A Dementia Evaluation Tool

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Dementia and Alzheimer's

How do we know where someone is within the world of dementia? It's as varied as the people experiencing it. 

Some people can talk about it. Some can even say, "I have Alzheimer's."

Others don't really know they have it. Or, it's too shameful to say out loud. 

The Greatest Generation

Our younger generations think everyone can say anything about everything, at any time, wherever they want. There seems to be a serious lack of verbal filters now-a-days. 

In contrast, our older generation, often referred to as The Greatest Generation, is our World War II generation. These parents of the Baby Boomers – they don't really talk about things. 

Like when they returned from World War II.

They didn't talk about it. They came back and went to work. They used the GI Bill, pursued education, bought houses, started families and got busy creating the middle class in America.

But, they didn't talk about it. 

Most of them also don't talk about end-of-life processes and many don't admit dementia.

Dementia Ravages The Mind

Furthermore, if they are suffering with dementia, their ravaged minds often don't allow them to articulate the process. This disease strips away the very neurons they need to describe it to us.

We lack any lab tests that can tell us where we are in the wide ranges of dementia. No enzyme level or blood test can identify its degree of severity.

So, how do we evaluate where they are? How can we talk about it amongst family members and with healthcare providers?

The use of vague terms like "late stage dementia" versus "end stage dementia" are frustratingly unhelpful. How do you really define late stage or end stage?

How do you define moderate or severe cognitive disease? They are all nebulous descriptions at best, subject to each person's interpretation and qualitative view.

We need something quantitative, something we can all see and agree upon. 

The FAST scale is just that. 

FAST = Functional Assessment Scale Tool

It was exasperating when we met with my mother's neurologist and he told us, "Well, she is probably in late state dementia, but not yet in end stage."

Excuse me? And just what is going to tell us when she is in end stage?

He didn't have an answer.

We left his office and vowed never to go back. It was a waste of our time and money just to have him tell us she has dementia. Yeah, we already knew that.

The greatest help came when the Palliative Care Nurse Practitioner presented us with the FAST scale. Finally, something we could quantify.

Here was a way to make sense of this intangible, yet devastating, disease. We were grateful that we could see where our loved one fell on the scale. Family members could discuss it with clarity.

"Here's where we are. Here's where we're going."

We didn't know how fast or slowly we'd get to the various stages, but we could see the inevitable steps that were coming.

And we could see the end result.

Stages Of The FAST Assessment

As shown on the FAST scale, Stages 1 through 5 are simple numbers with a description. Once you get to Stage 6, it breaks down into categories of 6a through 6e. Then, at Stage 7, it is divided into 7a through 7f.

When someone enters Stage 6, Palliative Care might be an option. Once someone enters into Stage 7, it is usually considered appropriate to be in Hospice. 

If you know anyone with dementia, take a look at the FAST Scale. It clarifies where your loved one is with the disease process.

The FAST scale provides a useful tool when we communicate with healthcare providers. Better healthcare decisions are made when we are all on the same page and use the same terms.

FAST scale for Alzheimer's Disease

 

The Myth Of Not Aging

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Myths About Aging

Pick up any article about aging and you'll see that 50 is the new 30 and 70 is the new 50.

As Baby Boomers head into, dare I say, old age, they're approaching it like they've attacked everything in their lives: head on and with a determined, "We're gonna change this!"

Have a good attitude!

Do this exercise!

Drink that vegetable juice!

It will keep you young! You won't age!

How many other products and ideas can you name that you "should" be doing? One more face cream, one more lip filler or Botox treatment, one more yoga pose. If you could just do one more something, then maybe you won't die. 

The Baby Boomers' can-do attitude worked in the 1960s, many things did change. And it will even work now, 50 – 60 years later, but only up to a certain point.

 
 

The Card Of Death Is Still In Play

We will still experience aging. We will still die.

