Alzheimer’s is a progressive neurologic disease that is gradually increasing at a drastic rate. It is a medical condition, a type of dementia affecting one’s memory, behavior, and thinking as the brain shrinks (atrophy) or when the brain cells die. It is usually seen in old people, mostly who are aged above 65 years. In today’s time, throughout the world, Alzheimer’s disease is considered to be one of the primary causes of disability and dependency among senior citizens and the seventh leading cause of death among all diseases. [1]

Alzheimer’s disease is not only a challenging health concern for the patient but also for every family member or those who stay with the patient at home. When any aged loved ones are diagnosed with Alzheimer’s disease, their family has to come forward to take care of them as long as possible. It can be highly beneficial if patients stay in a familiar environment, which is their home, but as their mental health declines, it would be even more difficult to take care of them.

There is no such definite solution in care for Alzheimer’s patients, so the caregivers usually devise their strategies to address the unique mixed symptoms of the patients. Furthermore, the effectiveness of certain ways employed in patient care at home is likely to change during the course of the patient’s illness. In that case, the only way to figure out what would work best for the patient is through constant trial and error. [3]

A caretaker of an Alzheimer’s patient must keep some things in mind which are recommended by the doctor. Continue reading to know about them in detail.

1. Come Up with a Daily Routine Care

By establishing a daily sequence of activities and tasks for Alzheimer’s patients, they can stay focused and oriented all day. The daily plan can be made after observing the routines of the patients and looking for patterns in their behavior and mood. Keep in mind the abilities and preferences of the patients may change at different times of the day, so be flexible and try to adapt when required. It is very important to have clear communication and understanding with the patients to facilitate the daily care tasks. [3]

2. Plan Engaging Activities and Encourage Socialization

Caregivers can keep Alzheimer’s patients active and interested by engaging them in different routine activities like cooking, walking, watching a movie, playing games, dancing, visiting friends and relatives, and many more. So, in a daily care plan, incorporate meaningful activities and hobbies that match the patient’s abilities and interests. It’s always recommended to build on their current skills instead of teaching something new. If the patient is getting agitated or frustrated, redirect their attention to something else. [1, 3]

3. Encourage and Support with Short Term Memory

In the early stages of Alzheimer’s disease, the patients may need some assistance and prompt to help with their tasks that involve the use of memory and thinking. This includes handling money and bills, remembering words and names, scheduling appointments, or keeping track of medications. A caretaker’s role must be to encourage the patients to try to cooperate and only help when they are not able to do that task on their own after their failed attempts. Also, they must be encouraged to make reminders to help them remember things. [1]

4. Try to Provide a Secure Environment

Alzheimer’s can have an impact on the problem-solving and judgment abilities of the patients, which can increase their risk of injury. So, the caretaker must encourage safety by taking certain precautions to avoid fire, burns fall, and any type of injury. All medicines, alcohol, poisonous cleaning products, firearms, and potentially hazardous tools and utensils must be kept away from their reach and locked. Also, ensure that the patient’s room does not have items cluttered here and there. [1]

5. Take Care of Eating Habits

The caretaker must adjust the meals for the patients to check on the nutrients they would need to maintain a healthy weight. Some patients are reported to crave constantly for food while some do struggle to consume sufficient minerals and calories. The patients must be allowed to choose what they want to eat, small meals must be given throughout the day, and the food must be served in utensils that they can easily hold. [1]

6. Research on the Behavior of Alzheimer’s Patients and Manage Them

Some of the behaviors usually seen in Alzheimer’s patients include sun downing (getting restless, agitated, and irritated in late afternoons and evenings) and sleep problems, wandering, hallucinations and delusions. As a caretaker, steps must be taken to manage these behaviors and avoid any mis-happening like getting eloped or lost. [3]

7. Deal with Driving Issues of Alzheimer’s Patients

Alzheimer’s patients have impaired cognitive and physical abilities, which are very much needed to safely drive automobiles. So, even if the patients knew to drive earlier, they no longer must be allowed to do the same. The patients may vehemently resist that so instead of arguing with them provide them other options for transportation so that their routine is not affected. [3]

What to do about Burnout in Alzheimer’s Caregivers?

The care for any kind of dementia can be emotionally challenging and improbably demanding. Alzheimer’s caregivers can overcome their difficulties in dealing with Alzheimer’s patients and even their burnout by being patient and flexible, prioritizing self-care, and also receiving from friends and family.

