be at the root of some cabin fever symptoms. This may make symptoms worse.

If you feel that your symptoms are getting worse, consider reaching out to a mental health professional who can help you understand what you’re experiencing. Together, you can identify ways to overcome the feelings and anxiety.

Of course, if you’re in isolation or practicing social distancing, you’ll need to look for alternative means for seeing a mental health expert.

Telehealth options may be available to connect you with your therapist if you already have one. If you don’t, reach out to your doctor for recommendations about mental health specialists who can connect with you online.

If you don’t want to talk to a therapist, smartphone apps for depression may provide a complementary option for addressing your cabin fever symptoms.

The Bottom Line

Isolation isn’t a natural state for many people. We are, for the most part, social animals. We enjoy each other’s company. That’s what can make staying at home for extended periods of time difficult.

However, whether you’re sheltering at home to avoid dangerous weather conditions or heeding the guidelines to help minimize the spread of a disease, staying at home is often an important thing we must do for ourselves and our communities.

If and when it’s necessary, finding ways to engage your brain and occupy your time may help bat back cabin fever and the feelings of isolation and restlessness that often accompany it.

Article from Healthline.com

May 2020 Activity Calendar

April 22, 2020 Community Outreach, Exercise, Life

Check out this activity calendar to keep yourself active and engaged in May!

LOL: Reduce Caregiver Stress with a Good Laugh

April 1, 2020 Caregivers, Life

For family caregivers, the mountains of laundry, endless messes that must be cleaned up, constant doctor’s appointments, complete surrender of one’s personal life and the painful process of watching aging loved ones decline is no laughing matter. We usually feel like crying more often than we feel like laughing.

But many experts say that laughing in even the grimmest situations is good for both our mental and physical health. A case of the giggles can relieve stress and boost “happy chemistry” within the body. Most caregivers desperately need to decompress and lift their spirits, and one way to go about meeting these needs is to teach yourself how to laugh despite the challenges you face every day.

The Science Behind the Benefits of Laughter

Gelotology is the study of the psychological and physiological effects of laughter on the body. Numerous scientific studies in this field suggest that laughter is a powerful form of complementary medicine that yields the following benefits.

Improved blood flow: William F. Fry, M.D., emeritus professor of psychiatry and behavioral sciences at Stanford University and pioneer of gelotology, and Michael Miller, M.D., cardiologist and professor at the University of Maryland School of Medicine, found that laughter causes the tissue that lines the insides of blood vessels to dilate or expand to increase blood flow to bodily tissues. This effect was so pronounced that it was similar to the increased blood flow caused by aerobic activity or statin therapy for lowering cholesterol.
Strengthened immune responses: Research led by Lee S. Berk, DrPH, a medical researcher at Loma Linda University, has found that laughter has a positive effect on the immune system, including increased production of antibodies and activation of protective cells like T-cells and Natural Killer cells that fight viral infections and tumor cells.
Reduced blood pressure: A study conducted in Japan showed that seniors attending adult day care experienced significant reductions in systolic blood pressure and heart rate following regular laughter therapy sessions.
Increased pain relief: Researchers from Oxford University studied the effect of laughter on pain perception and found that “social laughter elevates pain thresholds both in the laboratory and under naturalistic conditions.” Endorphins released while laughing can have an opiate effect thereby increasing pain tolerance.

The benefits of laughter may be tied to human physiology. “Babies laugh long before they learn how to talk,” psychologist and laughter coach Annette Goodheart explains. “Laughing is a wonderful, cathartic process. I’ve worked with Auschwitz survivors who told me that the people who were able to laugh were the ones who survived.”

Laughter may seem like an inappropriate reaction to difficult scenarios, but just because you laugh doesn’t mean you don’t care or understand the gravity of a particular situation. Laughing in response to even the saddest circumstances helps you deal with your emotions rather than keeping them bottled up. Sometimes laughter may lead to tears, but Sebastien Gendry, renowned yoga instructor and CEO of the American School of Laughter Yoga, assures that’s perfectly normal. “You cannot open up a box of emotions selectively. A hearty bout of laughter may lead to a good cry, which is also cathartic. If you have unexpressed emotions, laughter may help bring them out.”

Life isn’t always funny, particularly when caring for loved ones who are chronically ill or dying. Laughter forces you to be at peace with who you are and where you are. No one has a perfect life. “Laughter therapy is about how you react in the face of adversity. Sometimes, you can’t control your circumstances, but you can always control your reaction. How you react is always negotiable,” Gendry says.

How to Laugh When You Don’t Feel Like It

To reap the benefits of laughter, you don’t even need to be happy or have a reason to laugh. Faking it works just fine. “The body cannot differentiate between fake and real laughter; you get the same physiological and psychological benefits,” Gendry explains. “We change physiologically when we laugh. We stretch muscles in our face and body, our pulse and blood pressure go up, and we breathe faster, which sends more oxygen to our tissues.”

The American School of Laughter Yoga recommends the following laughter exercises that caregivers can try at home. You can experiment with these exercises for 30 seconds or a few minutes at a time—whatever feels good to you.