Perhaps Baby Boomers will promote changes that allow for better measures to prevent extended suffering. We hope they will add enough voices that aging people will have a better quality-of-life and have more end-of-life choices available to them.

With all of our advances in medicine, we are able today to force human bodies to stay on the planet, whether they should or not, long after our bodies would have naturally let go. Then, there's the added complication of dementia that strips away our ability to have a vote in the matter. 

So, we are left to ask the difficult questions. When is it simply too much?

When are we needlessly suffering? 

When do we say a last good-bye? 

Everyone Will Die

There is not one physical body that has not slipped off the mortal coil of old age and into death. There is not one "attitude" that stopped anyone from dying eventually.

Somehow, when we die earlier, we berate ourselves for not being able to muster up "enough right attitude" to prevent it, when in fact, it was the natural process of the break down of our bodies. Not due to our attitude at all.

I don't think we have to worry about sending old people off to their demise based on the criteria of age alone. However, we have to have some frank discussion about how we will define qualify-of-life.

 
 

We Are Mortal

Atul Gawande explores the many facets of aging and end-of-life decisions in his book, Being Mortal: Medicine and What Matters in the End.

This book was recommended to me by the eye specialist treating my mother for wet macular degeneration. In his specialty, the majority of his patients are in their last 10 years of life. His entire staff read the book to better help and understand their patients. 

Although trained as a surgeon, Gawande writes at a level that all of us can understand. He breaks down the aging process of our bodies so that it makes sense. No, we can't stop aging, but we can help. If we have an idea of what's coming, we can take steps to prepare for it.

He's not afraid to ask the question: how are we going to die? How do we die when so many interventions exist that can force us not to? 

Gawande explores this slippery slope that medicine finds itself on. His book is not about giving us an answer, but rather increasing awareness to better be able to make decisions for ourselves and our loved ones. 

Acute Care Versus End-of-Life

I'm a Women's Health Nurse Practitioner and all my healthcare practice is about "fighting the good fight" – doing everything to fix and heal my patients and beating back death at every step.

As my mother experiences an extended end-of-life process, this book helped me to understand the breakdown happening in her body. It helped me to see the parts of aging that I can't fix.

Being Mortal even provided a sort of comfort that I wasn't failing in my mother's care. Gawande describes how the aging process profoundly effects each and every organ. No part of us is spared.

Being Mortal: A Must-Read Book

If you are aging, or if you know anyone who is aging, Being Mortal is a must-read.

And since we're all aging, no matter what we may think, we all need to read this book. 

It's worth more than one read.

 

Throw Open Wide Your Window

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Nature Beckons

It's March. The sky is filled with grey pillows, weighing down into the tops of tall firs that stretch heavenwards to touch the clouds.

Throw Open Your Window

It's still o-dark-hundred. I throw open the window for fresh air into the bedroom, then jump back under the covers on the bed to move through the positions of TRT® hands-on of The Radiance Technique®.

It's my idea of an ideal "camping out" situation. The comfort of my own bed with heavy, warm blankets accompanied by the fresh air and sounds of nature.

 

The joy of listening to a Pileated Woodpecker drumming on the trees.
An owl, staying up late, chimes in with soft hooting.
It's Sunday – no construction guys to compete with unnatural noise.
Who needs a TV in times like these?

Outer And Inner Light

I close my eyes and move through TRT® hands-on positions, drinking in the light of spirit, drinking in the sounds of nature.

Cold air sneaks in the window and swirls above my covers, but I'm tucked in – safe and warm. 

What a grateful way to begin a morning. 

Pileated Woodpecker

Great Horned Owl

 

 

 

Calm Down

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There's a meme floating around that says how telling someone to calm down has never in the history of the planet actually helped anyone to calm down.

It's meant as a joke, but like most jokes, there's a kernel of truth to be found.

If you could just "be calm" – you'd probably already be calm, right? 

Isn't that true for most situations when someone tells you to "be" something different?

