Alzheimer’s disease

The surprising benefits of compassion meditation

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Stacey Colino, USNews: In recent years, mindfulness meditation has garnered loads of attention for its beneficial effects on the body and mind. Now, there’s a new star on the block: compassion meditation, a less well-known but increasingly popular contemplative practice that aims to strengthen feelings of compassion and empathy toward different people (both those you care about and those who are difficult).

“It’s deeply rooted in Buddhist philosophy, which has taught us a lot about how people are connected and what is the purpose of our existence,” explains Stefan G. Hofmann, a professor of psychology in the department of psychological and brain sciences at Boston University. “Compassion is the fundamental idea at the root of Buddhist philosophy – if life is suffering and we can’t avoid it, we need to embrace it and be compassionate toward the suffering of others. It brings us closer to others.”

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More than just a feel-good practice, compassion meditation leads to improved mood, more altruistic behavior, less anger, reduced stress and decreased maladaptive mind wandering, according to recent research. A 2013 study at the VA Puget Sound Health Care System in Seattle found that practicing loving-kindness meditation (a form of compassion meditation) for 12 weeks reduced symptoms of post-traumatic stress disorder, or PTSD, as well as anger and depression among veterans with PTSD. A 2005 study from Duke University Medical Center found that practicing loving-kindness meditation for eight weeks reduced pain and psychological distress among patients with chronic low back pain. And a 2015 study from Brazil found that practicing yoga along with compassion meditation three times a week for eight weeks improved quality of life, vitality, attention and self-compassion among family caregivers of patients with Alzheimer’s disease. …

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Mindfulness training can improve quality of life for memory impaired and their caregivers

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Medical News Today: Mindfulness training for individuals with early-stage dementia and their caregivers together in the same class was beneficial for both groups, easing depression and improving sleep and quality of life, reports new Northwestern Medicine study.

“The disease is challenging for the affected person, family members and caregivers,” said study lead author Ken Paller, professor of psychology at Weinberg College of Arts and Sciences at Northwestern and a fellow of the Cognitive Neurology and Alzheimer’s Disease Center at Northwestern University Feinberg School of Medicine. “Although they know things will likely get worse, they can learn to focus on the present, deriving enjoyment in the moment with acceptance and without excessive worry about the future. This is what was taught in the mindfulness program.”

The study was published in the American Journal of Alzheimer’s Disease and Other Dementias.

Neurodegenerative diseases such as Alzheimer’s are particularly hard on caregivers, who are often close family members. They tend to have an increased incidence of anxiety, depression, immune dysfunction and other health concerns as well as an increased mortality rate, according to prior studies.

This is the first study to show that the caregiver and the patient both benefit from undergoing mindfulness training together. This is important because caregivers often don’t have much time on their own for activities that could relieve their emotional burden.

The training also helps the patient and caregiver accept new ways of communicating, scientists said.

“One of the major difficulties that individuals with dementia and their family members encounter is that there is a need for new ways of communicating due to the memory loss and other changes in thinking and abilities,” noted study co-author Sandra Weintraub, a professor of psychiatry and behavioral sciences at Feinberg and a neuropsychologist at Northwestern Memorial Hospital. “The practice of mindfulness places both participants in the present and focuses on positive features of the interaction, allowing for a type of connection that may substitute for the more complex ways of communicating in the past. It is a good way to address stress.”

The study included 37 participants including 29 individuals who were part of a patient-caregiver pair. Most of the patients were diagnosed with dementia due to Alzheimer’s disease or mild cognitive impairment, often a precursor to dementia. Others had memory loss due to strokes or frontotemporal dementia, which affects emotions as well as speaking and understanding speech. Caregivers included patients’ spouses, adult children, a daughter-in-law and a mother-in-law.

Although the individuals with Alzheimer’s had mild to severe memory loss, they still were able to use other cognitive functions to participate in the mindfulness training and to experience emotion and positive feelings, Weintraub noted.

The participants attended eight sessions designed specifically for the needs of patients with memory loss due to the terminal neurodegenerative illness (dementia) and for the needs of their caregivers. Both groups completed an assessment within two weeks of starting the program and within two weeks of completing it.

Paller had expected mindfulness to be helpful for dementia caregivers based on previous research in the field. But he was uncertain whether a program would be successful for patients with memory impairments and whether patients and their caregivers could be trained together.

“We saw lower depression scores and improved ratings on sleep quality and quality of life for both groups,” said Paller, director of the cognitive neuroscience program. “After eight sessions of this training we observed a positive difference in their lives.”

“Mindfulness involves attentive awareness with acceptance for events in the present moment,” Paller said. “You don’t have to be drawn into wishing things were different. Mindfulness training in this way takes advantage of people’s abilities rather than focusing on their difficulties.”

Developing mindfulness is about learning different habits and a person has to practice a new habit for it to stick, Paller noted.

Paller said he hoped the study findings would encourage caregivers to seek out resources for learning mindfulness for themselves and the individuals with illness.

