Cyber Poems

Our 14 year old golden retriever, Rudy, died today. My wife, Pam, and I are grief stricken. Rudy was with us for more than half our married life. He was our hiking partner, our companion every day, our friend.

Thankfully, we have each other in our grief. And, we have had many grieving experiences together already. We’ve had some practice in how to do it.

Here’s some of what we’ve learned over the years about sharing grief together. Telling you about it will help me to begin the path for my own grief over Rudy.

1. Grief is a normal reaction to loss. It is a way we process emotionally, intellectually, and spiritually when something or someone important to us is lost in some way.

While grief has all the classic stages of denial, anger or depression, the overall feeling is the ache of sadness. It’s normal. It’s expected. It can even bring growth when we welcome it.

2. Each person has different needs and styles of grief. Some need to talk it through. Some need a lot of internal mulling. Some need to cry. Some need rituals.

Pam needs to sit and think, and then talk with me, often over and over. I need a lot of internal time to let it sink in and get past my normal emotional reserve. But I need to know that Pam is there ready to hear my thoughts and feelings as they make their way out of me.

It has been very important in our relationship to honor these different needs in each other. It hasn’t always been easy. Earlier in our life together we could mistakenly expect the other to do things our own way. That was usually experienced by the other as hurtful and non-accepting.

Sometimes, we shift roles. Today it was my turn for many tears. It was her turn to draw me out and listen. Usually it is the other way around. It doesn’t hurt to be flexible about all this stuff.

3. It’s NOT about being rational. It’s about being effected in an emotional way. It matters to us that we lost something or someone. We have some passion about it. It touches us deeply. It is not to be explained away.

The intellect comes into play, but we have to be careful.It is far too easy to retreat into the emotionless parts of the intellect and deny the pain. It’s easy to talk about the pain, rather than let ourselves experience and work through it.

The reason I have pain over Rudy is because he really, really mattered to me. My pain is a respectful response to the loss of a faithful companion. It hurts because such things should hurt.

4. Grieving together is invitational, not pushy. We can’t make someone grieve. We only invite the other to enter the process with us. We ask if they have some feelings to share, or if they’re open to hearing ours.

Judgement is not welcome. One’s pain is just what it is: pain. It doesn’t have to make sense, just felt and eventually released.

5. There is no prescription for the “right” amount of sadness or the “correct” type of feelings to have. We have each experienced very different levels of grief in different losses. Losing my father earlier in life was much more traumatic than when my mother passed many years later after a long life. Losing my way vocationally for a time was a dull ache that persisted for several years.

Because we are different people we will grieve differently. Expecting a partner to experience it in a certain way is a recipe for disappointment and defensiveness.

6. Telling stories helps a lot. Human beings have used stories for thousands of years to help communicate and process what is happening to them.

Pam and I tell each other the stories we remember. We include both the good and not so good experiences. It doesn’t matter if we’ve told the stories before. In this case, we have many good stories about Rudy and very few bad ones.

7. Rituals can help tremendously. I do not mean only formal rituals. They can be a great help, but more informal ones can be just as valuable.

For example, we’ve tried a special meal on a day of remembrance, a piece of music played now and again, or a place set at the holiday table representing one who once sat there. When our last dog died we had steak for breakfast the next day in his honor. We knew he would approve. All these little remembrances help us release a little more grief over time.

So, what will be the path of our grief over Rudy? We have already cried and spoke at length today. More will come of that. There are the pictures to look at from the past 14 years. Comforting our other dog who now misses her partner will comfort us, as well.

Pam will know I feel it when I look at the empty floor at my bedside. And, I will know to ask her about her feelings as we consider the timing of bringing a new puppy into the house. For us, the timing will not be right until much of the initial grief is experienced and resolved.

There will probably be a new ritual in our lives that has yet to be created. Improvising new ways of celebrating life has always been Pam’s gift.

And so, I will readily accept whatever shape this grief will take. Rudy will be remembered well one way or another, and the journey of our marriage will benefit from it. Together we say a good “Good-bye” to Rudy, so that we can say a very good “Hello” to what comes next.

