Centenarian Filipina Reveals Secrets to Longevity

July 29th, 2010

Excerpt from Marjorie Gorospe, loQal.ph

115-year-old I-Apayao native Rufina Daluyon reflects the healthy lifestyle of the I-Apayao tribe and despite her age, the centenarian shows no signs of serious illness.

Apo Rufina can still talk and can still walk but she only speaks Ilocano. She shares her stories to willing listeners through her great granddaughter Susan.

1. Lifelong Physical Activity
The I-Apayao tribe is related to Isneg tribe and both tribes are known as good farmers.

2. Diet – mostly vegetables
Susan says being a member of the I-Apayao tribe, Apo Rufina is very fond of vegetables.

3. Good Genes
Apo Rufina’s husband lived for 126 years. Apo Rufina has three children, but only one among the three is still alive at a still remarkable age of 90.

4. Spirituality and Gratitude

5. Discipline
“Napakahigpit nya (Rufina) lalo pagdating sa pag-uwi ng maaga sa bahay at tamang pagkain. (She is very strict, particularly on curfews and eating the right food),” says Susan in jest.

Centenarian Northern Philippines

Centenarian Northern Philippines

“Minsan tinatanong na rin nya kung bakit di pa sya namamatay at mukha daw nalimutan na siya ni Lord sunduin. (She often wonders why she’s still alive and that the Lord probably has forgotten about her),” says Susan who often visits her great grandmother and gives her a shower.

For her part, Susan says she is thankful for the life that God has granted Apo Rufina.

But Susan admits that things are getting harder for Apo Rufina. Susan says all they can do is to give her the love that she deserves while she is still alive.

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20% Discount on Vitamins, Eyeglasses and Diapers for Seniors

July 10th, 2010

The newly signed Expanded Senior Citizens Act 0f 2010, RA 9994 includes discounts for vitamins, minerals, diapers, and essential medical supplies. This includes Calcium for osteoporosis, Iron tablets for anemia, and B complex for patients with neuropathy.

However, the DOH and FDA have clarified that discounted drug and medicine purchases, now extend to vitamins and minerals specifically prescribed by doctors for senior citizens for purposes of prevention, treatment, or diagnosis of a disease or illness. This excludes those classified as “food supplements with no approved therapeutic claim”.

This law also mandates that DOH is to provide free pneumoccocal and influenza vaccines to indigent senior citizens.

Moreover, the 20% discount also extends to the purchase of essential medical supplies, accessories or equipment like eyeglasses, dentures, hearing aids, walkers or wheelchairs, and even to geriatric diapers.

Wheelchair

Wheelchair

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Medical Profession Needs to Prepare for the Rapidly Growing Elderly Population

June 17th, 2010

The Philippines needs to prepare for the burgeoning population of older persons. The population 60 years and above has grown at a very rapid rate, increasing from 3.2 million in 1990 to 4.6 million in 2000. By the year 2030, ten percent of our population will be composed of senior citizens. The National Institutes of Health (NIH) study “Status of Geriatric Education in Philippine Medical Schools” presented during the NIH Forum 17 June 2010, looked at how Geriatrics (the study of health and disease in old age) is taught in Philippine Medical Schools and the perception of graduating medical students on how well they can take care of old patients after receiving their MD diplomas.

The study revealed that most medical schools do have Geriatrics as part of a required course and 61% enjoy institutional support for developing said course. However, although 70% of the graduating medical students believe they are prepared to take care of the elderly in outpatient clinics and hospitals, only 61% of their teachers think they possess the necessary KAP (knowledge, attitude and practice) for such a job!

Some of the contributors to the lack in KAP of fresh graduates include the crowded medical course schedule and the lack of a curricular map of subjects that teach them how to take care of the elderly. Medical students learn the basics during the first three years of med school (classroom) but may not possess the skills in the final clinical years called internship (hospital exposure). The lack of clinical teachers and researchers were also identified as obstacles to the development of a good Geriatric program.