To take care of Alzheimer’s patients, the caretaker and care recipient can even consider in-home services by professional caregivers. Some of them could provide non-medical aids like daily assistance while others can provide medical care from a licensed health professional. These in-home services include personal care services (like eating, dressing, exercising, bathing, toileting, etc.), homecare services (like doing daily household chores, shopping, or cooking), companion services (like recreation activities and supervision), and skilled care services (such as wound care, physical therapy, giving injections, etc.). [1,2,3]

References:

1. https://www.thehealthsite.com/diseases-conditions/alzheimers-diseases-how-to-take-care-of-the-patient-at-home-910991/
2. https://www.alz.org/help-support/caregiving/care-options/in-home-care
3. https://www.agingcare.com/articles/alzheimers-disease-care-at-home-139990.htm

A workout routine is vital for our general well-being including cardiovascular health. The heart is just like a battery of the body and daily exercises can help improve this battery’s life and output. This is possible because the heart is getting trained by exercises to handle more stress and transfer the oxygen-rich blood to all other organs, hence providing more energy. Staying active can help in the modification of risk factors like hypertension, high cholesterol, high blood sugar, and inflammation that can result in heart diseases. And if done right, continuing exercises when having heart issues can even be safe.

However, there are instances when exercise can turn out to be too much for your body to accept and become a threat to cardiac health. When does this happen? Let’s look at certain warning signs of heart problems that one might experience during exercise. If you have any of them, immediately stop exercising and see a heart specialist. [1, 2, 3]

1. Chest Discomfort

Sudden chest pain or unexplained discomfort in the chest can be one of the first signs of an impending heart attack, especially while doing exercises. This feeling can range in its intensity from mild discomfort to intolerable pressure, and a fuller feeling at the center of the chest. It can be elusive and may appear and disappear. If this symptom persists for more than a few minutes, it’s time to promptly take help from a medical practitioner.

Furthermore, during physical activity, if one experiences chest tightness, wheezing, and coughing, it could be an indication of exercise-induced asthma which is more likely to occur if one has a family history of asthma. [1,  3]

2. Trouble in Breathing

An abnormal difficulty in breathing alongside chest discomfort or pinching chest pain during physical activity/ exercises could be a sign of a heart attack or its precursor. Breathing issues can happen either before one experiences chest pain/discomfort or even without any discomfort/pain in the chest. Normally, fast breathing or shortness of breath occurs when one does a workout. However, when one is doing physical activity or performing it at high intensity with ease suddenly gets winded/experiences shortness of breath, it could be due to a potential heart attack, exercise-induced asthma, heart failure, or any other medical condition.

Moreover, while breathing during straining exercises, one can also experience pain, swelling, and sharp pain. These could be due to muscle strain or injuries. The intercostal muscles which help stabilize the chest and allow normal breathing, might be injured. [1, 2, 3]

3. Light-Headedness, Extreme Tiredness, or Dizziness

Rigorous exercises can not only lead to body aches but also make one feel fatigued, dizzy, or light-headed. Mostly, this is because one has pushed too hard or didn’t eat or drink aptly before going for a workout. These symptoms could be a sign of diabetes, dehydration, a blood pressure problem, or possibly an issue with the nervous system. Dizziness could be an indication of a heart valve problem or an impending heart attack. If one is not able to get back to normal after taking breaks from exercises for water and snacks or if the light-headedness is accompanied by confusion, profuse sweating, or even fainting- one requires emergency medical attention.

One must be aware of the fact that no exercises should ever make an individual feel dizzy or light-headed, if that is happening it’s a for-sure sign that something is not right. If one experiences fainting along with chest pain, shortness of breath, and dizziness while exercising, it could be because of Hypertrophic Cardiomyopathy. [ 2, 3]

4. Abnormal Heart Rhythms

Throughout the workout, it’s important to keep track of the heart rate. Exercises do raise the heart rate but during rest periods the heart rate must start to come down. One must realize that heart thumping, skipping, or palpitating are all indications of heart issues including a heart attack. If the heart rate is staying high or beating out of rhythm even at rest, it’s time to stop exercising immediately. [1, 2,]

