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I created this web site to first tell the story of a 5,000 mile walk across the county along the American Discovery Trail, with posts from May 2011 – May 2012, and retold that journey recently from a different perspective. … Continue reading
As we get older we shed layers of invincibility. We injure ourselves more easily while taking longer to recover. Getting healthy at a younger age was a goal that, once reached, we tend to let slip. This is especially true for dieters who have to resume dieting after cycles of losing weight. At a certain age we have to be wary about letting things slip, as we get closer to when we can no longer recover. Septuagenarians approach that age when we must pursue health strategies that are more about a permanent lifestyle than reaching a goal.
Variety is the spice of life and is one of the key ingredients for maintaining a permanent lifestyle of exercise. In my case the variety of the four New England seasons correspond with four exercise seasons as well. By the time one season and exercise regimen concludes I am ready for the next one.
During the spring months of late March through May I am able to jog with Cindy in the adult stroller for 5-8 miles. From June into early August the deerflies become brutal the further we stray from the village center. I park Cindy at Robertson Plaza as I “run” stair repetitions, or at the village green as I “run” intervals around the perimeter, or at Yale’s summer school campus where I can run either hill reps or intervals without deerflies spoiling my exercise. From late August into early November I return to jogging with Cindy for 7-10 miles, while periodically alternating distance workouts with hill reps or intervals. From mid November to mid March I am unable to go out with Cindy and I either do a stair workout inside the house, or go for a trail jog when coverage is available.
In the past I mentioned how superb the stair workout is for maintaining fitness, while also being the most tedious. I doubt I could do my inside stair workout for a whole year, but because of my changing exercise seasons I do not have to. For that matter, I would even find my favorite exercise during fall season to be tedious if that was my routine year round. I actually look forward to my winter exercise regimen by the time that happens.
Efficiency becomes another important consideration as our remaining life expectancy shortens and what septuagenarians do with our time becomes more precious. This is doubly the case when, as a caregiver, I spend four plus hours each day just with meal time and the efficiency of an exercise frees up more time for other endeavors. This contributes to why I actually look forward to running up and down stairs in the winter. During these months I have a little more time for other projects that keep me sane.
One ingredient for an exercise becoming efficient is providing short bursts of anaerobic activity. This amounts to exercising vigorously enough to be gasping for air. I also include strength training in the form of sit ups and pushups with my efficiency exercise. Strength training provides brain health benefits, in particular the release of brain derived neurotropic factor (BDNF), a neurotransmitter that facilitates and maintains neuroplasticity.
In regards to this and other health matters I advocate you follow the principle and not my actual practice. You can do anaerobic workouts in more varied and enticing ways than sit ups, pushups and stair reps. At a gym you can use rowing, cycling, elliptical or treadmill machines, as long as you intersperse anaerobic bursts. Most gyms also provide a variety of options for strength training.
Sustained aerobic exercise provides the most important benefit of mindfulness, similar to yoga or meditation. With aerobic exercise you are not gasping for air, though you should be exerting yourself at least to the extent that you would not be able to belt out a whole song. As we progressively age the more difficult efficient exercise becomes, as well as varied exercise, but mindfulness exercise may continue.
A leisurely stroll in the woods also calms the mind and benefits the brain, even though the blood flow benefits are not as great. There may come a time when that is all an elderly or disabled person can do … or less. Cindy is not a septuagenarian yet has not been able to stroll on her own for years. Her continued will to live results in part from still getting out in the calm of our scenically pastoral town even without the benefit of exercise.
Variety, efficiency and above all mindfulness are my keys to a permanent lifestyle of exercise to maintain brain health and longevity.
Three sequential events happened so far in 2024 that affects my motivation to stay healthy as I approach seventy years on the planet. In January I weighed the heaviest of my life and retained that weight throughout the winter and into spring. As the year progressed I felt discomfort in my right hip that may be a touch of arthritis, aggravated by being overweight. Then less than two weeks ago the frame on the adult stroller snapped. My main form of exercise during the summer has been on hold since.