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Meditation, memory loss, Alzheimer’s and aging

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Gordon Richman, WASHINGTON, November 12, 2012 – Alzheimer’s is devastating and terrifying. Our grandparents are fighting it now, our parents preparing to fight it, and we know that we’re next. A recent bittersweet  NPR piece explained that in order for most currently-conceived Alzheimer’s drugs to work effectively, patients would have to start treatment early— up to 20 years early.

Most of us, as much as we fear Alzheimer’s, don’t want to take a cocktail of drugs for something that may or may not happen in 20 years. Although there are brilliant scientists and physicians working on helping people with Alzheimer’s (and those who might suffer from it in the future), most of this is theoretical. Fortunately, there are some fairly innocuous, easy and relatively inexpensive things older and middle aged people can do to fight memory loss. One of those things is the opposite of a modern miracle drug—it’s a health practice that’s over 5000 years old. That practice is meditation.

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Age

Earlier this year, the Thomas Jefferson University Hospital released a very interesting study. According to Medical News Today, the study showed that meditation can indeed help with memory loss. 15 older adults meditated for 12 minutes a day for 8 weeks, and the results were remarkable. Blood flow increased in key areas of the brain, and cognitive function improved as well. They were less depressed, less stressed and less confused. They were holding on to their memories.

Older people often become depressed and detached as their lives change, and as the world changes around them. Modern Western society is moving in unexpected directions, and it’s doing so at an alarming rate— a rate that some seniors have a hard time keeping up with. All of that stress, confusion and depression can add up to apathy and despair, which can lead to lack of mental engagement and activity. That engagement deficiency is unhealthy for several reasons, but it can also contribute to Alzheimer’s. Meditation is all about nurturing your mind and moving you away from negativity. It makes sense, then, that meditation can fight against Alzheimer’s and improve overall health.

In a Huffington Post piece from last year, Dr. Dharma Singh Khalsa put it succinctly, “…  This cutting-edge [neuroscience] research showed that stress, through the release in the body of a hormone called cortisol, could kill brain cells by the millions and lead to memory loss similar to Alzheimer’s disease. For me, this was an epiphany. I remember thinking that, if stress could cause memory loss, then why couldn’t anti-stress techniques, such as meditation, stop it from happening?”

Health

Some people, young, old or middle aged, refuse to try meditation. They think it’s a “new age” practice left to those who wear strange clothing and hold séances with their dogs. Meditation is actually good for just about everyone— it can help with stress, depression, anxiety, blood pressure and cholesterol. It’s free, it feels good and it doesn’t take much time out of the day. Those are huge selling points, especially for the suspicious. The biggest struggle in using meditation as a treatment for current and future Alzheimer’s patients might be getting them to actually try it. What sounds better, though—years of expensive pills or years of quiet, relaxed mindfulness?

If Dr. Khalsa and the Thomas Jefferson University Hospital are correct, it might only take minutes out of our day to fight a debilitating condition. The key, then, to utilizing meditation in the fight against memory loss is in building a daily routine.

Routine

The secret to successful meditation is to include it in a daily routine. Similarly, the key to successfully engaging your mind also lies in the realm of consistency. Older people, especially those who are retired, should have no problem adding meditation to their daily lives. Meditation, coupled with some regular social interaction, light exercise and other inexpensive, non-invasive techniques (such as Music for Memory are a gentle way to curb and reverse memory loss. They’re pleasant, productive and healthy—and they also don’t rely on expensive medications.

For middle aged people, finding a routine might be more difficult at first. The trick is finding about 15 minutes of uninterrupted time, preferably first thing in the morning, to sit down to meditate. There are many different meditation techniques available to suit any number of different personalities and preferences. The important thing is that it’s done daily.

Know that meditation is not for other people—it will work for you, and it can help you, especially if you’re worried about memory loss. It also doesn’t ask for anything in return. It’s there when you need it, and it will be ready when you are.

There will continue to be scientific breakthroughs in the realm of Alzheimer’s studies, but one surefire method has already been proven. Meditation might not be an instant cure-all, but it does help and it doesn’t pose any harmful side effects. Alzheimer’s is devastating, but it’s comforting to know that meditation works and that we don’t yet understand its full potential.

The Jefferson Myrna Brind Center of Integrative Medicine’s Dr. Andrew Newberg is extremely hopeful. Speaking with Medical News Today, he said, “This study is one of a growing body of neuroimaging studies to illustrate the neurological and biological impact of meditation, highlighting brain regions that regulate attention control, emotional states, and memory. It is a first step in understanding the neurophysiologic impact of this and similar meditative practices.”

We can take the first step anytime we’re ready.

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Yoga reduces inflammation response

UCLA study helps caregivers of people with dementia

Six months ago, researchers at UCLA published a study that showed using a specific type of yoga to engage in a brief, simple daily meditation reduced the stress levels of people who care for those stricken by Alzheimer’s and dementia. Now they know why.

As previously reported, practicing a certain form of chanting yogic meditation for just 12 minutes daily for eight weeks led to a reduction in the biological mechanisms responsible for an increase in the immune system’s inflammation response. Inflammation, if constantly activated, can contribute to a multitude of chronic health problems.

