Addicted to Anti-Anxiety or “Nerve” Pills — Benzodiazepine use disorder and what to do about it

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Image by Pete Linforth from Pixabay

Many people, especially women, develop feelings of anxiety and worry. Some call it “bad nerves.” This predisposition to feeling anxious can cause problems with everyday living, coping, and sleeping. I have assessed and interviewed many older people with a range of problems with anxiety. Feeling anxious is a completely normal reaction to stress or a situation where you may feel fearful. However, being in a continuous state of feeling afraid can cause problems both mentally and physically. Some say they feel like they are “trembling inside.”

Anti-anxiety medications (also known as “nerve pills”) are used by many people. These pills come from the family of “benzodiazepines.” Some of the commonly prescribed anxiolytics in Canada or the United States include (but not limited to):

  • Clonazepam (Rivotril)
  • Alprazolam (Xanax)
  • Lorazepam (Ativan)
  • Diazepam (Valium)

A commonly prescribed non-benzodiazepine that acts like one is Zopiclone (eszopiclone in the USA). It is commonly used as a “sleeping pill.”

Generally, benzodiazepines end in “pam” or “lam.” Use of these medications can initially improve symptoms by offering a sedating effect, however, they can also be addictive. Side effects of these drugs include increasing the risk of cognitive impairment, confusion, delirium, falls, fractures, drowsiness, and motor vehical accidents. They are not recommended for use by older adults. In fact, older people are recommended to gradually reduce their dosage (a slow and steady decrease is recommended over a sudden discontinuance due to withdrawal symptoms). Always talk to a doctor about any changes to your medication. As the dose is gradually reduced and preferably stopped, it is important to identify and optimize alternatives to managing any underlying issues. These alternatives are preferably not other medicines.

Sometimes these medications are used on an “as needed” basis. For example, if you are afraid of flying, and you need to go on an airplane, you can take one of these medications (prescribed by your doctor) to use in specific situations. Or, if you have claustrophobia and you need to go for a scan such as an MRI, taking this medication may make it more bearable.

I have also seen where these medications are prescribed for help with sleep. People who have an anxiety disorder may be prescribed this classification of medications to see if it helps reduce anxiety or panic attacks. In older people, antidepressants are the preferred class of medications to help with anxiety.

Some other key tips to remember:

  • Avoid taking benzodiazepines with opioids or alcohol.
  • These medications are more often prescribed to women (Almost 1 in 5 Canadian women report to have used in the past year).
  • Almost 1 in 10 Canadians in Quebec have been reported to have an addiction to benzodiazepines.
  • If a benzodiazepine addiction is present, consider there may also be other substance use disorders or behaviours present (e.g, alcohol, opioids, marijuana, gambling).
  • If you are older, it’s best not to start taking benzodiazepines.
  • If the addiction is getting worse, an admission to a treatment facility may be necessary.

If you are finding yourself feeling “addicted” or “dependent” on these medications (or other substances or behaviours), you are “craving” these drugs, or you are needing to increase your dosage, you may want to see your doctor to discuss alternatives. Reducing the risk of harm is key.

For more details, The Canadian Coalition for Seniors Mental Health has published the Canadian Guidelines on Benzodiazepine Receptor Agonist Use Disorder Among Older Adults (2019) and is found online: https://ccsmh.ca/wp-content/uploads/2019/11/Benzodiazepine_Receptor_Agonist_Use_Disorder_ENG.pdf

Angela G. Gentile, MSW, RSW

OK Boomer – A passing fad?

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Photo source: https://dailyillini.com/opinions/2019/12/02/ok-boomer-is-an-ok-trend/

The end of the decade brought forward a new catchphrase: “OK Boomer.” It’s meant to be humourous, but its real meaning is dismissive and insulting to the older generation. It is something a younger person would say to an older person in a sarcastic and mean way. It pits the younger generation against the older generation. This term exploded on the social media video clip site called TikTok and is now sweeping the nation.

I have been reading up on the term, and it seems that there continues to be quite a divide between generations. The older generation is known as the Baby Boomers (and those older than the Boomers are the Silent Generation). The younger generation is known as the Millennials, or Generation Y or Z.