Gradient Laughter: Fake a smile, giggle and then laugh slowly. Gradually increase the tempo and volume of your laughter.
Hearty Laughter: Spread your arms out beside you, look up and laugh heartily from deep down inside.
I Don’t Know Why I Am Laughing: Laugh (faking it is perfectly fine) and shrug your shoulders as you look at yourself in a mirror. Use your eyes and body language to convey the message that you have no idea why you are laughing!
Find Your Laughter Center: Probe your head with one finger as if looking for your laughter center. Imagine that each spot you push on triggers a different type of laughter and then act it out.
Conductor Laughter: Imagine you are a conductor. Direct an imaginary orchestra with enthusiastic arm movements as you sing a song of your choice in laughter sounds only, such as “ho ho ho” or “ha ha ha.”

Join a Laughter Club

Since Dr. Madan Kataria, a family physician from Mumbai, India, launched the first Laughter Club in 1995, Laughter Yoga has become a global phenomenon. This type of yoga (also known as Hasyayoga) is a dual body/mind approach to health and wellness. Today, there are Laughter Clubs around the world where people come together to use unconditional laughter and yogic breathing (Pranayama) to relieve stress and promote health. There are more than 100 Laughter Clubs across the U.S. and most of them offer free weekly meetings. You can find a club near you by visiting the Laughter Yoga University website. There are also laughter sessions available via telephone and Skype that are perfect for busy caregivers to participate in.

Learn to Minimize Caregiver Stress

The reality is that stress will always be an unavoidable part of life. The only aspect you can control is how you choose to deal with the negativity and tension that you encounter. Laughter is a simple and free way to cope with life’s ups and downs.

Article from AgingCare.com.

Therapy Fights Depression for People with PD

April 1, 2020 Life, Research

Cognitive behavioral therapy is a form of psychotherapy that increases awareness of negative thinking and teaches coping skills.

About 50% of people diagnosed with Parkinson’s disease will experience depression, and up to 40% have an anxiety disorder.

“The psychological complications of Parkinson’s disease have a greater impact on the quality of life and overall functioning than the motor symptoms of the disease,” says lead author Roseanne Dobkin, a professor of psychiatry at Rutgers University’s Robert Wood Johnson Medical School.

“Untreated, depression can accelerate physical and cognitive decline, compromise independence, and make it more difficult for individuals to proactively manage their health, like taking medication, exercising, and visiting the physical therapist.”

Depression in Parkinson’s patients is under-recognized and often goes untreated. Among those who receive treatment, antidepressant medication is the most common approach, though many patients continue to struggle with depressive symptoms.

The researchers investigated how adding cognitive behavioral therapy to the care individuals already received would affect their depression.

Cognitive behavioral therapy sessions helped patients re-examine their usual ways of coping with the daily challenges of Parkinson’s. Researchers individually tailored therapy, targeting negative thoughts—such as “I have no control”—and behaviors including social withdrawal or excessive worrying. Treatment also emphasized strategies for managing the disease, such as exercise, medication adherence, and setting realistic daily goals.

The researchers enrolled 72 people diagnosed with both Parkinson’s and depression. All participants continued their standard treatment. In addition, half the participants (37 people) also received cognitive behavioral therapy over the telephone weekly for three months, then monthly for six months.

By the end of treatment, individuals receiving only standard care showed no change in their mental health status, whereas 40% of the patients receiving cognitive behavioral therapy showed their depression, anxiety, and quality of life to be “much improved.”

The convenience of phone treatment reduced barriers to care, allowing patients access to personalized, evidence-based mental health treatment, without having to leave their homes, Dobkin says.

“A notable proportion of people with Parkinson’s do not receive the much needed mental health treatment to facilitate proactive coping with the daily challenges superimposed by their medical condition,” she says.

“This study suggests that the effects of the cognitive behavioral therapy last long beyond when the treatment stopped and can be used alongside standard neurological care to improve global Parkinson’s disease outcomes.”

The study appears in Neurology. Source: Rutgers University. Original Study

Study: People skip Parkinson’s, Alzheimer’s meds as prices rise

March 1, 2020 Life, Research

Rising drug costs are hampering the care of patients with debilitating neurological disorders like Parkinson’s disease and Alzheimer’s, a new study finds.

Patients are less likely to fill necessary prescriptions as out-of-pocket costs increase, said senior researcher Dr. Brian Callaghan, a neurologist with the University of Michigan, in Ann Arbor.

“It’s a pretty predictable 5 percent to 10 percent drop for every $50 increase in cost,” Callaghan said.

For patients with Parkinson’s disease, not taking medications as prescribed can severely impact their quality of life, he noted.

“The Parkinson’s medicines are supposed to help make their tremors better, help them walk faster better. Theoretically, it could prevent falls and hospitalizations,” Callaghan said. “It’s not really preventing people from dying. It’s enabling people to live better and have better symptom control.”

Previous studies have shown that out-of-pocket drug costs are rising for neurologic medications, Callaghan said.