This study also contains recommendations as to how the situation can be rectified; how we can mold our future doctors into providing excellent and compassionate healthcare for the elderly. We can begin by increasing the number of doctors that are trained and dedicated to teaching, and by establishing a well mapped curriculum in Geriatrics. We also need to support researches that lead to improvement of the health and quality of life of the aging Filipino. The Association of Philippine Medical Colleges, DOH, DSWD, NIH and CHED can help lead this change.

About the NIH and Aging Study Group:

The National Institutes of Health (NIH) was created on January 26, 1996 by the UP Board of Regents as an institutional home of a network of various research and extension units specializing in health and socio-biomedical concerns. This thrust is consistent with the country’s vision of “Health for All”.

Currently, the NIH has various research institutes and active study groups that continue to develop and produce outputs that serve as vital guideposts in shaping national programs and policies. The Aging Study Group and the Committee on Aging and Degenerative Diseases (COMADD) has contributed greatly to current clinical and educational programs and policies on Aging. The vision of COMADD is “The Filipino elderly enjoying a healthy body, mind and spirit, being treated with dignity, and valued as a productive member of society, in a dynamic process unique to himself, and beginning a life of unlimited possibilities”.

Principal Investigator:
Shelley F. de la Vega, MD., MSc
Chair, Aging Study Group
Institute of Health Policy and Development Studies
UP Manila-NIH

Co-Investigators:
Jose Alvin Mojica, M.D., MHPEd
Chair, Department of Rehabilitation Medicine
Philippine General Hospital

Josephine Agapito, PhD
College of Arts and Sciences
UP Manila

Click here to view related post in Manila Bulletin Online

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Age ≥65 yr Highest Case Fatality Rate for AH1N1 Swine Flu Pandemic

June 7th, 2010

Source: Writing Committee of the WHO Consultation on Clinical Aspects of Pandemic (H1N1) 2009 Influenza
Downloaded from www.nejm.org on May 6, 2010

Risk Factors for Complications of or Severe Illness with 2009 H1N1 Virus Infection.

Risk Factor Examples and Comments
1. Age <5 yr Increased risk especially for children <2 yr of age; highest hospitalization rates among children <1 yr
2. Pregnancy Risk of hospitalization increased by a factor of 4 to 7, as compared with agematched nonpregnant women, with highest risk in third trimester
3. Chronic cardiovascular condition Congestive heart failure or atherosclerotic disease; hypertension not shown to be an independent risk factor
4. Chronic lung disorder Asthma or COPD, cystic fibrosis
5. Metabolic disorder Diabetes
6. Neurologic condition Neuromuscular, neurocognitive, or seizure disorder
7. Immunosuppression Associated with HIV infection, organ transplantation, receipt of chemotherapy
or corticosteroids, or malnutrition
8. Morbid obesity – but not yet proved to be an independent risk factor for complications requiring hospitalization or ICU admission and possibly for death
9. Hemoglobinopathy Sickle cell anemia
10. Chronic renal disease Renal dialysis or transplantation
11. Chronic hepatic disease Cirrhosis
12. Long history of smoking Suggested but not yet proved to be an independent risk factor
13. Long-term aspirin therapy in children Risk of Reye’s syndrome; drugs containing salicylates should be avoided in children with influenza
14. Age ≥65 yr Highest case fatality rate but lowest rate of infection

* COPD denotes chronic obstructive pulmonary disease, HIV human immunodeficiency virus, and ICU intensive care unit.
† Morbid obesity is defined as a body-mass index (the weight in kilograms divided by the square of the height in meters)
of 40 or more.

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Preventing Alzheimer’s Part 2: The NIH Consensus 2010

May 4th, 2010

Part 2: Cognitive Engagement and Physical Activity

1. Cognitive Engagement.

Cognitive Training – modest benefits on cognitive functioning and a small but statistically significant effect on reducing the extent of age-related decline in cognitive function at a 5-year follow-up. Very small but statistically significant benefit on instrumental activities of daily living—for example, managing finances, managing medications, keeping house, and, in a subgroup analysis, benefit on driving performance in the elderly.