In between the Boomers and the Millennials is Generation X. That’s my generation. Those who are Gen Xers now are around 40–54-ish. Generation X is often forgotten about. It seems like we are invisible. Not young, but not “old.” It is kind of like the middle-child that often gets forgotten.

Each generation tends to point fingers at the next. I say we need to embrace each generation. Learn from what each has to offer.  Boomers are those born between 1946 and 1964. They are aged 55-73.

In order to move forward in a united front, we have to stop saying “OK Boomer,” and instead say, “I hear you. I see you. Let’s talk.” We have so much to learn from each other. Gen Xers now approaching that magical 55+ age. That age when we get a senior’s discount. We are almost there. I don’t want to be dismissed with “OK Gen Xer.” Just as much as the younger person doesn’t want to be dismissed with “OK Kid.”

So, what do you think of the term, “OK Boomer”? Is it just a recycled and new way of dismissing the older generation? Ageism rearing its head? Or is it nothing new and harmless?

I hope it’s just a passing fad.

 

Angela G. Gentile, MSW, RSW

http://www.AngelaGGentile.com

Cannabis and the Third Age: How Can Older Adults Benefit From This Plant?

Image from Pixabay

Image from Pixabay

This guest post is written by Bojana Petkovich. 

Cannabis (also known as marijuana) has suffered a fair share of stigma throughout the history of humankind. Even though plenty of its medicinal benefits have been known and tested for a long time, most of the world’s countries still keep cannabis illegal. Fortunately, Canada is not one of them any longer.

The Silent Generation and Baby Boomers clearly remember cannabis as illicit and all the stigma that went with it. One would think this mindset is perhaps the most difficult to change when it comes to fully embracing cannabis products, but this couldn’t be further from the truth. 

Why Are Seniors So Attracted to CBD-Based Products?

The answer is rather simple: older age comes at a price — your body is not the same as it used to be when you were younger, and cannabis helps a lot. Your skeletal, nervous, and muscular systems have aged, and there are several age-related diseases seniors are prone to. 

Some of these diseases can, however, be mitigated and battled using cannabis and its major constituents, cannabinoids (CBD). Such substances are diverse, and thus can help with plenty of symptoms and negative side effects.

The main reason a lot of older people lean toward cannabis and its products is that it is not like other heavy prescription drugs. It has hardly any worrying negative effects on your body, and it can benefit you greatly. These products do not harm your gastrointestinal tract and your nervous system, as opposed to prescription drugs for various pains, inflammations, and diseases.

Still, cannabis is also offered as a prescription drug and should be treated as such; this means that its abuse can result in cannabis use disorder that leads to severe side effects.

The National Cannabis Survey conducted by the government of Canada revealed that there has been a rise in cannabis use in seniors. Statistically, just over 40,000 people aged 65 and older used cannabis in 2012. As of 2019, the number rose to more than 400,000 people from this age group who consumed cannabis.

Age-Related Diseases and Cannabis

Diseases such as arthritis, glaucoma, dementia, osteoporosis, and adult-onset diabetes are some of the most common ones that come with old age. Cannabis is, however, known to help with all of them and many others.

Osteoporosis and bone-weakening diseases are some of the most common ones for older adults. They cause severe pain, limited activity and mobility, and overall weakness of your bones. Cannabis use is especially helpful when it comes to such diseases, as it speeds up the healing process of your skeletal system through osteoblast stimulation. These cells act as rebuilders and repairers of your bones, making them up to 50% stronger once the CBD treatment is finished.

Dementia is difficult to deal with, both for the one suffering from it and the person’s loved ones. Other than forgetting crucial things about your life, such as close family members and places, many people with dementia experience severe agitation, aggression, depression, and similar. The neuron cells saturated by excessive amounts of amyloid protein get inflamed, causing this vile disease. Luckily, tetrahydrocannabinol (THC) is there to reduce the amount of this protein, while inducing calmness. 

Diabetes is a problem for a growing percentage of the world’s population, especially in adults and the elderly. Diabetes statistics show people who use cannabis have around 16% lower fasting levels of insulin compared to those who do not use it, and type two diabetes is rather uncommon in cannabis consumers.

Pain is linked to many diseases and is the most common symptom. Cannabis is known for its ability to reduce different types of pain. Factually, 62.2% of cannabis users choose this plant and products based on it so they can relieve chronic pain.

