Nov 1, 2012

Dementia, Observation, Bunkhouse Logic, Bright Light

I believe bright light makes a person who is deeply forgetful (DFP) more awake and alert. They tend to speak more and seem to be "more there". DFPs seem to have more personality and an improved mood when exposed to bright light daily.

Bright light can be very helpful to a person living with dementia.
By Bob DeMarco
Alzheimer's Reading Room

Yesterday I mentioned Bunkhouse Logic and sure enough I get a couple of emails asking, what is Bunkhouse Logic?

There is a place in my mind, my brain actually, that I called the Bunkhouse. When I have a problem, have to make a decision, or feel stymied, I go to the Bunkhouse.

Before I go to the Bunkhouse, I grab my da Vinci pad, dim the lights, and sit in a comfortable chair. My da Vinci pad is large newspaper print pad. Big pieces of paper with no lines.

As I start thinking I doodle on the pad. Sooner or later the words start coming out of my hand.

This is a free form of thinking.

How did I determine that bright light improved my mother's outlook and behavior?

My initial observation started in the doctor's office. Before we would go to the doctor and as I was getting my mother ready, shower, dressed, etc., Dotty would get in a very bad mood and her behavior was awful. I'm not going. I don't want to go. I am not going to the GD doctor. No. No. No. No.

Once we arrived in the doctor's waiting room, Dotty would refuse to talk to me, refuse to look at me, and she had that heart wrenching, sour puss, I'm not here look on her face.

Eventually we would get moved from the waiting room to the observation doctor's room. Dotty. I want to go home. Can we go home now.

However, the nurse (or assistant) would start talking and smiling at Dotty as she took her temperature, blood pressure, etc. Dotty would begin to loosen up.

When Doc C (Chiribogga) would come in. He would sit on this very low stool with wheels on it. He would immediately start talking to Dotty (not me). Doctor C had a very reassuring voice, and a great smile which he used.

At a certain point, Dotty would start smiling and interacting. There is not a GD thing wrong with me. Hey, at least she was talking.

By the time we walked out, Dotty was in a completely different mood. What was the reason? My initial observations. Was it the bright light? The social interaction with the assistant and doctor? The fact that we all care about her?

At first, and before I took a trip to the Bunkhouse, I assumed it was the visit to the office and the bright light.

But one night I decided, time to go into the Bunkhouse.

No matter what I wrote two words kept coming out of my hand. Bright Light. To a much lesser extent, socialization.

I did some research on the Internet. There really wasn't anything much about the connection of Alzheimer's, dementia, and  bright light. There was plenty of information about bright light and how it was being used with patients suffering from depression. Even some on persons with strokes, and neurological problems.

I decided in the bunkhouse that I would start taking Dotty out into the bright light every day. Along with this I decided that we would begin (resume) living our life.

We started the bright light by sitting Dotty next to a big window as soon as she woke up. Opening the blinds, wide open. Once I opened them I never closed them again. Not even to this day. Dotty always had them closed. Dotty didn't want anyone looking in (a bit of paranoia).

How Bright Light and Our Daily Routine Improved Dotty's Behavior and Vision

Me? I thought. You wanna look in, be my guest. Look in at your won risk. You might get startled from time to time.

After we started using the bright light daily, Dotty seemed to have a better attitude. Her mood after the doses of bright light did improve.

Search the Alzheimer's Reading Room Knowledge Base for Answers to Your Questions, and Solutions to Problems

Next, I had to ask myself, is it the light, or the major dose of Vitamin D she was receiving from the sun?

As it turns out the elderly don't get enough Vitamin D, and the pills they take are not every effective. When you get older your body doesn't absorb the Vitamin D, or Vitamin B, from  pills or food effectively.

Yes, a shortage of either Vitamin D or B can make you act depressed or worse, like a dementia patient.

Later in our journey with Alzheimer's, I started using spiral notebooks to take down my observations, to look for patterns like time of day, or the catalysts for mean or challenging behavior.

I guess you could say all these observations took me back to the Bunkhouse where I developed solutions to each and every problem. One by one.

The bottom line. You have to be a detective. You have to be an observer. You have to think about what is happening, and also put it in the context of time. Same time every day? After some act on your part, every time?

I learned through observation and by writing in my notebook that I was the one making Dotty mean at times. I finally realized that if I left her alone for 15-20 mintues she might get all mean shortly thereafter.

How did I figure that one out?  Well, Dotty kept telling Joanne on the phone at night that I was going out all day, and she didn't know what I was up to, but I was up to something.

That something, the unknown, clearly something evil in Dotty's mind was the catalyst for words like - get out, I don't need you, I don't want you here.

How did I figure it out? Because I finally realized that Dotty thought I was leaving her alone all day even though I was only throwing out the trash, or talking to a neighbor. Alzheimer's patients do not have a good construct of time. Fifteen or twenty minutes can seem like all day.

I read my notes, went up into the Bunkhouse, figured out what the roots to each problem were; and then, worked on them one by one.

My belief. 93 percent of Alzheimer's patients are kind and gentle. The other 7 percent were or are dysfunctional by nature, or they don't have Alzheimer's instead they have a related dementia that presents with very different symptoms.

Now you can sit around and complain. Or, you can go into your Bunkhouse and discuss this with yourself. Ninety three (93) percent of you are going to be successful in changing the ways things are.

Here is a tip. The change starts with you, not the other way around.

I'll close by asking you this? If you are a full time AD caregiver what else do you have to do? Why not change your world?

Why not become the very best caregiver you can be?

Just asking.

Note a study conducted in 2011 found this about bright light.
Caregivers said patients receiving the treatment seemed more awake and alert, were more verbally competent and showed improved recognition, recollection and motor coordination. They also said patients seemed to recapture their personalities and were more engaged with their environment. Patients' moods also were described as improved.
They could have asked me about this in 2005.

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Bob DeMarco is the Founder and Editor of the Alzheimer's Reading Room (ARR). Bob is a recognized influencer, speaker, and expert in the Alzheimer's and Dementia Community Worldwide. The ARR Knowledge Base contains more than 4,000 articles. Bob lives in Delray Beach, FL.

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Original content Bob DeMarco, the Alzheimer's Reading Room