Reporting in the current online edition of the journal Psychoneuroendocrinology, Dr. Helen Lavretsky, senior author and a professor of psychiatry at the UCLA Semel Institute for Neuroscience and Human Behavior, and colleagues found in their work with 45 family dementia caregivers that 68 of their genes responded differently after Kirtan Kriya Meditation (KKM), resulting in reduced inflammation.

Caregivers are the unsung heroes for their yeoman’s work in taking care of loved ones that have been stricken with Alzheimer’s and other forms of dementia, said Lavretsky, who also directs UCLA’s Late-Life Depression, Stress and Wellness Research Program. But caring for a frail or demented family member can be a significant life stressor. Older adult caregivers report higher levels of stress and depression and lower levels of satisfaction, vigor and life in general. Moreover, caregivers show higher levels of the biological markers of inflammation. Family members in particular are often considered to be at risk of stress-related disease and general health decline.

As the U.S. population continues to age over the next two decades, Lavretsky noted, the prevalence of dementia and the number of family caregivers who provide support to these loved ones will increase dramatically. Currently, at least five million Americans provide care for someone with dementia.

“We know that chronic stress places caregivers at a higher risk for developing depression,” she said “On average, the incidence and prevalence of clinical depression in family dementia caregivers approaches 50 percent. Caregivers are also twice as likely to report high levels of emotional distress.” What’s more, many caregivers tend to be older themselves, leading to what Lavretsky calls an “impaired resilience” to stress and an increased rate of cardiovascular disease and mortality.

Research has suggested for some time that psychosocial interventions like meditation reduce the adverse effects of caregiver stress on physical and mental health. However, the pathways by which such psychosocial interventions impact biological processes are poorly understood.

In the study, the participants were randomized into two groups. The meditation group was taught the 12-minute yogic practice that included Kirtan Kriya, which was performed every day at the same time for eight weeks. The other group was asked to relax in a quiet place with their eyes closed while listening to instrumental music on a relaxation CD, also for 12 minutes daily for eight weeks. Blood samples were taken at the beginning of the study and again at the end of the eight weeks.

“The goal of the study was to determine if meditation might alter the activity of inflammatory and antiviral proteins that shape immune cell gene expression,” said Lavretsky. “Our analysis showed a reduced activity of those proteins linked directly to increased inflammation.

“This is encouraging news. Caregivers often don’t have the time, energy, or contacts that could bring them a little relief from the stress of taking care of a loved one with dementia, so practicing a brief form of yogic meditation, which is easy to learn, is a useful too.”

Lavretsky is a member of UCLA’s recently launched Alzheimer’s and Dementia Care Program, which provides comprehensive, coordinated care as well as resources and support to patients and their caregivers. Lavretsky has incorporated yoga practice into the caregiver program.

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When we don’t make anything “wrong”

Sometimes when I talk about Radical Acceptance, I like to tell the story about Jacob, a man who at almost seventy and in the mid-stages of Alzheimer’s disease attended a 10-day retreat I was leading.

A clinical psychologist by profession and a meditator for more than twenty years, Jacob was well aware that his faculties were deteriorating. On occasion his mind would go totally blank; he would have no access to words for several minutes and become completely disoriented. He often forgot what he was doing and usually needed assistance with basic tasks—cutting his food, putting on clothes, bathing, getting from place to place.

A couple of days into the retreat, Jacob had his first interview with me. These meetings, which students have regularly with a teacher while on retreat, are an opportunity to check in and receive personal guidance in the practice. During our time together Jacob and I talked about how things were going both on retreat and at home. His attitude towards his disease was interested, sad, grateful, even good-humored.

Intrigued by his resilience, I asked him what allowed him to be so accepting. He responded, “It doesn’t feel like anything is wrong. I feel grief and some fear about it all going, but it feels like real life.” Then he told me about an experience he’d had in an earlier stage of the disease.

Jacob had occasionally given talks about Buddhism to local groups and had accepted an invitation to address a gathering of over a hundred meditation students. He arrived at the event feeling alert and eager to share the teachings he loved. Taking his seat in front of the hall, Jacob looked out at the sea of expectant faces in front of him … and suddenly he didn’t know what he was supposed to say or do. He didn’t know where he was or why he was there. All he knew was that his heart was pounding furiously and his mind was spinning in confusion.

Putting his palms together at his heart, Jacob started naming out loud what was happening: “Afraid, embarrassed, confused, feeling like I’m failing, powerless, shaking, sense of dying, sinking, lost.” For several more minutes he sat, head slightly bowed, continuing to name his experience. As his body began to relax and his mind grew calmer, he also noted that aloud. At last Jacob lifted his head, looked slowly around at those gathered, and apologized.

Many of the students were in tears. As one put it, “No one has ever offered us teachings like this. Your presence has been the deepest dharma teaching.”