Arthritis, a disease that attacks joints, tends to trouble 1in 2 older people. The feeling of stiffness and pain, followed by fatigue and swelling are some of the most noticeable symptoms. A 2018 study from the International Journal of Geriatric Psychiatry reports a strong bond between arthritis and depression, and seniors have been using cannabis to fight this disease. Not only that, but in 2018 they were up to 20 times more likely to admit they used marijuana in comparison to statistics from 1984. 

Bottom Line

As we enter an era where many symptoms, illnesses, and diseases are becoming a part of a blurry past due to technological advancement, older people can finally start experiencing a painless and easy day-to-day life. Cannabis is already making a massive change, as people opt for CBD-based products more and more every year, and we cannot wait to see this plant’s full spectrum of benefits in the future.

 

About the author: Bojana Petkovich is always on the lookout for new adventures and creative drives. Bojana is currently mesmerized by the fast-paced cannabis industry and providing the internet community with valuable information via LoudCloudHealth. The information on LoudCloudHealth is backed up by scientific studies. The articles on diseases and conditions treated by cannabis or CBD have sources to scientific research in their links. The statistics pages have their sources listed at the end of each article.

Low-Risk Alcohol Usage Guidelines for Older Adults – Know your limits

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Photo by bruce mars on Pexels.com

Most adults enjoy drinking alcohol on occasion. Sometimes, though, this occasional drink turns into a daily habit. One drink turns into two or more. If a person is not mindful, this habit could turn into an addiction. Addiction is also known as dependency or substance use disorder.

People can become addicted to not only alcohol but drugs, including prescription drugs (such as benzodiazepines and opiates). For example, nicotine, the drug found in cigarettes, is very addictive. Addictive behaviour can also be problematic, as in gambling, sex, or online gaming.

Addiction is a complex condition, a brain disease that is manifested by compulsive substance use despite harmful consequences. People with addiction (severe substance use disorder) have an intense focus on using a certain substance(s), such as alcohol or drugs, to the point that it takes over their life. They keep using alcohol or a drug even when they know it will cause problems. Yet a number of effective treatments are available and people can recover from addiction and lead normal, productive lives. – American Psychiatric Association, retrieved 03 Dec 2019.

For a number of reasons, it is essential to keep in mind that as we age, it is recommended we reduce our consumption of alcohol. For adults aged 65 and older, it is important to be aware of the low-risk guidelines.

Canada’s Low-Risk Guidelines (DrinkSense for Seniors) which is provided by the “Canadian Centre on Substance Use and Addiction”, states that limits for adults (not older adults) who drink alcohol should be 10 drinks a week for women with no more than two per day, and 15 drinks a week for men with no more than three drinks a day on most days. There is no specific limit for older adults, but one of their “Safer Drinking Tips” includes the advice of “Always consider your age, body weight, and health problems that might suggest lower limits.”

 

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Standard Drink Portions:

      • Beer – 341 ml (12 oz.) of 5% alcohol content
      • Wine – 142 ml (5 oz.) of 12% alcohol content
      • Cider/Cooler – 341 m. (12 oz.) 5% alcohol content
      • Distilled alcohol/80 proof liquor (rye, gin, rum, vodka, etc.) – 43 ml (1.5 oz.) 40% alcohol content

 

I attended an “Aging and Addictions” course in November 2019 which was held by the Addictions Foundation of Manitoba, and they supported the drafted recommendations entitled “Prevention: Low-Risk Drinking Guidelines” for those 65 and older (noted below).

 

Low-Risk Drinking Limits (65+)

    • Women: No more than 1 standard drink per day, with no more than 5 drinks in total per week.
    • Men: No more than 1-2 standard drinks per day, with no more than 7 per week in total.
    • Non-drinking days are recommended every week.

Source: Canadian Coalition for Seniors’ Health. Canadian Guidelines for Older Adults. Prevention, Assessment, and Treatment of Alcohol Use Disorder, 2019.

 

These drafted guidelines are more in line with what I would recommend. I have seen what alcohol dependence can do to people and it is heartbreaking. And as noted in a previous post here on my website, to help preserve cognitive health, experts recommend no more than 2-4 drinks per week (see my Memory Rescue book review.)