These events reveal how my motivation to stay healthy shifted as I face becoming a septuagenarian. Thriving as a caregiver in the present still motivates me, but the threat of impending arthritis concerns me about possible journeys in the future. Ten years ago I last slept out under the stars; I have not gone so long without sleeping outside since before I became a Boy Scout. Even if I never have the opportunity to go on a long distance journey again, I do not want arthritis to be the cause. That means losing weight in the present to avoid the progression of arthritis in the future.
My blood pressure monitor helped motivate me to stay fit in the past. My stressful situation combined with whitecoat syndrome sometimes caused my blood pressure to spike and get rejected as a blood donor. The daily feedback from the monitor motivated me to lower my blood pressure through lifestyle choices such as exercise, which coincidentally kept my weight down as well. Yet this past year my blood pressure stayed relative low despite the weight gain. I continue to go for 5-10 mile jogs with Cindy in the adult stroller, though I now suspect that with my extra blubber what I fancy to be a jog may look like a crawl to an observer.
Evidently, the blood pressure monitor no longer provides enough motivation to control my weight and thwart arthritis. Now I monitor myself with what most people do for losing weight, a scale. I had gone from 20% overweight down to 10% when the stroller broke. After immediately gaining a few pounds back (why is it so much quicker to gain weight than lose it?), I have found other ways to exercise until I repair the stroller, with my scale continuing to be a constant motivator.
I usually focus on the lifestyle factors of being social, positive and active for maintaining brain health. I do this because of their primary importance for living well despite media providing more information about the value of exercise, diet and rest. Yet I find my established routine for lifestyle factors such as being social easy to maintain; diet and exercise proves to be the greater challenge for me.
My next few entries will share the perspective and insights of a long term, septuagenarian caregiver who is motivated to maintain healthy diet, exercise and rest.
I gradually adjusted to Cindy’s condition, much like a swimmer slowly wading into cool waters rather than plunging in. For those that do not see Cindy on a daily basis their adjustment was more like a plunge, sometimes with a similar shock. Our kids were shocked to varying degrees from the “plunge,” as were our extended families of siblings. Less shocked were the circle of friends who came to help out as companions for Cindy, the self-awareness that they would not be shocked probably accounted for their willingness to volunteer in the first place.
Then there are our visiting granddaughters, ages two (Marabelle) and four (Lyla). They are not shocked at all, since they did not know their Grandma to be any other way. Lyla and Marabelle play around their grandma without any discomfort and are conscientious about giving her a kiss on the cheek goodbye when they leave. Lately in this warmer weather we all go out to explore the village center, with Lyla eager to help push Grandma in the stroller.
When we walked across the country Cindy frequently mentioned she looked forward to having grandchildren. At times that would tug at my heart because I did not know if her wish would come true. When our grandchildren first arrived during her hospice years I still lamented that she could not fully enjoy what she had wanted so much. I also lament that our granddaughters cannot receive Cindy’s full warmth and vibrancy. I fear I am lacking as a substitute.
Yet there is still much to be cherished in this situation. Action speaks louder than words. Nothing I could say to my grandchildren would demonstrate the value of love and responsibility to others as effectively as being Cindy’s caregiver. Nothing could prepare them for treating the less fortunate with compassion better than being part of her care as well. Obviously I wish Cindy never had dementia, but seeing our granddaughters handle this situation better than most adults comforts me during this trying time.
Like many others in this information era I use a tablet for a wide variety of tasks. The one tablet/smartphone tailored task for which I stubbornly rely on pen, paper and clipboards are making lists. In a long ago post I revealed my penchant for all kinds of lists on clipboards. The one most important for reducing mess in my life, and hence stress, is the monthly to do list.
Just before the start of a new month I list the tasks I want to accomplish in a left hand column. I might add new tasks to the list as the month progresses while crossing off the ones achieved. I put an X mark by a task that is no longer feasible for that month. In a right hand column I make smaller lists for ongoing tasks that I know will take months. One to be covered in more detail soon is my Unenlightened Wisdom project.
Jotting down tasks unclutters my mind, freeing up space for more focused endeavors. Uncluttering the mind is yet another strategy for preserving brain health. I continue with the old fashioned way of pen and paper because there is something more gratifying, more mess reducing and stress releasing, in the physical act of crossing out a line item on the list.