However, these results from a single trial must be replicated to confirm the benefits of cognitive engagement on preventing
cognitive decline over a longer time period and in study subjects with varying levels of baseline cognitive abilities before a firm recommendation can be made.

2. Physical Activity. Increased physical activity, including walking, may help maintain or improve cognitive function in normal adults.

Tai chi PGH Geriatric Clinic

Although encouraging, these data should be viewed as preliminary. Work is ongoing to further investigate the benefits of
physical activity.

Factors associated with decreased risk of Alzheimer’s disease and cognitive decline were cognitive engagement (as indicated by literacy and social enrichment), physical activities in later life, and a diet low in saturated fat and high in vegetable intake. Light to moderate alcohol intake
is reported to be associated with reduced risk of Alzheimer’s disease, but results are inconsistent for cognitive decline

Source: NIH State-of-the-Science Conference:
Preventing Alzheimer’s Disease and Cognitive Decline
April 26–28, 2010

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Committee on Aging University of the Philippines-National Institutes of Health

July 20th, 2008

Brief History of the Committee on Aging and Degenerative Diseases

The University of the Philippines Manila is the country’s leading institution for health research and development. The creation of the National Institutes of Health was approved by the Board of Regents at its 1094th meeting on 26 January 1996, and with it, the Gerontology and Disabilities Programs Cluster, through the Committee on Aging and Degenerative Diseases. The committee is composed of various physicians, academicians, and allied medical professionals within the UP-PGH system.

The COMADD is currently comprised of volunteer consultants from various Clinical and Basic Sciences Departments of the UP-PGH system:
1. Philippine General Hospital – Clinical Departments are involved through their representatives, including: Internal Medicine, Family Medicine, Surgery, Orthopedics, Rehabilitation, Neurology, Psychiatry and Nutrition.
2. UP College of Nursing – membership representation
3. UP Manila College of Arts and Sciences – membership representation thru the Department of Behavioral Sciences (Anthropology)
4. College of Allied Medical Professionals
5. College of Pharmacy
6. College of Dentistry

Mission-Vision: Institute for Aging and Degenerative Diseases
Vision
The Filipino elderly enjoying a healthy body, mind and spirit, being treated with dignity, and valued as a productive member of society, in a dynamic process unique to himself, and beginning a life of unlimited possibilities.
Mission
The institute shall create with the aging Filipino, unlimited possibilities for their value added life through scientific research, training and education, and specialized services.

Clinical Programs
The Committee on Aging and Degenerative Diseases through it multidisciplinary membership is involved in the development and management of various clinical programs within the UP-PGH system, including:
Outpatient geriatric evaluation and wellness clinic
Inpatient geriatric medical consultation
Memory clinic
Stroke unit
Rehabilitation unit (physical, occupational and speech therapy)
Menopause clinic
Specialized services such as Spine/Osteoporosis care; Rheumatology clinic

Policy Development
The Committee and its members have been directly involved as technical advisers in the development of
The Philippine Plan of Action for Older Persons, DSWD
The Health Program for Older Persons, DOH
Baseline Surveys for the National Objectives of Health, DOH, NIH
Periodic Health Examination Guideline, PHILCLEN, DOH
Alzheimer’s Disease Association of the Philippines Recommendations on Diagnosis, Prevention and Management
Education

The Committee has undertaken 9 successful Post-graduate courses in Geriatric Medicine for physicians, nurses, and allied medical professions since 1997

Research

The Committee and its members are involved in funding and development of essential national health researches including those that resulted in the Policy and Recommendation documents above.