To see how these higher prices affect patient care, Callaghan and his colleagues singled out three neurologic diseases for which there are effective drugs available at a wide variety of prices:

Parkinson’s disease, where the drug pramipexole cost $35.90 for a 30-day supply in 2016, compared to $12.40 for the drug ropinirole.
Alzheimer’s disease, where a month’s supply of rivastigmine was $79.30, compared to $3.10 for the drug donepezil.
Peripheral neuropathy, where pregabalin cost $65.70 for a month compared to $8.40 for gabapentin.

The researchers used a private insurance claims database to track more than 80,000 patients’ prescriptions during a 15-year period, comparing how often they filled prescriptions with their out-of-pocket costs.

In 2015, the Alzheimer’s drug donepezil cost about $3 for a 30-day supply, and researchers found that people filled their prescriptions about 70 percent of the time. On the other hand, the drug rivastigmine cost about $100, and people filled those prescriptions only 45 percent of the time.

A $50 increase in out-of-pocket costs was associated with an overall 12 percent decrease in a patient’s access to Alzheimer’s medications, the researchers found.

The same pattern held for Parkinson’s patients and people with peripheral neuropathy, which causes numbness and pain, usually in the hands and feet.

“I am not surprised,” James Beck, chief scientific officer for the Parkinson’s Foundation, said of the study results. “The free Parkinson’s Foundation Helpline team hears similar stories from people with Parkinson’s disease every day. The cost of medications is a key factor in their budgets and everyday lives.”

The medication regimen for people with Parkinson’s is especially complex, “and the timing of multiple pills a day often taking into account meals is incredibly arduous,” Beck said. “Therefore, missing doses of medications will have the effect of a reduction in quality of life. People may not be able to move as well, sleep as well, or do the activities they enjoy as a result of missing their medications.”

Callaghan pointed out that medication adherence is probably even worse for patients with disorders like multiple sclerosis, where there are only a handful of medicines available and all are expensive.

Callaghan and Beck recommended that patients talk with their doctor and pharmacist if they’re struggling to pay for their medications. There could be cheaper drugs available that would work as effectively.

“For Parkinson’s disease, there are three types of medications that people often take as their first medication. The evidence suggests that starting with any of these medications leads to similar positive outcomes,” Beck said. “Therefore, people with Parkinson’s disease and their providers can work together to identify what might be the most affordable medication to start with in treating their Parkinson’s disease symptoms.”

The study was published online Feb. 19 in the journal Neurology.

Article from UPI.

Pingpong May Help Reduce Some Parkinson’s Symptoms

March 1, 2020 Life, Research

The game of pingpong, or table tennis, may hold promise as a form of physical therapy for Parkinson’s disease, according to a preliminary study presented at the American Academy of Neurology’s 72nd Annual Meeting in Toronto, Canada.

The findings show that 12 Parkinson’s patients who participated in a pingpong exercise program once a week for six months experienced improvements in several symptoms, including facial expressions, posture and rigidity. They were also better at getting dressed and getting out of bed.

Parkinson’s disease is a movement disorder in which the brain chemical dopamine gradually declines. This process results in slowly worsening symptoms that include tremor, stiff limbs, slowed movements, impaired posture, walking problems, poor balance and speech changes.

“Pingpong, which is also called table tennis, is a form of aerobic exercise that has been shown in the general population to improve hand-eye coordination, sharpen reflexes, and stimulate the brain,” said study author Ken-ichi Inoue, M.D., of Fukuoka University in Fukuoka, Japan.

“We wanted to examine if people with Parkinson’s disease would see similar benefits that may in turn reduce some of their symptoms.”

The research involved 12 individuals with an average age of 73 with mild to moderate Parkinson’s disease. The participants had been diagnosed with Parkinson’s for an average of seven years. They were tested at the start of the study to see which symptoms they had and how severe the symptoms were.

The patients then played pingpong once a week for six months. During each weekly five-hour session, they performed stretching exercises followed by table tennis exercises with instruction from an experienced table tennis player.

The program was developed specifically for Parkinson’s disease patients by experienced players from the department of Sports Science of Fukuoka University.

Parkinson’s symptoms were evaluated again after three months and at the end of the study.

The results show that at both three months and six months, study participants experienced significant improvements in speech, handwriting, getting dressed, getting out of bed and walking. For example, at the beginning of the study, it took participants an average of more than two attempts to get out of bed. At the end of the study, it took an average of one attempt to get out of bed.

Study participants also experienced significant improvements in facial expression, posture, rigidity, slowness of movement and hand tremors. For example, for neck muscle rigidity, researchers assessed symptoms and scored each participant on a scale of 0 to 4 with a score of 1 representing minimal rigidity, 2 representing mild rigidity, 3 representing moderate rigidity and 4 representing severe rigidity. The average score for all participants at the start of the study was 3 compared to an average score of 2 at the end of the study.

Two participants experienced side effects; one person developed a backache and another person fell down.

“While this study is small, the results are encouraging because they show pingpong, a relatively inexpensive form of therapy, may improve some symptoms of Parkinson’s disease,” said Inoue. “A much larger study is now being planned to confirm these findings.”

The main limitation of the study was that participants were not compared to a control group of people with Parkinson’s disease who did not play pingpong. Another limitation was that a single specialist assessed the patients.

Article from Psychcentral.com.