Steve Roberts is an experienced Marriage and Family Therapist who shares tips and real life relationship secrets from over 20 years of practice. Get Insight and Wisdom for your Relationships at: http://www.WhatWorksForCouples.com

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I believe that major change and loss in our lives is a door to grow ourselves, to become more loving, compassionate and accepting towards others and ourselves. We have choices that determine what the journey will look like.

Change isn’t easy and it can be quite painful. About twenty years ago, I endured the loss of a parent, a sister and a terrifying sexual assault within a two-year span. More recently, I experienced a car accident, loss of another parent, and the death of my marriage within a year’s time.

During the first trio of losses, I didn’t have a good map for my journey. I made some positive choices, yet I also did a lot of kicking and screaming. More recently, I chose another route. I didn’t resist the change and the pain. Instead, I embraced it as a gift for transformation.

As a grief therapist, I’ve watched the conscious and unconscious choices my clients make. I saw that change was made more painful through resistance and running from feelings. I saw that one’s thoughts about change and belief in one’s ability to change gracefully were key components. If I believe the journey is going to be horrible, it will be. If I believe that I can go through the experience with more ease, less suffering and grow my soul incredibly as a result, then that’s what will happen.

I also saw that these painful moments in our lives are sacred and are blessed by the presence of spiritual helpers.

Now consider this. I believe that every time we are faced with a major life challenge:

* That we are surrounded by our own band of angels, spirit guides and departed loved ones who become part of our ‘team’ to deal with this challenge, and to help us transform to the next ‘level’.

* That these spiritual helpers are ‘feeding’ us thoughts, ideas and perceptions that will assist us to heal and transform, especially if we have given them the ‘ok.’

* That there is incredible ENERGY that accompanies each of these life events that is available to us to PROPEL us forward into becoming more fully who we were meant to be.

* That by consciously choosing to use our spiritual help and this amazing energy and creative Life Force that comes with loss and challenges, we join the ranks of a growing collective of inspired and inspiring souls who are healing themselves and the planet.

* That we need never suffer again in the same way as we face one of these challenges because each of us is a co-creator and harnesser of this powerful team of transformers.

* That we can actually EMBRACE CHANGE and move into changes with confidence and with tools to stay focused on positive transformation; we can then pass on our knowledge to friends and family to improve their lives too.

Yet we have to be mindful and awake. We can all transform ‘unconsciously.’ It’s a little like sleep-walking. We just let ourselves be at the mercy of the energy and hope for the best. And though I truly believe that each person is going through their life challenges exactly the way they’re supposed to, I also believe we are given messages of hope for something more meaningful, something that can align us more with a life of more ease, vitality, and joy. I am grateful to my clients and to myself for showing me the possibilities and the power of believing change is a gift. And I know, with great peace, that I am surrounded by loving spiritual beings, and I can choose to transform by grace. It’s a much better ride, I must admit.

Marcia Breitenbach is a therapist and presenter, and has written 2 books and made 4 CD’s of original music having to do with change, grief and transformation.

Visit her at http://www.griefandlosshelpsongletter.com and get your f.r.e.e. inspiring songs and proven strategies for dealing with life’s challenges.

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San Baronto is a Beautiful village positioned in the heart of Northem Tuscany close to birthplace of Leonardo Da Vinci and within touching distance of the most charming and famous Italian Renaissance cities.
It is ideally situated for touring and visiting these valuable cities.

Relaxing days can be spent on beautiful nature walks in the local area, rich in flora and fauna.
Comfortable strolls through the woodland paths of our area, the Montalbano hills, or slightly further afield into the renowned Chianti zone towards Siena.

On your return we would welcome you with typical Tuscan fare prepared in our own kitchen with locally sourced ingredients and a wide selection of local wines.

Our family hotel is positioned in a quiet residential area and is particularly well suited to families and children with the added benefit of safe natural parkland within our grounds and a private swimming pool with sundeck. There is also a childrens play area, a mini market and secure, private parking for both cars and coaches.
Public transport is easily accessible from near the hotel.