Be This, Be That

Be mindful. Be aware. Be thankful. We are constantly admonished to be a multitude of things, but it's difficult, if not impossible, to become a state-of-being on command.

Furthermore, once someone starts barking at you to be one thing or another, it's not uncommon to have the reaction, "Don't tell me what to do!"

So, what to do?

Do we just will ourselves to be something? That doesn't seem terribly effective either.

Perhaps we can support ourselves on the path of becoming if we take an action that leads us in the direction of what we desire.

To Be, Take An Action

For example, instead of saying "Calm down" or telling ourselves "Don't be upset" – how about if we say, "Breathe."

Focus on the breath. Slow it down. Take a long breath in through the nose, hold for just a second and then, slowly release it out of the mouth.

Just breathe. It's an action.

We often advise our medical patients to focus on their breathing when they are undergoing a procedure. We find that saying to them, "Don't be nervous," when faced with a fearful or painful procedure is not helpful. Furthermore, it dismisses their feelings of being nervous. Instead, we focus on the breath, in and out, to help get them through the procedure.

The action of focusing on the breath helps to decrease the grip of fear or pain.

Take An Action With TRT® 

There are many dimensions inside of us. We have the inherent, wonderful ability to move past one way of being into another state-of-being.

We don't have to let outer circumstances toss us about like choppy waves on the ocean, as if we were not in charge of our own being.

The Radiance Technique® (TRT®) accesses universal energy. When TRT® is applied to the dynamic energies of our being, it helps to bring balance to our thoughts and emotions. Use of TRT® promotes rebalancing of energies that are out of alignment that we're not even aware of. How liberating!

We don't have to pick apart every little thing, analyze it or talk about it – we can relax in the healing energy that is accessed by TRT®.

Moving in the direction of wholeness is found in the simplicity of TRT® hands-on – Radiant Touch®. You take an action, apply your hands-on (right in the moment or for extended times of meditation) and then, let the healing energy walk you home.

The next time someone tells you to "be something" – take a breath and apply your TRT® hands-on. Of even greater importance, when you tell yourself to be something... do the same thing.

The wholeness that is already within you is ready to shine. 

 

Happy New Year

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Welcome 2017

Time races across the centuries and another year ticks past. A year doesn't meander anymore, it rushes past like an out-of-control wildfire. 

Say hello to 2017. 

You Are The Burning Flame

Many would say 2016 was a wild year. Ups, downs and inside-out. Wins and losses. Strong polarities that pulled people apart and gathered others together. 

Don't let the events of the outer world dim your inner fire. Stand steady in your heart. 

You are the spiral. You are the burning flame within the flower of your expression.

Students of The Radiance Technique® (TRT®) can keep their inner flame burning bright with use of TRT®. 

Stoke the fire within by daily use of TRT® hands-on. When it seems the darkest is when even more hands-on is called for.

Sometimes, in our most difficult moments, all we can do is close our eyes, breathe and do TRT® hands-on. With TRT®, we have a precise way to access universal energy and the fire within us is always expanded.

Keep Your Flame Burning Bright

 
“Your life spark fires from within your innermost temple
no one can reach there but you
it is your inner sacred sanctum…
you are your own master there
only you can reach and ignite your fire!”
— Osho
 

Happy New Year. Keep burning bright.

 

O Holy Night

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It's Christmas Eve

A hush falls across the land as we gather for Christmas Eve.

We finish our Christmas shopping and gather with family and friends. We light candles and offer prayers. Midnight mass is chanted in churches large and small.

We spiral into Christmas Eve on stars of light.

A Star In The East

“And for a moment, the sky stood still while a new star was born.”

Suspended in the firmament, a powerful star sparkled and beckoned. Wise men followed the light. It's possible that an alignment of the stars is what drew the astrologers as far back as... 

April 17, 6 BC when the Sun, Jupiter, the Moon and Saturn aligned in the constellation Aries while Venus and Mars were in neighboring constellations.