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Warning: American Board of Geriatrics

September 7th, 2008

The American Geriatrics Society (AGS) would like to alert members to the activities of an organization calling itself “American Board of Geriatrics” (ABG) and a related organization called “The American College of Geriatrics.” Certification from this Board is not recognized by the American Board of Medical Specialties (ABMS), or its approved member specialty boards, nor does the AGS recognize this as evidence of Board certification in geriatrics or in its consideration for advancement to a Fellow of the Society. The ABG claims to be a tax-exempt 501(c)(3) public charity. The Internal Revenue Service has advised that the ABG does not have such tax-exempt status.
Link to American Geriatric Society

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National Academy of Science and Technology Resolution on Active Aging

July 16th, 2009

NATIONAL ACADEMY OF SCIENCE AND TECHNOLOGY (NAST), PHILIPPINES
31st Annual Scientific Meeting
08-09 July 2009; The Manila Hotel

Resolution on Active Aging

Whereas, in the global scene, the population of older persons grows at a rate of 2.6 percent every year, which is significantly faster than the population as a whole, which increases at 1.1 percent annually;

Whereas, in the Philippines, the population 60 years and above, has grown at a very rapid rate increasing from 3.2 million in 1990 to 4.6 million in 2000;

Whereas, in the Philippines, the rate of growth of the population 60 years and above, is at 3.6 percent per annum;

Whereas, the 1987 Philippine Constitution, Republic Act Nos. 7876, 8425 and 9257, General Appropriations Act of 2006, and Executive Order No. 266 were formulated to take care of its elderly members to design programs which will be beneficial to senior citizens, their families and the rest of the communities that they serve;

Whereas, the Philippine Plan of Action for Senior Citizens covering the period 2006-2010 identified major areas of concerns, target outputs, and responsible agencies/institutions, which have to be fully implemented;

Whereas, active aging is the process of optimizing opportunities for health, participation and security in order to enhance quality of life as people age;

Whereas, active aging allows people to realize their potential for physical, social, and mental well being throughout the life course and to participate in society according to their needs, desires and capacities, while providing them with adequate protection, security and care when they require assistance;

Whereas, the active aging approach is based on the recognition of the human rights of older people and the United Nations Principles of independence, participation, dignity, care and self-fulfillment.

NOW, THEREFORE, the National Academy of Science and Technology, Philippines on their 31st Annual Scientific Meeting recommends the following action point to be addressed accordingly by the appropriate agencies.

• Service Delivery

 Recognize home and residential care as a significant strategy for better care for the aging population, through standardized guidelines (DOH and DSWD);

 Designate health professionals, trained and dedicated to the care of the senior citizens in all hospitals, especially in the DOH retained hospitals (DOH);

 Subject services, drugs and other items to 20% discount based on the retail price which already includes VAT (DOF);

 Create an enabling and conducive work environment while allowing the elderly to work and remain productive (DSWD and DOLE);

• Research and Innovation

 Conduct research to address pressing concerns and issues affecting the aging population (DOST and DSWD);

 Establish an institute for aging that will identify and implement priority researches on the aging population including the development of new parameters for defining and characterizing the dependency ratio for senior citizens (UPM-NIH);

 Create innovative mechanism for savings and income generation for the purpose of providing regular pension for senior citizens (DOST);

 Create an investment mechanism and income protection for the senior citizens (BSP and NEDA);

 Develop nutritional standards for the elderly that are affordable and cost effective (DOST);

 Develop technology for improved access, functional independence, and social connectivity for senior citizens (DOST).

• Training and Education

 Give high priority to the promotion of quality aging by all sectors of both public and private sectors (DepEd);

 Launch information and education campaign to promote lifestyle change through primary and secondary education on aging (DepEd);

 Incorporate in the school curriculum values formation specially for better appreciation of the elderly (DepEd); and

 Educate middle age workforce on the benefits of senior citizens and prepare them for retirement (GSIS, SSS, DSWD);

• Policy

 Revisit the composition of the National Inter-Agency Coordinating and Monitoring Board (DSWD);

 Review existing laws to ensure their proper implementation (DSWD);

 Establish, fully implement, and further strengthen the Office for Senior Citizens Affairs (OSCA) in all Local Government Units (DILG); and

 Consolidate and update national data related to aging (DSWD).