UPDATE: My previous entry revealed my help wanted call for more coverage. It appears now for July and beyond I will have reliable Tuesday and Thursday morning coverage. Yay! I am still looking for a housemate or some other means to present at conferences, perform for community gigs or long weekend respites. All brainstorming ideas welcome!
I am a my life, my responsibility kind of guy. I will never take an aptitude test. Neither Myers Briggs nor any other personality assessment will engage my participation. I quickly scroll past all the social memes that will tell me what celebrity, animal, etc I am most like. I rebel against the self-fulfilling prophecy. I will be who I want to be, when I want to be, with the option to change my mind whenever conditions call for that.
Yet despite my allegiance to free will there are times during this caregiver journey that I cannot help but feel a deterministic universe conspires against me. For example, I recently found out that I did not clear all the hurdles to have solar panels installed after all. The last minute hold up? The ramp that I use to get Cindy out in her adult stroller interferes with access to the utility box required for the solar panels. I likely will wait until fall, after our outdoor season, to clear that last hurdle. Or at least I hope it is the last hurdle.
My cursing of the fates stems not from solar panels, but from lack of coverage. The amount of coverage I receive in a week determines what I can do besides being a caregiver. This can be sorted into four hierarchies of increasing importance.
Home Care and Errands
Once Cindy needed a hospital bed on the first floor, I relied upon aides for the care functions of giving Cindy a sponge bath and hair shampoo, using this time to take care of errands as well. Only a handful of times over the past seven years has there been so little coverage that Cindy did not get a sponge bath that week. Usually I get at least ten hours of coverage, which allows me enough time to get all the weekly errands done in addition to Cindy’s care.
Projects
Projects such as this blog keep my mind engaged and provide more purpose in life. I need more than ten hours of coverage per week in order to progress with projects, which is more than I get lately. I switch back and forth between different approaches and agencies to find coverage, but there has been a shelf life for aides no matter which strategy I use. Too many weeks without more than ten hours of coverage builds frustration over the inability to get anything done.
Fun
With more than twenty hours of coverage I can have a little fun. For me that means hiking, visiting folks or dining out. Last year was a good year for coverage and I managed to have a little fun on almost a weekly basis, not so this year. I thought I secured an aide a couple weeks ago that provided sufficient hours for fun, but that already has fell apart. Pessimism over the current state of affairs changing suggests I need to try something radically new.
Vacations
For vacations I would be satisfied with occasional long weekends. This happened for the first time last year, after I found out Cindy might come off of hospice care. No coverage could be found to keep her at home, but hospice allowed for her to kept in a nursing home for a couple nights instead. Nothing wrong happened there, but keeping her at home would have been so much better had adequate coverage been available.
With a longer block of time available to me I also would arrange for performing the American Discovery Symphony or engage in public speaking at caregiver conferences. The time has come to go beyond the blog to provide information and inspiration for others with their own caregiver journeys. I feel like my potential light is partly hiding under a bushel.
The unreliability of coverage for projects or fun, and the unavailability of coverage for vacations or gigs, leads me now to employ a brand new strategy. I seek a housemate, which is not the same as a live-in caregiver. As always I will be the primary caregiver, but in return for free room and board I hope to find a female nonsmoker who can help with caring for Cindy during lapses in coverage, and to stay with her during an occasional long weekend.
CNA experience would be a bonus but aides will still visit and I will remain the main source of Cindy’s care. I can train anyone for what might need to be done in my sparse absence. Throughout our marriage we welcomed people into our home for lengthy stays with everyone treated as family.
I joined a site called Care.com to search for such a person. There have been a few inquiries, but caregivers on that site primarily seek a job, not a place to live. One person agreed to an interview and even checked out this blog. Yet the morning of the interview I had an overwhelming premonition, which alas came true, that neither would she show up for the interview, nor would she notify me to cancel.
So I am reaching out to our social networks to help me find a housemate. I abhor playing the victim almost as much as aptitude and personality tests, but my frustration has been building. This free will acolyte is starting to curse the fates. I implore anyone reading this to help me spread the word or provide any leads towards finding a housemate. Comments or emails welcomed. Help me to help Cindy, myself and others.