5. Pain

Noticing a sudden chronic pain in the back, neck, or jaw radiating from the chest, may signal a heart condition like a heart attack, especially if the origin is not easy to pinpoint. However, if one is experiencing chest, tightness, pain, or pressure along with symptoms like difficulty breathing, jaw pain (feeling like a bad toothache), nausea, or fatigue, it could be a sign of angina and not a heart attack. If this pain/discomfort begins or worsens when one is exerting himself/herself, then exercising must be discontinued and medical help must be taken as soon as possible. [1, 3]

6. Profuse Sweating

Sweating is the body’s way to cool itself and maintain its internal temperature in balance with the atmospheric temperature/ weather conditions. A regular workout won’t usually cause much sweating but if the body is stressed, it will overcompensate. A sudden increase in sweating while exercising could be a sign of trouble. It could be a dangerous symptom of any sort of heart concern including heart attack, especially when it is accompanied by nausea. [2, 3]

7. Numbness in the Left Arm

While exercising, if suddenly one is not able to feel anything, except maybe tingling from shoulder to the hand, it could be a serious symptom of a potential heart attack. During a heart attack, there is an obstructed blood flow in the coronary artery because of a blockage. Sometimes, one might have problems with the arteries and veins that carry blood throughout the body. Vascular disease can result in numbness and tingling in the arm. [4]

It could be life-threatening, if one does not pay attention to any of the above-mentioned symptoms Continuing exercises and not going for immediate medical attention, if experiencing this symptom, can put one’s heart at risk of cardiac arrest and have long-lasting ill effects. Not only the heart, but these effects can also even impact other internal organs as they get deprived of oxygen to work normally. Thus, it’s recommended to slowly progress with a workout with the help of a trainer and not forget to rest, have a healthy diet, avoid smoking, drug, or alcohol intake, drink plenty of water, and even keep blood pressure and blood sugar levels in check.

References:

1. https://www.thehealthsite.com/diseases-conditions/chest-pain-to-sweating-profusely-7-dangerous-symptoms-of-heart-problems-during-exercise-910079/
2. https://health.usnews.com/wellness/fitness/slideshows/signs-you-should-stop-exercising-immediately
3. https://www.ibtimes.com/8-signs-heart-problems-during-exercise-you-should-never-ignore-2858044
4. https://my.clevelandclinic.org/health/symptoms/21971-left-arm-numb

Dementia is not a specific disease rather it is an overall term for a collection of symptoms that are caused by brain disorders. These symptoms differ according to the part of the brain that is damaged. Usually, the effect is on one’s memory, thinking, and social abilities and the impact is severe enough to interfere with one’s daily life. The most common type of dementia is Alzheimer’s but there are other kinds such as:

• Young-onset dementia- where symptoms start appearing before the age of 65.
• Lewy Body dementia- is caused by protein deposits called alpha-synuclein (the abnormal Lewy bodies) inside the nerve cells of the brain.
• Vascular dementia- is caused by loss of blood flow to the brain and is likely to have a major impact on one’s thinking and problem-solving ability.
• Frontotemporal dementia- a rarely seen group of brain disorders that affects the language abilities and behaviour.
• Mixed dementia- when one has more than one type of dementia. [1, 2, 3]

Dementia Is More Common in Women Than Men

Dementia is more common in aged women rather than men as on average women have a longer life span than men. In addition, after scanning of brains of people with dementia, experts have found that brain cells naturally die faster in women than they do in men. Researchers also suggest that the female sex hormone, estrogen helps cells to communicate more effectively in the prefrontal cortex and hippocampus region of the brain, which could increase their risk of dementia too. [2]

Whether if one is concerned about themselves or about their loved one, they need to be aware of the warning signs of dementia, so that one can make sure and keep a check on the early diagnosis. These symptoms involve cognitive and psychological changes.

Here are the most common 10 warning signs of dementia.

1. Language Issues

Dementia patients can have trouble finding the right word to express themselves, may forget simple words, and may substitute wrong words into a conversation that others can’t understand.

2. Loss of Memory

It’s normal to occasionally have important things skipping the mind only if one remembers after a short while. However, anyone living with dementia would often forget things or even struggle to retain or recall any new information that they have received recently.

3. Difficulty Performing Usual Daily Tasks

People who are stuck in their busy schedule may at times forget their routine tasks like serving part of a meal but they would remember about it sometime later. However, in the case of dementia, one would forget how to perform a typical familiar task such as getting dressed or preparing a meal.