IT IS FURTHER RESOLVED that the National Academy of Science and Technology, Philippines supports the national program for aging and commits to the creation of the National Advisory Council on Active Aging that will further define the strategies and programs that have to be implemented to realize the aforementioned objectives.

Download documents and Annual Scientific Meeting Proceedings link to NAST

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Asia Pacific Geriatric Conference 2011

August 2nd, 2009

On July 5 2009, members and officers of various Asia Pacific Geriatric Societies gathered in Paris for a meeting of the Asia-Pacific Geriatric Network. Represented were geriatric medicine specialists form the Philippine Society of Geriatric Medicine, The Australia and New Zealand Geriatric Society, The HongKong Geriatric Society, Malaysia Geriatric Society, Indonesia Geriatric Society. Also represented were teaching and research centers such as the University of the Philippines National Institutes of Health, University of Western Australia, University of Malaya Kuala Lumpur, National Taiwan University Hospital and National Health Research Institute of Taiwan.
The group agreed to actively participate and contribute in the success of the Cebu 2011 scientific program, to be hosted by the Philippine Society of Geriatric Medicine.AsiaPacificGeriatricNetwork MeetingParis 09

Members of the International Scientific Committee are:
Edward M F Leung, Hong Kong
Czeresna Heriawan Soejono, Indonesia
Catherine Yelland, New Zealand and Australia
Leon Flicker, Australia
Philip Poi, Malaysia
Joel Eleazar, Philippines – Overall Scientific Chair

Visit the PSGM Website for regular updates and announcements.

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How to Make Wise Health Choices

March 13th, 2010

Ask yourself these questions before following a health advise from a friend:

1. Is this person giving advise a friend or a salesperson?

2. Will I suffer from harm if I do not follow his/her health advise?

3. What kind of product or procedure is this person recommending?

4. What are the benefits?

a. what are the effects on my body/mind and are these the effects I desire?
b. how soon can the benefits be felt?
c. how long will the effects last?
d. how many in 10 who follow the advise will feel the benefit? how many in 100?
e. how many in 10 people tested represent my age group?


Watch out for testimonials or personal anecdotes! One person in ten may have benefited but you need to ask: “How many took the product? What happened to the nine others who took the product?”

5. Are there side effects or harmful outcomes?

how many in 10 persons will feel worse? how many in 100?

7. Will the cost/money/time I spend be worth the benefit?

8. Do I have enough information to make a wise health choice?

a. ask about scientific randomized trials or systematic reviews on the product or procedure in which all relevant studies are identified and those of adequate quality selected. Results from selected studies are usually pooled (using meta-analysis) to give the
best single estimate of effect.
b. ask for help from a trusted physician but avoid doctor shopping.
c. search trusted internet sites and peer reviewed medical journals.

Do your homework! Click any of these links for medical information on western and complementary medicine Medline Plus , the Cochrane Review of Complementary Medicine and Pubmed and the US Food and Drug Administration

Watch out for quacks and snake-oil salesmen!
You may be dealing with a quack if:
1. The information only includes stories of patients who benefit from the product.
2. You cannot obtain information on the number of people who do not improve after taking the product/procedure.
3. The advertiser is quiet about those who experience harmful side effects.

Reference: Irwig et al. Smart Health Choices. Allen and Unwin 1999.

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Preventing Alzheimer’s Part 1: The NIH Consensus 2010

May 4th, 2010

Part 1: Supplements and Medicines for Alzheimer’s Prevention

Available scientific evidence is inadequate to conclude that any known preventive strategies are effective. This conclusion is based on a review of published literature of randomized, controlled trials (RCTs), the most rigorous, highest quality evidence.