Services:
Swimming Pool
Natural parkland within grounds
Play area for children
Secure private parking for coaches and cars
Open air restaurant in summer season

DISTANCES IN KM:
Firenze - San Baronto 38 Km.
Lucca - San Baronto 43 Km.
Pistoia - San Baronto 11 Km.
Pisa - San Baronto 45 Km.
Siena - San Baronto 75 Km.
Vinci - San Baronto 9 Km.

From Firenze A11 - Exit Pistoia - direction Empoli - Lamporecchio
From Lucca A11 - Exit Montecatini - direction Empoli - Lamporecchio
From Pisa (FI-PI-LI) - Exit Empoli - direction Montecatini and Vinci

Looking for budget Hotel in Lamporecchio? Pls visit our catalogue of Hotels, where you can find also a wide range of Tours in Pisa and compare price for double room in Lamporecchio.

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If you have ever lost someone dear to you it is likely that you can still summon up the grief that you may still be carrying deep inside yourself as a result of the loss. If this grief, which is usually felt as a deep saddness, is something that you would like to clear in yourself then you may find some hope here.

In this brief passage I would like to address this grief in a way that you have probably never seen or heard of before. Following what comes next may leave you feeling transformed, so I caution you in advance.

Grief:

Is the saddness that is associated with a significant loss (say of
another person)

The feeling of loss is, by definition, that which tells us that once there was another person,

Hence the feeling of loss helps to remind us that there once was another person, so that,

We won’t forget the other person, so that

We can feel like we are still connected to the other person, so that,

We can feel better in ourselves and feel that we are not alone, so that

We can feel at peace, happy and contented.

So, in summary: (A) The saddness helps us feel connected to the loved one, at peace, happy and contented.

But this is clearly not true is it?

The saddness is there primarily because we have “lost” the other person and are therefore “disconnected” from them. Also, clearly saddness is the opposite of being at peace, feeling happy or contented, isn’t it?

Now, if you wish, acknowledge to yourself that (A) is not true and notice how you feel inside.

If you followed this so far you may be feeling some or all of the following:

a) Confused
b) Skeptical
c) Lighter
d) Relief
e) At peace
f) More contented
g) Expansive
h) Enlightened
i) Happier
j) More connected to your loved one but in a happier more desirable way.
k) Have an awareness that you are really “not” separated from your loved one.

If you felt a) or b) above then you are still needing the grief for some reason. If you felt any of the other feelings then I think you already know what this is about.

If you wish to know more then you are free to visit the web site in my bio below.

Dr. Nick Arrizza is trained in Chemical Engineering, Business Management & Leadership, Medicine and Psychiatry. He is a Key Note Speaker, Author, Stress Management Coach, Peak Performance Coach & Researcher, Specializes in Life and Executive Performance Coaching, is the Developer of a powerful new tool called the Mind Resonance Process(TM) that helps build physical, emotional, mental and spiritual well being by helping to permanently release negative beliefs, emotions, perceptions and memories. He holds live workshops, international telephone coaching sessions and international teleconference workshops on Physical. Emotional, Mental and Spiritual Well Being.

Personal URL: http://www.telecoaching4u.com

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Helpers often ask questions such as: “What should I do? What should I say? Am I doing the right thing? Did I do the wrong thing?” Here are some suggestions for how to best help those in grief.

1) Do give grievers the permission to grieve. You do this by your presence, understanding and acceptance of where they are.

2) Do expect volatile reactions from the bereaved. Those in grief are on an emotional roller coaster.

3) Do be “present” to the bereaved. Give the griever your full attention as they share their loss with you. It is so very meaningful to them and therapeutic as well.

4) Do view the loss from the griever’s perspective. Their loss is unique and their pain is their own. You cannot know their loss without viewing it from their perspective.

5) Do maintain an appropriate emotional distance from the griever. Do not make their loss your loss.

6) Do encourage verbalization of feelings and memories of the deceased. Talking about the one who died is therapeutic for those suffering grief. It helps them process their loss and begin to formulate perspective.