Rather than pushing away his experience and deepening his agitation, Jacob had the courage and training simply to name what he was aware of, and, most significantly, to bow to his experience. In some fundamental way he didn’t create an adversary out of feelings of fear and confusion. He didn’t make anything wrong.

We practice Radical Acceptance by pausing and then meeting whatever is happening inside us with this kind of unconditional friendliness. Instead of turning our jealous thoughts or angry feelings into the enemy, we pay attention in a way that enables us to recognize and touch any experience with care. Nothing is wrong—whatever is happening is just “real life.” Such unconditional friendliness is the spirit of Radical Acceptance.

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Yoga can enhance quality of life and slow cellular aging in caregivers

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For every individual who’s a victim of Alzheimer’s — some 5.4 million people in the United States alone — there’s a related victim: the caregiver. Spouse, son, daughter, other relative or friend; the loneliness, exhaustion, fear, and most of all stress and depression, takes a toll

While care for the caregivers is difficult to find, a new study out of UCLA suggests that using yoga to engage in very brief, simple daily meditation can lead to improved cognitive functioning and lower levels of depression for caregivers.

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Dr. Helen Lavretsky, professor of psychiatry at the UCLA Semel Institute for Neuroscience and Human Behavior, and colleagues report a further benefit as well: a reduction in stress-induced cellular aging.

The report appears in the current online edition of the International Journal of Geriatric Psychiatry.

As the U.S. population continues to age over the next two decades, the prevalence of dementia and the number of family caregivers who provide support to these loved ones will increase dramatically. Currently, at least five million Americans provide care for someone with dementia. The detrimental burden on them, in terms of their own lives, can be severe.

For example, says Lavretsky, who also directs UCLA’s Late-Life Depression, Stress and Wellness Research Program, “We know that chronic stress places caregivers at a higher risk for developing depression. On average, the incidence and prevalence of clinical depression in family dementia caregivers approaches 50 percent. Caregivers are also twice as likely to report high levels of emotional distress.” What’s more, many caregivers tend to be older themselves, leading to what Lavretsky calls an “impaired resilience” to stress and an increased rate of cardiovascular disease and mortality.

While medication can improve depression, many caregivers may be opposed to the use of medication because of the associated cost and drug side-effects. That consideration motivated Lavretsky and her colleagues to test a brief mind-body intervention for stress reduction.

The researchers recruited 49 family caregivers who were taking care of their relatives with dementia. Their ages ranged from 45 to 91 years old and included 36 adult children and 13 spouses. The participants were randomized into two groups. The meditation group was taught a brief, 12-minute yogic practice that included an ancient chanting meditation, Kirtan Kriya, which was performed every day at the same time for eight weeks. The other group was asked to relax in a quiet place with their eyes closed while listening to instrumental music on a relaxation CD, also for 12 minutes every day at the same time for eight weeks.

At the end of the eight weeks the researchers found that the meditation group showed significantly lower levels of depressive symptoms and greater improvement in mental health and cognitive functioning, compared with the relaxation group. In the meditation group, 65 percent showed a 50 percent improvement on a depression rating scale, and 52 percent of the group showed a 50 percent improvement on a mental health score. This compared to a 31 percent depression improvement and a 19 percent mental health improvement for the relaxation group.

The researchers also found that meditation increased telomerase activity and thus slowed cellular aging. Telomerase is an enzyme that maintains the DNA at the ends of our chromosomes, known as telomeres. Telomeres are associated with a host of health risks and diseases, which may be regulated in part by psychological stress. In the absence of telomerase activity, every time our cells divide, our telomeres get shorter and shorter, until eventually, they become so short the cells die. If high telomerase can be maintained or promoted, though, it will likely promote improvement in telomere maintenance and immune cell longevity.

In the study, the meditation group showed a 43 percent improvement in telomerase activity compared with 3.7 percent in the relaxation group.

“Although the relation between mental and physical health has been previously documented, the mechanistic links are beginning to be understood at the cellular level,” said Lavretsky.

“To a varying degree, many psychosocial interventions like this have been shown to enhance mental health for caregivers,” she said. “Yet given the magnitude of the caregiver burden, it is surprising that very few interventions translate into clinical practice. The cost of instruction and offering classes may be one factor. Our study suggests a simple, low-cost yoga program can enhance coping and quality of life for the caregivers.”

The pilot results were “striking,” she said, given the improvements that were shown in mental health, cognition, and telomerase activity over a short eight weeks at a mere 12 minutes a day. “We found that the effects on cognitive and mental functioning and telomerase activity were specific to the Kirtan Kriya. Because Kirtan Kriya had several elements, including chanting, mudras (hand gestures) and visualization, there was a ‘brain fitness’ effect in addition to stress-reduction that contributed to the overall effect of the meditation.” Lavretsky plans a follow-up study to provide further confirmation of this potential mechanism in a neuroimaging study of Kirtan Kriya.

Recently, UCLA launched its new Alzheimer’s and Dementia Care Program, which provides comprehensive, coordinated care as well as resources and support to patients and their caregivers. Lavretsky has incorporated yoga practice into the caregiver program.