Summary of Detailed Interventions:
1. Vitamins, Nutrients, and Dietary Supplements.
Vitamin E – no evidence that this factor altered the onset of the Alzheimer’s disease.

Gingko biloba – A recent, large long-term RCT showed no reduction in the incidence of Alzheimer’s disease, leading to the conclusion that there is not sufficient evidence to support the efficacy of gingko biloba.

2. Medications
Cholinesterase inhibitors (donepezil, rivastigmine, galantamine) – this class of drugs is not effective in preventing Alzheimer’s disease.

Anti-hypertensive medications – negative with insufficient evidence for protection against Alzheimer’s disease.

NSAIDs—rofecoxib, naproxen, and celecoxib—suggest an increased incidence of Alzheimer’s disease with treatment.

Conjugated equine estrogen, one combined with methyl progesterone – suggest an increased incidence of dementia (including Alzheimer’s disease) with treatment.

Together, these trials suggest that no known medication can be said to reliably delay the onset of Alzheimer’s disease.

Source: NIH State-of-the-Science Conference:
Preventing Alzheimer’s Disease and Cognitive Decline
April 26–28, 2010

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Folic Acid Does Not Prevent Memory Decline

July 18th, 2010

The addition of folic acid to the list of vitamins and supplements for the prevention of memory decline is addressed in this meta-analysis. Wald et al conducted a meta-analysis of 9 randomized controlled trials on folic acid, with or without vitamin B and its effect on memory, speed of information processing, language and executive function (decision making). The median duration per study is 6 months and the median age of participants is 75 years.

The results showed no effect of folic acid in the prevention of cognitive decline (memory, speed of information processing, language and decision making) among individuals without preexisting dementia.

The pooled standardized mean difference
in cognitive function test scores was 0.01 (95% CI,
-0.08 to 0.10) after a median treatment of 6 months; an
increase of 1% of a standard deviation of a cognitive
function test score, with confidence intervals excluding
an improvement or a deterioration greater than 10% of 1
standard deviation.

Studies of longer duration are needed in order to address the role of folic acid in the prevention of cognitive decline.

Source: The American Journal of Medicine (2010) 123, 522-527

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Implementing Expanded Senior Citizens Act of 2010

July 10th, 2010

The Implementing Rules and Regulations (IRR) of Republic Act 9994 (Expanded Senior Citizens Act of 2010) went into effect on July 6 granting the full 20 percent discount – privileges to senior citizens.

Secretary Soliman emphasized that senior citizens who have queries and complaints may call the DSWD hotlines 951-7120 and cellphone number 0999-314-7425 or visit the National Coordinating and Monitoring Board (NCMB) website at http://ncmb.dswd.gov.ph and email at ncmb@dswd.gov.ph

“We also plan to set-up Help Desks at the DSWD Central Office and in all DSWD Regional Offices for senior citizens without access to phone lines and the internet,” Secretary Soliman added.

Secretary Soliman appealed to senior citizens to refrain from abusing the privileges under RA 9994. “The law is the government’s way of acknowledging and giving praise to senior citizens who contributed to nation building, and is designed for the sole enjoyment of the senior citizens, so please do not abuse these privileges,” Secretary Soliman stated.

DSWD Sec Dinky Soliman

DSWD Sec Dinky Soliman

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Lifestyle Diseases (Sakit sa Puso) A Poem by JD

July 1st, 2010

Lifestyle Diseases (Sakit sa Puso)

Sinulat ni JD Agapito

Sa dami ng sakit sa ating lipunan

Sakit ng katawan ay kayang pigilan

Lalo na’t sa puso ang pag-uusapan.

Disiplina ang siyang tanging kailangan

Bakit ko nasabi ang huli kong linya?

Dahil ang sakit ay tayo ang may gawa.

Alam na masamang kumain ng taba.

Hanap nitong dila’y karneng mamantika.