7) Do help the bereaved recognize and accept the loss.

Do listen non-judgmentally and with acceptance.

9) Do allow the grieved to cry, talk, and review without interruption.

10) Do help the griever with normative data about the grief process. Assure the grieved that they are not “crazy” and that what they are experiencing is all a part of the grief process.

11) Do help the griever with practical responsibilities (grocery shopping, take the children for a couple of hours, drive to the bank, make phone calls, etc.).

12) Do help the griever understand the need to develop a new relationship with the deceased.

13) Do be informed about grief and providing gentle compassionate care.

14) Do be helpful and keep in touch.

15) Do encourage healing.

16) Do encourage counseling if behaviors appear pathological or extreme.

17) Do be aware that weekends, holidays and evenings may be more difficult for the bereaved.

18) Do help the bereaved avoid unrealistic expectations as to how they “should” feel and when they will be better. It is helpful when appropriate to say, “I don’t know how you are able to do as well as you are.”

19) Do ask griever to accompany you on some outing or engage in some activities with you (at appropriate time of course).

20) Do encourage grievers to participate in support groups.

Rev. Saundra L. Washington, D.D., is an ordained clergywoman, social worker, and Founder of AMEN Ministries. http://www.clergyservices4u.org She is also the author of two coffee table books: Room Beneath the Snow: Poems that Preach and Negative Disturbances: Homilies that Teach. Her new book, Out of Deep Waters: A Grief Healing Workbook, will be available soon.

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“This is Our Finest Hour?” “I Have a Dream?” No, nothing like that. This is a speech of 2 words I heard the other day.

I was in a hospital getting a chest x-ray, a prerequisite for surgery on my broken ankle. It’s been two weeks since it happened, two weeks full of pain, change, and coping. I’ve described how it happened, learned how to get around the house on crutches, visited doctors and labs, waited on x-rays, and asked neighbors to get the mail and groceries.

I’ve also been put through the pre-op battery of tests - blood tests, EKGs, chest x-rays, and discussions with my doctor, who felt the best approach was surgery.

In my EQ Alive! program, which trains and certifies EQ coaches, I’ve participated in the weekly EQ Check In along with the students. We tell each other how we feel physically, spiritually, mentally, and emotionally. We begin each teleclass that way, and listen closely to the answers. EQ competencies include emotional expression, and also Integrated Self, being in touch with all aspects of yourself. Most of all it means not engaging in the meaningless, “How are you?” “Fine.”

In a shutdown and coping mode, I thought I was being realistic about how I was feeling. I said I was in pain. I said I was physically slow and the painkillers had dulled me mentally, and that spiritually things were the same as ever. What more was there to say? I never gave it a thought.

So there I was in the hospital. I’d been sent to the wrong place and walked about a mile on the crutches to find that out. I was accepted, however, thanks to the work of a nurse named Lupe with very high EQ who just pushed the order on through. And then, mercifully finally in a wheelchair, I’d been wheeled to the x-ray waiting area and left in the hall.

As I sat there, a woman on a stretcher was wheeled up. I could tell she was sick. Her hair hadn’t been washed in a while and she had a nose tube for oxygen, and a tube in her arm. Her color didn’t look good and she barely moved. She reminded me of my dad the last time I saw him in the hospital. She was accompanied by two women. The first one went over to sign papers, and the other one walked off down the hall.

A technologist walked out toward the woman on the stretcher when I heard the speech that touched me so. I think she thought he was coming to take her into the x-ray room.

“I’m afraid!” she cried out.

“God love her,” I thought. “So am I!”

I tried to get out of my chair and go to her, but the technologist beat me to her. Speaking to her in her native tongue, Spanish, he rushed to her side, took her hand and started soothing her. “Abuelita,” he called her, “little grandmother,” a term of endearment. A nurse brought out a screen to give her privacy and she quieted.

She quieted and I thought: Why is it so hard to get to “I’m afraid”?

Of course I’d been afraid the whole time, from the moment I heard the bones turn in my ankle. I started repeating, “Please don’t let it be broken, please don’t let it be broken.” There was no way to tell, and I was left with pain and fear.