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“Ten Thousand Joys and Ten Thousand Sorrows”: an interview with Olivia Ames Hoblitzelle

Ten Thousand Joys and Ten Thousand Sorrows,

This book is intensely personal. Was it difficult to write?

Yes, at times it was difficult to write, but I felt a great sense of purpose. just before Hob died, I promised him that I would write a book and his voice would be in it. That became like a covenant between us. Also, I felt compelled to write the book. I realized that our background with meditation and the wisdom traditions gave us valuable perspectives which could be helpful to others. I hadn’t seen any books about how spiritual perspectives or practices could help with Alzheimer’s, and that’s what had helped us more than anything. In fact, the book can be helpful for people dealing with any serious illness and no matter what their spiritual tradition.

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How did Buddhism and meditation help you and Hob to deal with his illness?

More than anything else, our Buddhist practice and understanding made a profound difference to both of us in handling his decline. Through meditation one learns to find an inner refuge – a place of stillness – in the midst of all the changes and challenges. When we accept how much we can’t control, that everything is impermanent, we can begin to step out of our struggle with life. Meditation helps one develop equanimity and acceptance of whatever comes up, and that is a great help in dealing with the losses and heartbreak of Alzheimer’s. To be realistic, meditation is not a panacea, but it is a tremendous support for which both of us were very grateful.

Title: Ten Thousand Joys and Ten Thousand Sorrows: A Couple’s Journey Through Alzheimer’s
Author: Olivia Ames Hoblitzelle
Publisher: Tarcher/Penguin
ISBN: 978-1-58542-827-4
Available from: Amazon.co.uk or Amazon.co.uk Kindle Store, and Amazon.com or Amazon.com Kindle Store.

How did Hob’s way of viewing his illness – and the world – help you to accept the situation?

He had a great sense of humor and a wry outlook on life. That helped a lot. Humor breaks the tension of difficult situations. It’s a gift because it shifts perspectives and allows you to laugh. On one level, he couldn’t believe he had this diagnosis. Even quite far along, he kept saying he was going to beat it. On another level, he was totally open and told everyone he had Alzheimer’s, which bowled people over. Many people don’t know there is something wrong with them or else never talk about it. I think Hob’s openness was a great help to him and everyone around him. Certainly it was for me.

Were any positive shifts in your relationship brought about by Hob’s illness?

The most important shift was the deepening of our love for each other. I kept reminding him that we were in this together, and that I would stand by him to the end. I tried to feel into his situation, to walk in his shoes, as the expression goes. Often my heart broke open with compassion and love for him. The frictions of relationship pretty much fen away, and you realize that you’re mainly living with the love. That’s a hidden blessing.

There was also a big shift from his fierce independence to his needing to become more dependent on me. I both accepted that reality and suffered with it. Both of us went through a gradual process of surrender – for him, to the inevitability of his losses; for me, to accept that those losses were “in the natural order of things,” one of my favorite expressions for keeping a balanced perspective.

Being Hob’s primary caregiver, was it difficult to balance his needs with your own? How did you work though frustration?

Keeping one’s balance is a constant issue! Burn out is a huge hazard for all caregivers, so was determined to honor my own needs. I arranged for regular time away to write, meet a friend, be in nature, or just let down. I asked good friends to come and be with Hob, take him for a walk, have lunch with him. I thought about this balance issue a lot and plenty of times I lost it!

When I got worn out and frustrated, I’d do anything to get a tiny respite; go to the garden, just sit and breathe, or be alone for a cup tea. Sometimes I was so exasperated, I’d drive off and in the privacy of my car, I’d shout or roar — any sound that helped to release my pent-up feelings. Sometimes I broke down, and it turned out tears were the most important relief.

Or I’d do exactly the opposite, surprising even myself. I’d choose to move toward him, push through my own feelings, and say, “I need a hug.” That would totally soften the frustration. I came to see that as a kind of spiritual practice, because I was choosing to make a loving gesture instead of collapsing into my own feelings.

How did you and Hob handle tough subjects like death and loss?

We were really fortunate here. First of all, we had our meditation background. Meditation is about acceptance and letting go, invaluable qualities in the face of loss. Then we had both been involved with hospice work where you’re constantly living with issues of death and dying. Finally, we could both talk about the subject of death relatively easily, and we did. Even with some of our closest friends when he was talking about wanting to end his life early.

With Alzheimer’s, loss seems to be a constant reality. Sometimes Hob grieved his losses, but given his nature, he usually made light of them. Other times he simply couldn’t believe what was happening to him As for me, I grieved quietly because my sadness upset him, and why add that to his burdens? Anybody dealing with Alzheimer’s will tell you what a heartbreaking illness it is. I think we do a lot of our grieving as we go along in both little and big hits. It’s important to acknowledge and feel the grief That’s human, after an, and if you don’t, it’s apt to come out in physical symptoms.

What is the ‘doorway practice’ and how did it help you during Hob’s last months?