Kung may pera nama’y panay rin ang punta

Sa mga food chains na prito ang siyang tinda.

Sa order na chicken, balat ang inuuna.

Mataas na kolesterol siyang ‘di iniinda.

Bukod pa nga rito’y ang hindi paggalaw.

Panay ang pag-upo’t di man lang sumayaw.

Kahit na minsan lang sa buong isang araw.

Maglakad lakad ng taba ay matunaw.

Maging sa inumi’y di displinado.

Kung uminom ng softdrinks sadyang bigay todo.

Dapat ay minsan lang sa buong ‘sang linggo.

Mas maraming tubig ang dapat sa iyo.

Kaya’t mas marami ang may hypertension.

Dahil sa kinai’y mayr’ong alta presyon.

Dagdagan pa natin ng lahat ng tensyon.

Dala na rin mismo ng mga sitwasyon.

Kaya kung ikaw ay hindi magbabago.

Lalo pa kung ika’y naninigarilyo.

Tiyak ang buhay mo ay mamimiligro.

Sakit sa puso ang tatapos sa iyo.

Dito sa aking tula ‘y may hihilingin.

Pwede bang pagkain ay sadyang isipin

Para makontrol ang taba maging asin.

Mga simpleng bagay ‘wag ng problemahin.

Kaya’t sana ay hindi pa mahuli.

Itong aking payong hangad ay mabuti.

Upang maiwasan itong maatake.

At di na mangyari itong pagsisisi.

Dahil may dalanging kasama ang tula.

Itaas sa Diyos ang nais na sadya.

Sa kanyang patnubay lahat magagawa.

Kung buhay ay maayos, siya’y matutuwa.

Contributed by COMADD NIH Member
Prof JD
June 28, 2010 5:00

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Coping With Dementia: Violence and Aggression

May 16th, 2010

Tips from the Alzheimer’s Disease International website:

Violence and aggression

“Violence and aggression are caused by the illness.”

From time to time, the person may become angry, aggressive or violent. It is not a personal attack on you, but a part of their illness. There are many reasons why a person with dementia may feel angry. They may not like being helped with things they used to do on their own, or may simply be frustrated due to an inability to do things.
Angry Skull
These short-term changes happen for a variety of reasons such as the person’s sense of loss of social control and judgment, loss of the ability to express negative feelings safely, and loss of the ability to understand the actions and abilities of others. It is therefore worth finding and avoiding the causes of unwanted certain reactions.

If the person feels angry, aggressive or violent, keep calm and try not to show fear or alarm. Give them more space and try to draw their attention to a calming activity.

This is one of the most difficult things to cope with for a caregiver, and if violence occurs often, you will need to seek help. Talk to someone for support, and speak with your doctor about help with managing the person.

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Coping with Dementia: Alcohol and Cigarette Smoking

May 16th, 2010

Modified from Alzheimer’s International UK:

Alcohol and cigarettes

“Supervise drinking and smoking to make sure accidents don’t happen.”

There is no problem for a person with dementia drinking alcohol in moderation if their medication allows. However the person may forget they have just had a drink and so have another one. This cycle can lead to repetition with the person becoming drunk or unmanageable.

1. Do not buy or store alcohol at home.
- reduce the number of bottles of alcohol available in the drinks cabinet
- empty or dilute some of them.
2. Distract the person with another activity, so that they do not think about drinking.
3. Provide water, juice, light soda, and other healthy cool drinks.

Tobacco Smoking Elderly

Cigarettes introduce a greater danger because of the risk of fire and damage to health.
1. Do not buy or store cigarettes at home.
2. Always supervise the person when smoking
- but remember the dangers of second-hand and third hand smoke!!!
3. Discourage smoking altogether and enroll in a smoking cessation program
4. Make sure that the clothes they wear and the furniture in the house are fire-resistant.
5. Install a smoke alarm, which can alert you to any danger.

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