After turning my alarm off in the morning I check in on a few news and social media sites and then spend a little time on one of my writing projects. About an hour later I arise to start Cindy’s day as well. I often sing one of two songs to her as I try to get her day started right: “Good Morning” from Singing in the Rain, or “Rise and Shine” which features our son Noah’s name. I often sang these songs in the morning long before Cindy became afflicted with Alzheimer’s, imposing my obnoxious cheerfulness to start the day. I sing them to Cindy now to keep a family tradition fresh in her mind as much as starting her day with good cheer.
After breakfast I do range of motion exercises with Cindy. She glances down at me as I start with her legs. When I move to her right arm her glance remains down towards her feet. When I get to her left arm her gaze is directly into my eyes. The straightening of her left arm naturally lowers my head towards hers and I kiss her with every repetition. During one of the repetitions, sometimes at the start, sometimes later, I lower my head further and whisper into her ear: “I love you Cindy.”
Also in the morning I stand at the foot of Cindy’s hospital bed and practice flatpicking on my acoustic guitar. I spend much of the time practicing new material of various difficulty, pausing to comment about my successes and failures as they occur. This provides the most natural setting for friendly “chatting” with Cindy. Her countenance does not register anything more than simple engagement, but that is enough for me to think our “chats” serve a purpose.
I wait until after lunch before I first read to her. Currently I am reading the Beverly Cleary books about Henry and Ramona. Before this I read through the Lord of the Rings series, before that the Harry Potter series, before that the 33 books in the Oz series by the first two authors, before that the Indian in the Cupboard series. These are all books we read out loud to our kids, sometimes curling up on the couch with them for an hour or more. By reading them to Cindy I hope I am reviving and stimulating thoughts of family inside her … plus as a big kid I enjoy them.
Sometimes after the range of motion exercises I hold Cindy on my lap and rock her for a little bit. In the afternoon when I do this I make sure to tell her: “We make a good team!” or “You are my Expedition Woman!” This attempts to increase her self-esteem without saying “I am proud of you,” which seems inappropriate for the situation.
In the evening I practice classical guitar as a way to wind down. I still practice movements from my American Discovery Symphony occasionally by accompanying the YouTube videos I have uploaded. This effectively preserves one of the most memorable, amazing chapters of our lives, the 5,000 mile walk across the country. As other memories fall away I hope this one persists until near the end.
At bedtime I convert the “couch” into my “bed” by sliding it over next to Cindy’s hospital bed. She usually is in peaceful repose by this time, if not already asleep. Right before turning off the light I lean over to kiss Cindy on the forehead and say: “Good night Cindy. Sweet dreams.”
I realize now that what I do for a loved one as a caregiver benefits any loved one. I tell our kids more frequently that I love them now. Perhaps more importantly, out of the blue I will tell them I am proud of them. Doing this without a prompt from some specific achievement acknowledges their worth based on who they are, not what they do. Imagine that I hold Cindy on my lap and tell her how sorry I feel for her, how life has dealt her such a bad hand. I always offer commiseration rather than affirmation. Would Cindy have the same positive state of mind? Would anyone? Tell someone you love something affirming today.
How I start and end Cindy’s day are lessons learned from raising our kids. Ever notice how readily and joyfully kids start the day if the cares of the world have not yet descended upon them? They helped to start my day with joy as well. Conversely, at the end of the day I either sang or read to my kids at bedtime, hopefully helping to end their day in peace. Being a caregiver reinforced in me the belief that at least one partner should start the day in joy, while the other helps to end the day in peace.
As a parent I found that reading to our kids was the single most nurturing thing we did for them. The sound of a parent’s voice, the feel of a parent’s warmth, the engagement of the mind from such intimacy cannot be duplicated by any electronic device. Why not read to a spouse, partner or friend as well?
Range of motion exercises may not be necessary for your situation, but what about yoga together? Or massages? I tell you now I wish this was a lesson I had learned before becoming a caregiver.