Was it broken? Is this because my bones are getting old and this is just the beginning? Will this mean arthritis pain for the rest of my life? Will the insurance cover it? What on earth is my deductible? How can I ever manage this at home alone? Will it need surgery? General anesthesia? Will I survive it? Will they have to rebreak it like one neighbor says, and put in 6 screws like the other one says? What will happen?

I shut all these things down and used words like “tired” and “in pain,” but at the core, yes, I was afraid. Fear of the unknown, and fear of being helpless and dependent.

I was also afraid of the fantasized reactions of others, having come from a family of shame and blame. I think nothing will ever “happen” to me that I won’t feel like I caused it and was a ‘bad girl’ because of that. Words from an overwhelmed, shame-and-blame mother who saw everything as simply more work for her. Whatever caused the ankle to break, I should’ve known better, I shouldn’t have done it, I shouldn’t have been there, and I should never have let it happen - as if I were omniscient and omnipotent. That means all-knowing and in control of everything in the world. It was family that taught intellectual words, not feelings. Old childhood fears. In line with, “Whatever it is you fear has already happened.”

And at that particular moment in the hospital corridor, well you never know what will turn up on any chest x-ray, no matter why it’s required. Nor had the results of the EKG come in yet. What if I went in with a broken ankle and came out with a bypass? Or worse yet, out the back door on a stretcher. It’s been known to happen.

As J. Powell says in “Why Am I Afraid to Tell You Who I Am?” emotions are not moral (good or bad). Feeling frustrated, or being annoyed, or experiencing fears and anger do not make one a good or bad person [a weak or strong person.] But this is theory. In our day-to-day lives most of us blame ourselves for our feelings.” And if we judge them to be “bad,” or unacceptable to us in some way, we bury them.

So there I sat in my wheelchair, silent and alone. And there was Abuelita, expressing her fear and getting comforted. It’s an old lesson: People care. If we say we’re afraid we can be comforted. If we don’t, we can’t.

All studies show that people do best who have a strong social support network, and if you don’t say WHO you are and HOW you are, you aren’t getting the connection that sustains you. You remain alone in the presence of others, which is the loneliest you’ll ever be.

And let me close with the words of the technologist who finally did my x-ray. Dianna was her name. She read the name of my company, Emotionally Intelligent Solutions, on the chart. “What’s that,” she said, “Is that like I’m to the point where I can’t stand any of my co-workers any more and I think they’re dumb and ignorant and feel like I’m about to explode,”

Yes, EQ is about that, too!

The woman works two 16-hour days, physical and demanding (how on earth do you do that?) and has three children at home. I gave her my card. I hope she’ll call me. It may not be her co-workers that are the problem.

And that’s the power of Emotional Intelligence. If you are the problem, you are also the solution, and Emotional Intelligence is the bridge between the two.

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Part of Emotional Intelligence is understanding the emotions of others, and one of the most important channels we use to communicate emotions is nonverbal communication.

When we’re engaged in communication, we must pay attention to all sorts of things besides just the actual words. No matter how we try to define words, they still mean one thing to one person, and another to another.

To understand this, all you need to do is take a sentence and emphasize different things, or use a different tone of voice. For instance, try saying this sentence 5 different times, each time emphasizing a different word: “I know what he said.” The emphasis makes quite a difference.

Now consider that what “he” said was, “I love you.” How would you say “I know what he said”? Certainly with tenderness, love, and maybe even awe.

However, if the person who said “I love you” was someone you despised, you would say “I know what he said” with resignation, or pity, or maybe even disdain.

Now consider what “he” said was that you were the one solely responsible for the demise of the project. How would you say, “I know what he said”? Agitated, and there’s a big “but” about to follow.

Included in nonverbal communication are tone of voice, pace, posture, proximity (how close the person is to you), gestures, facial expressions, and movements (small and large). All ways of communicating besides language.