The doorway practice evolved after he began passing out unexpectedly, and I realized that any of these episodes could be the final one. So whenever I came to the door of the room where he was resting, for example, I’d prepare myself for the fact that he might have died. This inner preparedness came to me naturally. Mysteriously, it wasn’t heavy at au. Rather, it intensified the preciousness of life, of our time together, and yet let me be prepared for whatever might happen. I know it helped me deal with his passing out episodes with equanimity That doorway practice would arise spontaneously. I’d feel remarkably calm determined and strong. Again meditation helped me a lot. One could say meditation is a preparation for crisis management!

What general advice would you offer to someone who is caring for a partner with Alzheimer’s?

  • Accept that this is one of the most difficult challenges you’ll ever face.
  • When you realize that you’re their lifeline in a dissolving world, every supportive and loving gesture is a gift to them.
  • For me, when one of my spiritual teachers suggested that caregiving was an opportunity for me to practice the positive qualities of compassion, patience, generosity, and kindness, it helped give meaning to the humblest of tasks.
  • Have compassion for yourself when you feel frustrated, impatient, or angry, because caring for an Alzheimer’s patient is a Herculean task.
  • Ask friends and family for help! People want to help out, and there’s a real risk in becoming isolated.
  • Know what gives the patient comfort or reassurance. For us, it was always touch, physical closeness, music and beauty.

There are many more answers to this question in the Reflections, Suggestions, and Seed Thoughts at the end of each chapter.

How has your life changed since Hob’s death?

Obviously losing one’s spouse is a heart wrenching loss, but I was determined to continue living as fully as possible. And I did. By writing the book, I was integrating the enormity of the experience and harvesting the insights that come with retrospect- a complex mix of grieving, creativity, and honoring our last chapter together. My greatest wish is that the book continues to be helpful, and hopefully our gift to others facing similar challenges.

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“Ten Thousand Joys and Ten Thousand Sorrows,” by Olivia Ames Hoblitzelle

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Ten Thousand Joys and Ten Thousand Sorrows

To be clear from the start, this book is worthy of the rich praise it has received. The inner jacket liner contains three pages crammed with accolades from what could be easily construed as the Who’s Who of leading contemporary spiritual leaders and health professionals. The book is a moving and loving story of this extraordinary couple’s experience.

It is a love story. It is a love story written from the deeply touching and personal perspective of a remarkable woman living through her equally remarkable husband’s dementia and death. The book covers the six years from his first symptoms to his death as she emotionally lived the various pieces of their life together as it changed profoundly. The book is drawn from her journals, giving the reader the direct expression of her emotions as they went through her.

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The theme and tone of the book are both poignantly captured in a phrase that is the Postlude to the narrative, “Dance me to the End of Love,” a line drawn from a Leonard Cohen poem. The book is a dance in its delicate movement, its cadence and its intimate flowing emotion. The reader is watching lovers dance, from inside one of the dancers. It is sweeping love story between two extraordinary people who, as we learn from the book, and feel from its author, have each lived extraordinary lives.

Title: Ten Thousand Joys and Ten Thousand Sorrows: A Couple’s Journey Through Alzheimer’s
Author: Olivia Ames Hoblitzelle
Publisher: Tartcher/Penguin
ISBN: 978-1-58542-827-4
Available from: Amazon.co.uk or Amazon.co.uk Kindle Store, and Amazon.com or Amazon.com Kindle Store.

The extraordinary qualities of the writer, of her husband and of their lives together are stamped throughout the book, from the jacket liner to the back cover. This entices the reader; gives a sense of wonder and awe to the experience of the close connection with their lives, their struggles and their needs, each of them, to come to so ordinary a thing as death. It is a strength of the book; two sparkling, talented people who lives have soared above us in a glorious flight of remarkable accomplishments, experiences, encounters, facing together an ignoble debilitating illness and the commonness of death. This also is a puzzle for the reader.

What is so very extraordinary about the lives of the writer and her husband removes them from what is all too ordinary, the plight of most people and families who face the same challenge. When we bring to mind the estimated 5.4 million Americans who suffer from Alzheimer’s Disorder, and their 14.9 million unpaid caretakers we are carried to a different and less exalted reaction than the one we are left with at the end of this beautiful and extraordinary experience. Every family’s story, of course, is different and singular.

What is incongruent is that we cannot conceive of most of these millions (millions that will swell in a few decades to tens of millions in what has been described as an epidemic) as extraordinary. We cannot conceive of these millions having the resources financially for the care that is described in “Ten Thousand Joys and Ten Thousand Sorrows”. We cannot imagine millions having the homes in Vermont and in Cambridge, Massachusetts. We cannot imagine millions with the support of a large network of loving and distinguished friends, and of renowned spiritual leaders. We cannot imagine millions dying peacefully in their homes surrounded by loving caregivers.