The star could have appeared up to two years before the wise men arrived in Jerusalem.

Grant Mathews, a Notre Dame astrophysicist, believes the wise men were "Zoroastrian astrologers who would have recognized the planetary alignment in Aires as a sign a powerful leader was born."

“In fact, it would have even meant that this leader was destined to die at an appointed time, which of course would have been significant for the Christ child, and may have been why they brought myrrh, which was an embalming fluid.

Saturn there (in that part of the sky) would have made whoever was born as a leader, a most powerful leader, because Saturn had the strength to do it, in their view.”
— Grant Mathews
 

Christmas Is In Our Hearts

Perhaps you spend Christmas with a large, noisy family or maybe your Christmas night is at home with a beloved pet. If you have studied The Radiance Technique® (TRT®), allow yourself some extra time for TRT® hands-on. 

Amidst all the gatherings and activities, the light burns bright and we can tap into that expanding light in our meditations. Hold yourself close to the light.

Remember that Christmas exists in our hearts.

Today we are all wise men when we follow the light in our own hearts.

 

Snow In Seattle

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When Snow Comes To Seattle

It's December and we expect wintery weather to arrive with a flurry of snow. We pull our collars tight and burrow into our scarves as we hurry home under grey, snow-laden skies. Our pantries are stocked with winter comfort foods. 

Seattle, however, doesn't get much snow. It's nestled on a hill next to a large, salty body of water. This makes for a temperate climate and that means we don't have long, deep winters or hot and humid summers.

So when a little snow comes our way, excitement jumps through everyone. The local newscasts follow it snowflake by snowflake. Schools prepare to close. Children bounce around, ready to build a snowman on their snow day.

Snow came at the beginning of December.

To The Store For Warm Clothes

With snow in the forecast, I scurried off to pick up warm accessories.

I had already purchased a waterproof rain coat that included a warm liner. The day before the predicted snow, I ran back to Eddie Bauer to complete the ensemble. I added a warm hat and gloves. Waterproof boots are next on my list.

As we go to bed, the first light snowfall begins.
“It was the first “measurable” snowfall to stick and accumulate in the lowlands of Western Washington and Seattle in nearly two years, according to the National Weather Service in Seattle.”
— Q13 Fox news
 

The Snow Begins

The snow started at night. We went to bed wondering what we would see in the morning. Waking up at 6 am, it was still coming down in fat, sloppy snowflakes, but by 8 am, it had already tapered off. 

People were thrilled to have some snow to play in and others dreaded driving in it as they headed to work. Retirees breathed a sigh of relief that those days are behind them and blissfully enjoyed the snow knowing they could stay home for the day.

Trees looked festive for the holidays with the most natural of flocking, real snow. Low, grey skies softened the feel of the land.

“It was a delight to many Washingtonians. Earlier in the day, in Lewis and Thurston counties, adults and children ran out to play in snow and build snowmen and have snowball fights.”
— Q13 Fox news
 

Connecting To The Environment

Students of The Radiance Technique® (TRT®) can connect to their feelings about the weather. Do you find difficulties with certain seasons? Perhaps you're anxious about having to drive to work in the snow. Using Front Position #3 can help to decrease anxiety.

Maybe you have favorite seasons? Using TRT® hands-on, you're able to explore your relationship with the world around you and connect at deeper levels.

Do you look forward to the snow? Or perhaps you're a snowbird, flying away as soon as it appears. 

After The Snowfall

Snow doesn't linger long in the Seattle lowlands. Temperatures rise and storm drains trickle with the sound of melting ice crystals. Rain washes the rest of it away.

While the snow disappears in the lowlands, the higher elevations build their snow pack. Local ski resorts relish the promise of a robust ski season. Snow bunnies dream of icy escapades that await.

Meanwhile, in Seattle, snowmen melt into the grass and we dream of snowflakes that may come again.