Nonverbal communication is important because it is less under our conscious control than the words we speak. Therefore it tends to reveal our emotions, whether we intend to or not. After all, there are times when we wouldn’t want someone to know how we “really ” felt.

With practice you can learn to modulate a good bit of your nonverbal communication, but not all of it. For instance, there’s something called “the Adam’s apple jump” that remains involuntary. According to The Nonverbal Dictionary©, this jump of the cartilage in the throat is “an unconscious sign of emotional anxiety, embarrassment, or stress.” It means the man doesn’t like what’s going on, or strongly disagrees.

The expansion and contraction of the pupil’s in our eyes is another example of something that’s very hard to control. Our pupils expand when we like something (”let more of this in”) and contract when we do not (”I don’t want to see this”). We do this in response to sunlight, but also to emotional things.

So how do you interpret what’s going on? The first step is to notice change. If the person’s been sitting in a certain position for quite a while and then shifts dramatically, something has happened you need to take note of. However, here’s the tricky part. It could be they think you’re lying, it could be they got a cramp in their leg, it could be they love what you’re saying and wanted to move closer (unconsciously), it could be they have to go to the bathroom, it could be something you said angered them.

Someone told me the other day how much they liked doing phone work. I agreed with her, saying that it filtered out a lot of distractions. “Yeah,” she said, “all those things I’m imagining that aren’t really going on.”

So how do we quit imagining and figure out what the nonverbal message meant? It takes practice. You begin with self-awareness - noticing your own nonverbal reactions. Start paying attention to the things YOU do in the course of communicating. Notice when you move, when you change your facial expression, what you do with yours hands. Then hook it up with what was going on, to explain why you do these things.

Next, start observing more in others. Facial expressions and gestures can be tricky, especially if you’re in a multicultural situation. A sign of peace in one country is a gross obscenity in another. Some cultures are more facially expressive than others. A smile can mean “I agree” in one country, while in another country, direct disagreeing isn’t permitted, so a smile is just a convention.

You can study nonverbal expressions through photographs by accessing some of the sites on the Internet.

Then start asking more questions when it’s appropriate. And it may always be appropriate as far as that goes. As my friend said … we imagine. Nobody likes to feel like you’re “mind-reading,” and the more important the conversation, the more important that you check out what you think the other person meant, or said, or implied. When we assume, we can get into trouble.

In fact you should check in from time-to-time just to see if they’re still paying attention. For instance someone who interviews people all day long tends to tune out if you talk more than 90 seconds.

Interjecting things such as “Was that what you had in mind?” or “Am I addressing the point in a way that’s helpful?” can bring the other person back. Your reading of nonverbal communication will tell you they’ve left when their eyes glaze over.

If you see a shift in the nonverbal that concerns you, note it, think about it, and then respond appropriately. It’s important to observe what’s going on in the other so you can keep the conversation on course. It’s part of Emotional Intelligence, social skills and good manners.

For instance, one person may want to hear all the details of your surgery, while it may be too much for another. You may need to vent your spleen about your ex-spouse or your boss, but the listener may find it too intense and become uncomfortable. If you’re getting “warding off” signals, back off.

In negotiations and sales, you must be alert to changes that can signal you’re using the wrong approach so that you can reorient and try something different.

Being able to read nonverbal communication effectively is important to your social and professional relationships. It will affect your ability to be intimate, to sustain friendships, to influence people, and to succeed in your career.

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Votive candles will look best when you put them on all surfaces in a room. In this case, the bathroom. Place them on the sink rim, the rim of the tub and on any shelves you have or on the back of the toilet.

Pillar Candles For the Living Room

These look most dramatic and are best in odd numbers and when clustered in varying heights. Put them on floors or tables - side tables and dining tables and always use caution in high traffic areas of the house.

Battery Operated Candles For the Kids’ Room

Light up the kids’ room with a safe alternative to flame candles. They work with batteries and not fire. They’re like nightlights but much more elegant and attractive.

Jar Candles For the Kitchen

These are great for the kitchen and kitchen dining area because these candles are scented in yummy scents such as vanilla and chocolate and strawberry.