In this way the ordinary and the extraordinary are juxtaposed too nearly. We suspect the wreckage of dementia on the many millions and their families is something quite different than what this book has told of. We suspect that so many die alone. We suspect that so many are broken by the financial impossibilities of good care. We suspect the isolation and loneliness of those families who cannot afford care, who chose to leave their jobs to care for their stricken relatives, whose world then becomes a small one of long and weary days and sleepless nights. We know of the number caretakers who die early, earlier than their loved one with Alzheimer’s. We know of those who live with Alzheimer’s much longer than the six years described so movingly by Olivia Hoblitzelle, many of whom, unlike her husband, dwell in silence or are unable for years to remember who is in the room with them or what they did or said two minutes ago.

So we remind ourselves that “Ten Thousand Joys and Ten Thousand Sorrows” is a particular story about particular people. It is a tender and touching love story that can give us comfort and inspiration. It is not about us. But may still be a help to us. The “Suggestions” at each Chapter’s end may be practical reminders for some of us. The “Seed Thoughts” also at the conclusion of each Chapter will be consistently useful to us (“May I cultivate compassion toward myself and others”, May I find new ways of handling my negative emotions.” “May I accept the challenge of this situation”, “Let me be calm”).

“Ten Thousand Joys and Ten Thousand Sorrows” is uplifting for us in the way that all stories of courageous struggle are. And it brings that us that sweet and painful poignancy of all powerful love stories.

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Brains of Buddhist monks scanned in meditation study

Matt Danzico: In a laboratory tucked away off a noisy New York City street, a soft-spoken neuroscientist has been placing Tibetan Buddhist monks into a car-sized brain scanner to better understand the ancient practice of meditation.

But could this unusual research not only unravel the secrets of leading a harmonious life but also shed light on some of the world’s more mysterious diseases?

Zoran Josipovic, a research scientist and adjunct professor at New York University, says he has been peering into the brains of monks while they meditate in an attempt to understand how their brains reorganise themselves during the exercise.

Since 2008, the researcher has been placing the minds and bodies of prominent Buddhist figures into a five-tonne (5,000kg) functional magnetic resonance imaging (fMRI) machine.

The scanner tracks blood flow within the monks’ heads as they meditate inside its clunky walls, which echoes a musical rhythm when the machine is operating.

Dr Josipovic, who also moonlights as a Buddhist monk, says he is hoping to find how some meditators achieve a state of “nonduality” or “oneness” with the world, a unifying consciousness between a person and their environment.

“One thing that meditation does for those who practise it a lot is that it cultivates attentional skills,” Dr Josipovic says, adding that those harnessed skills can help lead to a more tranquil and happier way of being.

“Meditation research, particularly in the last 10 years or so, has shown to be very promising Read the rest of this article…

because it points to an ability of the brain to change and optimise in a way we didn’t know previously was possible.”

When one relaxes into a state of oneness, the neural networks in experienced practitioners change as they lower the psychological wall between themselves and their environments, Dr Josipovic says.

And this reorganisation in the brain may lead to what some meditators claim to be a deep harmony between themselves and their surroundings.
Shifting attention

Dr Josipovic’s research is part of a larger effort better to understand what scientists have dubbed the default network in the brain.

He says the brain appears to be organised into two networks: the extrinsic network and the intrinsic, or default, network.

The extrinsic portion of the brain becomes active when individuals are focused on external tasks, like playing sports or pouring a cup of coffee.

The default network churns when people reflect on matters that involve themselves and their emotions.

But the networks are rarely fully active at the same time. And like a seesaw, when one rises, the other one dips down.

This neural set-up allows individuals to concentrate more easily on one task at any given time, without being consumed by distractions like daydreaming.

“What we’re trying to do is basically track the changes in the networks in the brain as the person shifts between these modes of attention,” Dr Josipovic says.

Dr Josipovic has found that some Buddhist monks and other experienced meditators have the ability to keep both neural networks active at the same time during meditation – that is to say, they have found a way to lift both sides of the seesaw simultaneously.

And Dr Josipovic believes this ability to churn both the internal and external networks in the brain concurrently may lead the monks to experience a harmonious feeling of oneness with their environment.
Self-reflection

Scientists previously believed the self-reflective, default network in the brain was simply one that was active when a person had no task on which to focus their attention.

But researchers have found in the past decade that this section of the brain swells with activity when the subject thinks about the self.

The default network came to light in 2001 when Dr Marcus Raichle, a neurologist at the Washington University School of Medicine in the US state of Missouri, began scanning the brains of individuals who were not given tasks to perform.

The patients quickly became bored, and Dr Raichle noticed a second network, that had previously gone unnoticed, danced with activity. But the researcher was unclear why this activity was occurring.

Other scientists were quick to suggest that Dr Raichle’s subjects could have actually been thinking about themselves.

Soon other neuroscientists, who conducted studies using movies to stimulate the brain, found that when there was a lull of activity in a film, the default network began to flash – signalling that research subjects may have begun to think about themselves out of boredom.

But Dr Raichle says the default network is important for more than just thinking about what one had for dinner last night.

“Researchers have wrestled with this idea of how we know we are who we are. The default mode network says something about how that might have come to be,” he says.

And Dr Raichle adds that those studying the default network may also help in uncovering the secrets surrounding some psychological disorders, like depression, autism and even Alzheimer’s disease.