I periodically claim that I hope this website informs and inspires other potential caregivers, but the little gestures that increase the quality of life should not be just for the afflicted. Or, to look at this another way, we are all afflicted by something, we all benefit from the care of others directed our way. Tap into the caregiver that lies within you.
The Special Report for the most recent issue of the AARP Bulletin was titled: “The Future of Alzheimer’s.” After glancing through the content I feel compelled to remind folks that I told you so. On page 17 of the bulletin the following quote was featured:
“Controlling neuroinflammation is at the forefront of new drug ideas for Alzheimer’s. In 2023, there were more drugs in human trials for inflammation than for any other target.”
After Cindy was officially diagnosed with Alzheimer’s in the Fall of 2012 I set my Google Alerts to “Alzheimer’s” and “brain health.” The Alzheimer’s alerts typically consisted of press releases targeting investors more than researchers. Every new discovery or drug test on mice promised hope for combating the disease in humans, except that all the focus was on beta-amyloid plaques and none of the successes transferred to human subjects. At best, cognitive decline slowed for a few months.
I found the brain health alerts tremendously more informative. I discovered there were super agers with amyloid plaques that never had dementia, plus several causes of dementia that did not involve amyloid plaques. The common pathology with all the causes was instead the oxidative stress that results from inflammation and occurs inside the cells. Perhaps most importantly I discovered that brain health depended on a range of lifestyle factors that reduced oxidative stress.
I challenged the conventional research and beliefs in a 2016 blog post titled: “The Alzheimer’s Murder Mystery.” For almost a decade my advocacy for brain health focused on lifestyle prevention rather than medical cures, maintaining that even if a real medical cure should be found, lifestyle prevention still should be the preferred choice if that is an option.
The AARP Special Report almost comes to this same conclusion. Almost. It reports on the disappointments of the latest round of drugs such as lecanemab. It acknowledges that healthy living provides hope. It acknowledges that prevention is key. Then in the penultimate paragraph AARP reports: “Prevention studies using drugs are gearing up.” The success of statins with lowering cholesterol is offered as an example of the future hope for Alzheimer’s.
Sigh.
As a person in a stressful situation with a family history of hypertension I am concerned about blood pressure. Health care professionals from doctors, to nurses, to phlebotomists to CNAs have recommended I take statins when my blood pressure was high. Not a single one ever suggested lifestyle changes. Not one. Yet I relied only on lifestyle changes to lower my BP from 175 over 125 to as low as 113 over 78 within a month.
I am not against medical treatments, but I am against oxymorons like “preventive medicine.” The use of medicine is to correct the way your body functions. In that regards medicine is a cure, even if also seen as preventing something fatal. “Living well” is purely a preventative strategy, though one that does not generate as much income for the pharmaceutical industry.
“Preventive” medicine prevents one affliction; living well wards off almost all afflictions. Using medicine to “prevent” one thing may mask the way you need to live your life to prevent other additional health problems. Ultimately, you may need to take more “preventive” medicine to address those problems. Indeed, a “preventive” medicine for one affliction may be the cause of another. I am curious as to how many people that rely on medicine for “prevention” end up taking a multitude of pills.
The focus now on inflammation causing Alzheimer’s I believe to be the right one. Considering that stress causes inflammation, should your prevention strategy be making life less stressful for yourself? Or will you wait until a “preventive” pill is discovered? Choose wisely.
A few biochemicals produced by our bodies enhance brain health. Neurotransmitters send messages within our central nervous system, while hormones circulate throughout the larger, peripheral nervous system. Sometimes the same biochemical serves both functions. Rather than producing them on a continual basis, we need to experience particular moods or behaviors in order to benefit from the following biochemicals:
Dopamine
Dopamine controls memory, learning, concentration and sleep. Dopamine also motivates and rewards the brain for healthy behaviors.
Serotonin
Serotonin enhances our mood and sleep. Adequate serotonin levels help stave off depression.
Endorphins
Endorphins block sensations of pain and stress, thus enhancing feelings of wellbeing.
Oxytocin
Oxytocin engages people in social bonding ranging from sex to empathy. It can reduce blood pressure and cortisol levels while enhancing wellbeing.
BDNF (Brain-derived neurotrophic factor)
BDNF stimulates the growth and plasticity of neurons and brain tissue.