4. Impaired Judgment

In dementia patients, judgment and decision-making abilities are not apt. Thus, they may end up not recognizing something that could be a great risk for their health and safety like a medical condition that needs immediate attention from the doctor or wearing layers of clothing on a hot day.

5. Misplacing Things

Anyone who is in a hurry or not in a good mental state may temporarily misplace their belongings. However, those who are having dementia would start to put their things in appropriate places. For instance, they may keep a wristwatch in the freezer.

6. Disorientation to Place and Time

Many people might at some point in time have faced the same situation like entering a room and forgetting the reason for going there or having difficulty in remembering what date or day it is but might remember any time later. However, dementia patients have a problem remembering what day of the week, date, or time it is or can get easily lost in their street and not be able to find a way back to their home.

7. Problems with Abstract Thinking

Many people face difficulty in performing tasks that require abstract thinking such as balancing a check book or using a calculator. However, someone who has dementia may have significant difficulty in carrying out such tasks due to a loss of their understanding of what numbers and symbols mean and how they are to be used. They won’t be able to easily reason out things or solve problems.

8. Personality Changes

Over time, one’s personality can show subtle changes. Anyone having dementia would behave in a way that’s out of his/her character. They may experience striking changes in their personality and can become withdrawn, suspicious, or confused. The changes also involve fearfulness or lack of interest.

9. Changes in Mood and Behavior

Anyone at some point in time can feel sad or moody. However, people living with dementia can exhibit severe mood swings from being calm to tearful to angry without any apparent reason. They may have anxiety, depression, paranoia, hallucinations, and agitation.

10. Loss of Initiative

Normally, people do get tired of household chores, social obligations, or business activities, but they usually regain their initiative. However, people with dementia may lose interest in their family, friends, and favorite activities. They may become passive in the work they have started and would need cues and prompting to become involved.

The dementia symptoms can vary based on the cause. Other than the above-mentioned signs of dementia, one can even experience challenges in understanding visual and spatial information. Dementia patients can have problems in seeing things, have double vision, and face issues in navigating space such as getting lost while driving or easily and correctly placing things in their right place.

If one is concerned about any of the signs of dementia, the next step is to see a doctor. Only a qualified healthcare expert, after performing multiple tests and assessments, can confirm one of having dementia.

Note that all symptoms of dementia are not listed here, the symptoms vary based on the type of dementia. Each one has its own set of early symptoms. In advanced dementia, memory loss and difficulties in communication often become severe. The patients also face mobility issues, behavioral problems, appetite and weight loss problems, and even urinary bladder incontinence. [1, 2]

References:

1. https://alzheimer.ca/en/about-dementia/do-i-have-dementia/10-warning-signs-dementia
2. https://www.elder.org/dementia-care/signs-of-dementia-in-women/
3. https://www.mayoclinic.org/diseases-conditions/dementia/symptoms-causes/syc-20352013#:~:text=Dementia%20is%20a%20term%20used,memory%20loss%20has%20different%20causes.

Most people are unaware of the gallbladder and its functions while some find the gallbladder as their area of concern. The gallbladder is a small, pear-shaped organ located just beneath the liver. Its role is to store extra bile juice released from the liver. These bile acids help in the breakdown of fatty foods. The bile acid is released from the gallbladder to the small intestine through a connecting tube called the bile duct to digest the fatty food. [1, 2, 3]

Unfortunately, there may be times when the gallbladder is not acting as efficiently as intended, hence affecting one’s general well-being. As a result, there could be a multitude of undesirable consequences such as the build-up of thick bile acids that could create obstructions in the gallbladder and prevent it from getting emptied properly. This could be due to many possible outcomes, most likely of which are gallstones. When this happens, it’s a sure sign to either get the gallbladder issue treated (if minor) or get the organ surgically removed entirely- a procedure called a cholecystectomy. [3]

When do Doctors Recommend Cholecystectomy?

1. Symptomatic Gallstones

Gallstones are the solid bile deposits that form within the gallbladder. They become problematic if they get stuck inside the gallbladder or any of the bile ducts and cause inflammation, infection, nausea, vomiting, bloating, and/or abdominal pain. In some cases, gallstones can lead to biliary colic- a specific kind of pain that is often first felt in the upper right part of the abdomen and sometimes may radiate to the right shoulder or upper back starts in the middle of the night or soon after having a meal, lasts for about 15 minutes or several hours, and may cause nausea and vomiting. If these symptoms appear, it’s an indication to get the gallbladder removed at the earliest or there is a higher risk of severe complications of gallstones.