“If you look at Alzheimer’s Disease, and you look at whether it attacks a particular part of the brain, what’s amazing is that it actually attacks the default mode network,” says Dr Raichle, adding that intrinsic network research, like Dr Josipovic’s, could assist in explaining why that is.

Cindy Lustig, associate professor of psychology and neuroscience at the University of Michigan, agrees.

“It’s a major and understudied network in the brain that seems to be very involved in a lot of neurological disorders, including autism and Alzheimer’s, and understanding how that network interacts with the task-oriented [extrinsic] network is important,” she says. “It is sort of the other piece of the puzzle that’s been ignored for too long.”

Dr Josipovic has scanned the brains of more than 20 experienced meditators, both monks and nuns who primarily study the Tibetan Buddhist style of meditation, to better understand this mysterious network.

He says his research, which will soon be published, will for the moment continue to concentrate on explaining the neurological implications of oneness and tranquillity – though improving understanding of autism or Alzheimer’s along the way would certainly be quite a bonus.

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Chappaqua resident gives Alzheimer’s patients hope

wildmind meditation news

Patch.com: Dorothy Erler may have Alzheimer’s disease, but that hasn’t slowed the 82-year-old Westchester resident down one bit.

In 2009, Erler was one of eight individuals who participated in a clinical study conducted by the Cornell University Memory Center based on the TTAP Method, which stands for Therapeutic Thematic Arts Programming.

The innovative program utilizes the arts and meditation to help individuals with Alzheimer’s and other forms of dementia to have an enhanced quality of life.

“I enjoy the activities,” says Erler, who sketched a picture of a cabin. “The sketch reminded me of a vacation spot that I would go with my family during the summers on Lake Owassa in Northern New Jersey near the Pennsylvania border. We had canoes and rowboats. It was a very memorable time in my life.”

The method has been proven in 11 clinical research studies and in 2010 was awarded “New York State Most Innovative Program.” It is based on nine steps — Conversation, Music & Meditation; Drawing & Painting; Sculpture; Movement & Dance; Poetry & Writing; Food Programming; Theme Event and Phototherapy.

“When performed, these activities stimulate the left and right brain regions, which increase cognitive functioning and psychosocial well-being,” explains Linda Levine Madori, Ph.D., a two-time Fulbright Scholar, clinical therapist, professor, researcher and author of the method.

Currently, the TTAP Method is being used in facilities all over the tri-state area including hospitals, skilled nursing homes, assisted living facililities and community day programs. This year Madori, a Chappaqua resident, will be training nurses, aides and caregivers in the TTAP Method certification training program in Schumacher Nursing Home through Beth Abraham Health and Hospital Services, one of the largest nurse and aide placement services in Westchester.

“The TTAP Method moves modern day research into practice, providing caregivers, healthcare providers and clinicians new and innovative ways in which to interact, communicate and provide person-centered care in an inexpensive non-pharmaceutical intervention,” Madori said.

Erler, who is currently living in an assisted living facility in Westchester, meets with Madori once a week.

“I think Dr. Madori is very good with her relationships with people,” she said. “She can really get them to relax and respond to her.”

Since Madori has been working with Erler she is not the only one who has seen marked improvement. “When I see Dorothy regularly and when she does the TTAP Method her cognitive ability rises. She has had her highest cognitive score she ever had … her neurologist can’t even believe it.”

Erler’s neice, Diane Erler, is grateful for the progress her aunt has made.

“We were very lucky to come to Burke Rehabilitation Center in White Plains when my aunt was diagnosed with Alzheimer’s disease. In the time my aunt was in the study we noticed her cognitive skills greatly increased,” she said. “It is not a one shoe fits all program. It is a program that works with a person’s strength and weakness so they can flourish. Dr. Levine Madori really takes time to get to know the patient. She is very in-tune with the elderly. She can definitely make a change in the way people look at Alzheimer’s disease. A lot of people think it is just a memory disease while it is so much more.”

When Madori first started working with Erler, she said she was a little withdrawn and a bit resistant to try new things. By the third week, Erler started to click with the meditation and began to open up and share her personal story.

“I had no idea Dorothy traveled all over the world as a buyer for B. Altman’s. She dressed the president’s wife when they came to New York,” Madori said. “This proves that when somebody lives their life we don’t spend that much time thinking about it, so the TTAP Method helps you think about what you have done and share what you have done over your lifetime with others. It gives you more self-esteem, self-worth and self-satisfaction.”

The TTAP Method has put Erler on the right path. “I think it gives me a little more sense of being able to do more,” she said.

Madori will be forming caregiver support groups, educating individuals on how they can apply the method to enrich the lives of their loved ones who may have Alzheimer’s. The TTAP Method support group also trains the caregiver on how to better cope with caring for a loved one or an individual through meditation and creative art expressions. Group sessions will be held at her private practice in Chappaqua and Armonk.

Original article is no longer on chappaqua.patch.com, and hasn’t been archived on archive.org.

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