Releasing only one of these biochemicals does not necessarily benefit the brain. The “rush” from metabolizing sugars releases only dopamine, rewarding the ingestion of our body’s direct energy source, a necessary function but easily one that can be done in excess. In contrast, the “high” felt from brisk exercise releases all five of the biochemicals listed above. You want to feel the “high,” not the “rush,” for the sake of brain health, and several forms of being positive can help you achieve this.
Being positive enough to enhance brain health does not happen readily.
*Appreciation does not provide the benefit of feeling “high” on life from gratitude.
*Admiration does not provide the benefit of feeling awe from nature, music or kindness.
*A sarcastic chuckle does not provide the benefit of a jovial belly laugh.
*Pausing to reflect does not provide the benefit of meditation.
*Completing a task does not provide the benefit of fulfilling a purpose.
If you suspect you never felt a brain health “high” before, imagine the rush from dopamine being tempered by the calmness of serotonin and the stress relief of endorphins and oxytocin, along with the sense of heightened brain function from BDNF. Perhaps euphoric describes the mood better. I recommend vigorous exercise, as much as that may sound unpleasant to some, as the most reliable way to experience this mood. Once you know what the mood really feels like, then the sufficient intensity for being positive might be easier to achieve.
One cannot easily incorporate a mood into a routine. You can schedule exercise or a game night, but not when you will have a good belly laugh. I suggest instead that you focus on eliminating negative emotions from your daily routine. Marketing in general plays on your negative emotions to sell you a product, an idea or a party platform. You may think that a social media meme or news anchor is telling you what you want to hear, but if they do so by making you angry, fearful or entitled they could care less about your brain health, only that you buy what they are selling.
Fortunately, chances are that if you incorporate being active and social into your routine, the more intense expressions of being positive will follow along.
Being active takes different forms. Much of being social requires being active, and we all know the importance of exercise. As for that, this year I resumed regular stair workouts this year. With the expanded coverage I had for 2023 I got outside more in winter and exercised only on those days. The result was weighing the heaviest ever going into summer and now going into 2024 as well. As tedious as they may be, the stair workouts should remedy that.
Finger dexterity requires the most brain power of any physical activity. Early on in my Google Alert feeds for brain health research repeatedly reported on the brain health of people who knit. Knitting is not my thing, but music is. Lately research has resurfaced once again confirming the correlations into old age between both singing and playing an instrument with vibrant brain function.
Practicing and playing guitar in Cindy’s presence has long been part of my routine and will continue. What about you? Do you draw? Sculpt? Knit? Quilt? play an instrument? Choose any old or new activity requiring finger dexterity to incorporate into your daily routine.
Research indicates that learning new software, even video games, contributes to brain health. I need to learn intricate video editing software in order to achieve my goal of providing video podcasts on this blog’s content. The results will be staying mentally active for me and better entertainment for followers. I may need the whole year to get the necessary training in, but a routine should develop that allows me to post videos regularly once I do.
The benefits to my brain health from creating video podcasts will substitute for the benefits that composing a symphony previously provided. Had I been able to satisfy my travel ambitions by now I would be learning new languages, revealed to be a particularly effective mental activity. What about you? Choose something new to learn befitting your own nature and situation.
I also am engaged in a mental activity that may take 10-20 more years to complete, a series of essays called “Unenlightened Wisdom.” The essays will be compiled into five collections and additionally feature cartoons by the award-winning cartoonist of “Speed Bump,” Dave Coverly. By the end of this year I hope to complete the first collection that focuses on brain health and will provide a few advanced excerpts on this blog. Those who subscribe to the blog will be sent the introductory essay for the collections when it is ready for the public.
I view the “Unenlightened Wisdom” essays as my life’s work, drawn from my unique combination of extensive experiences as a caregiver, long distance journeyer and academic. They give me purpose, a most important activity for remaining vibrant as we age. What about you? Engage in a vocation, projects or hobbies that provide stimulating purpose to your life.
This covers being active with the mind and body. An active soul depends in large measure upon being positive, the next topic in this series. Please like and subscribe if you find this content worthy.