2. Acute Cholecystitis

It is the inflammation of the gallbladder which is a serious medical condition that can only be treated by surgical removal of the gallbladder.

3. Pancreatitis

When gallstones slip into the bile duct and block it, the pancreatic enzymes are stopped to travel into the small intestine and forced to return to the pancreas. This causes inflammation of the pancreas which in turn could lead to serious health issues. Thus, the best way to treat it would be to completely remove the gallbladder.

4. Cancer of the Gallbladder

Gallbladder cancer is the rarest type of cancer. But, if one is suffering from gallbladder cancer or is at high risk of developing the same, cholecystectomy can be beneficial for survival.

5. Other Gall Bladder Issues

Anyone having choledocholithiasis or Biliary dyskinesia is also recommended for gallbladder removal. Choledocholithiasis is a medical condition wherein the common bile duct contains one or more gallstones. Biliary dyskinesia is a motility or functional disorder of the gallbladder where the organ is not effectively contracting and ejecting the bile acids.[ 2, 3]

Common Signs and Symptoms that Indicate the need for Gallbladder Removal

1. Abdominal Pain

It is the most commonly reported symptom in patients having gallbladder stones that typically occur after eating. The pain can be described as anything from sharp and stabbing to cramping and dull. One may confuse it with pain from gas or acid reflux because of its intermittent nature. However, one must be careful about the potential dangers of any abdominal pain that lasts for several hours.

The abdominal pain due to gallbladder issues is typically felt in the direct center or upper right portion of the abdomen. For some patients, it may extend to the right shoulder blade and the upper back. The pain may be stronger either while having greasy or fatty foods or when taking a deep breath. Immediate medical attention is advised when one is experiencing intense pain such that he/ she cannot sit or find any comfortable position.

2. Digestive Issues

Just like symptoms of many digestive issues, gallstones can lead to symptoms like vomiting, nausea, dark urine, and abnormal color of the stool. If someone is having chronic gallbladder disease, he or she may experience undesirable symptoms such as indigestion, acid reflux, excess gas, and heartburn. These signs may make it difficult for one to distinguish the problem with the gallbladder from other digestive problems. If there are more than four bowel movements on daily basis for at least three months or unexplained fever, it could signal an infection that needs to be treated without much delay.

3. Weight Changes

Obese or overweight people are more likely to have gallstones because weight gain can alter the balance of bile acids and cholesterol in the gallbladder. They would find more difficulty in getting their gallbladder emptied as the excess of cholesterol and bile acids would accumulate in their gallbladder and harden to form gallstones. This means losing weight could surely help one reduce the risk of gallstones, but if weight loss is rapid, it can also trigger gallstones because of the potential imbalance between the levels of cholesterol, bile acids, and lecithin. Usually, this case is seen in people who have undergone bariatric surgery as they tend to lose significant weight in the first 3-6 months and women during and immediately after their pregnancy. Those who desire weight loss must go for daily exercises and a well-balanced diet as extremely low intake of fats in diets can inhibit the contractions of the gallbladder. [1]

How is the Gallbladder Removed?

Laparoscopy cholecystectomy is the minimally invasive procedure to remove the gallbladder. It involves proving general anesthesia to the patient to ensure comfort throughout the surgery. The procedure commences with the making of four small incisions along the abdomen. These cuts are used to insert a laparoscope and other specialized surgical instruments into the abdomen. The abdomen is inflated with gas to provide the surgeon with more inner space to operate better. During the procedure, the surgeon along with his/her supporting team makes use of a tiny camera fitted at end of the laparoscope and a monitor to navigate easily inside the body and operate on the gallbladder. After the removal of the gallbladder, X-rays are taken to ensure that remaining gallstones or bile are not causing any obstructions and the gallbladder is further checked for cancer. [3]

References:

1. https://whalenclark.com/warning-signs-you-might-need-your-gallbladder-removed/
2. https://www.goodrx.com/conditions/gallstones/signs-you-need-your-gall-bladder-removed
3. https://arizonapremiersurgery.com/2020/12/10/warning-signs-you-may-require-gallbladder-surgery/