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The sexual toy business has observed a hefty increase in trade since the seventies. This is part of the marital aid revolution and a large benefit to mankind. Sexual toys are a wonderful way to add passion into your sex life, sexual toys may help you come to orgasm and sex aids regularly put a grin on your face. Butt Plugs are always great fun with lube!

Whichever spectacular marital toy you decide to get this Xmas let your wants be your guide. If you are into rough sex then go and get yourself a leather whip. if you are into romantic play then go and get yourself some feathers. Keep your eyes open and see where it takes you.

The most celebrated sex toys on the sex market have got to be the vibrating marital aids. The above mentioned awesome sex aids have been everywhere for years and you have perhaps seen one in your local sex shop. Vibrating marital aids come in a multitude of lengths and colours, you can get vibrators in a miniature size for your backpack right up to 12 inches. The wonder of a vibrator is the brilliant vibration that it gives off, this vibration is the big source of orgasm for gals and may usually be changed in intensity to suit the woman. Sex aids are stunning.

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I’m surprised when some patients and caregivers confuse dementia and Alzheimer’s as one and the same. Each time a family member is suffering from memory loss, the conclusion is always Alzheimer’s. Is it reasonable to label all dementias as Alzheimer’s?

As a clinician, my answer to queries is that Alzheimer’s dementia is only one type of dementia and that not all dementias are Alzheimer’s. Aside from Alzheimer’s disease, other dementias exist such as Dementia with lewy body, Vascular dementia, Parkinson’s disease with dementia, and dementias due to various neurologic and medical conditions.

How will you know if a person is suffering from Alzheimer’s dementia? What is Alzheimer’s dementia?

Alzheimer’s dementia is a neurologic disorder characterized by a progressive and irreversible cognitive decline associated with impairment in functioning. The cognitive deterioration consists of memory impairment. Initially there is recent memory impairment but as the disease progresses, even the long term memory is affected.

In addition to memory impairment, a patient with dementia has impairment in one of four cognitive areas: aphasia, apraxia, agnosia, and impairment in executive functioning. Aphasia is a problem in language characterized by inability to express oneself, repeat words or phrases, or understand what is being said. Apraxia is inability to adequately perform a usual motor activity such as combing the hair or brushing the teeth despite no paralysis or musculoskeletal abnormality.

Agnosia is inability to recognize objects or things despite no sensory deficits. For instance, a demented patient cannot recognize a key or a pen placed in his or her hands without looking at it.

Impairment in executive functioning is characterized by difficulty in abstract reasoning and in organizing things, schedule, and activities. Patients with this problem give concrete meaning to proverbs. For example, when a patient is asked what “don’t cry over spilled milk” means, the patient responds, “It’s easy. Just wipe it!” Moreover, knowing the specific similarities and differences of certain things (e.g. apple versus orange) is a struggle for some patients.

What are the possible causes of Alzheimer’s?

The cause of Alzheimer is still unknown. However, several risk factors have been identified. One major risk factor is age. The risk of developing dementia increases as our age advances. Older individuals therefore are more at risk. Having said this, Alzheimer’s can also happen to young individuals.

Other important risk factors include the presence of apolipoprotein E4 allele, the predominance of plaques and tangles in the brain, and the brain’s impaired cholinergic system.

Is there any successful treatment for Alzheimer’s?

Alzheimer’s disease is irreversible so current medications are only geared to slow down the deterioration. These acetylcholisterase inhibitors, namely galantamine, rivastigmine, and donepezil, are aimed at improving the cholinergic functioning in the brain by inhibiting the cholinesterase enzyme. Although initially indicated for mild to moderate dementia, some recent evidence shows that some of these drugs may also benefit patients with moderate to severe dementia. Further studies are warranted to determine its efficacy in this group.

Copyright © 2004. All rights reserved. Dr. Michael G. Rayel - author (First Aid to Mental Illness-Finalist, Reader’s Preference Choice Award 2002), psychiatrist, and inventor of Oikos Game: An Emotional Intelligence Game. For info, visit http://www.oikosglobal.com and http://www.soardime.com

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