For those who have a drinking problem, there is often stigma and shame attached. Many people can’t abstain or reduce their drinking behaviour on their own (harm reduction) and need help. If you or someone you know has a drinking problem, addiction or dependence, please contact the Addictions Helpline in your area.

> Addictions Helpline Canada 

> Addictions Helpline USA

AA 12-Step (https://www.aa.org/) or Smart Recovery (https://www.smartrecovery.org/) are peer support options to consider as well.

If you are considering getting on top of your drinking problem and need someone to talk to, please contact me and I can assist you in finding the help you need.

Angela G. Gentile, MSW, RSW

 

References:

https://www.psychiatry.org/patients-families/addiction/what-is-addiction

https://amho.ca/wp-content/uploads/Mon-300pm-IP1-3a-Older-Adults-with-Alcohol-Related-Problems-Best-Practice-Guidelines.pdf

https://www.canada.ca/en/health-canada/services/substance-use/get-help/get-help-problematic-substance-use.html

https://www.samhsa.gov/find-help/national-helpline

https://www.aa.org/

https://www.smartrecovery.org/

https://www.drinksenseab.ca/drinksense-tips/seniors/

https://ccsmh.ca/alcohol-guidelines/

“A Standard Drink” image source: https://studentaffairs.lehigh.edu/content/what-standard-drink

 

 

 

 

The ​Long Road to Recovery

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Anyone who has had or has cancer or any other chronic illness or disease knows there is a certain amount of time when they feel they are truly on the road to recovery, recovered, or have discovered their “new normal.” I am one of those people.

I was diagnosed with anal cancer in April 2017. I finished treatment in August 2017. One and a half years later, I can say I am starting to feel “recovered” for the most part – “still recovering” in other areas –– and have discovered my new normal.

My new normal includes ongoing and long-term physical rehabilitation as a result of pelvic radiation damage. I am not complaining (radiation saved my life!), I am just sharing that although some people look great after a big ordeal like cancer, there could be ongoing battles that you may know nothing about. Invisible wounds and scars are very common for people who have experienced cancer.

Recently I attended an art show, and I received a few compliments on my appearance (the picture above was taken at the end of a Hawaiian vacation last month). I know I am feeling much better physically, and my self-image is shaping up. My hair is almost all grown back and highlighted again; I am back to yoga once weekly, and I have started back on my elliptical and doing stretches and weights. I even started wearing my FitBit again. My modest goal of 6,000 steps daily is still a ways away, but at least I am working towards it.

I have also been enjoying my new “intermittent fasting” lifestyle and my relationship with food. I am feeling in control of my life and my body. It’s taken almost two years, but I finally feel like each day I feel better and better.

I am enjoying moderating and managing support groups on Facebook. The “Anal_Cancer Support” group on Facebook is doing amazingly well and has recently achieved the 10-year milestone and the 300th member. Having cancer has expanded my social network by leaps and bounds. A profound and harrowing experience can bring more people into your life – if you want it. You just have to open up and ask for it.

The “Dementia Caregiver Solutions Support Group” is also growing and the admin team recently expanded to include two new moderators who are actual caregivers. They join three professionals to moderate and keep things on track. I find comfort in knowing I have given caregivers this safe forum to share, vent, and get advice for such a difficult time in their lives.

I am also pursuing other volunteer opportunities to help me reach more people who may benefit from my experience, passion, and support. I seem to have an infinite amount of “help” to give, and I am looking for ways to do so –– in a way that will keep me balanced and not over-taxed.

I continue to write for a company called Trualta. I am enjoying my writing projects and look forward to writing for more companies and individuals as the opportunities present themselves.

I am also helping people get married, sort out their problems, write books, develop websites and more. I am starting to consider finishing up my book on aging well (this will be my fifth book!).  Where all this will take me? Who knows. The long road to recovery takes us places that we never dreamed of. I am looking forward to continuing on this journey.

Angela G. Gentile, MSW, RSW

 

Caring for Parents with Memory Issues (Video; 28 minutes)

 

 

Where does one begin when memory problems become an issue with an aging parent?

Issues such as getting a diagnosis, terminology (What is the difference between Alzheimer’s and dementia?), resources (Book: Caring for a Husband with Dementia; App: Dementia Caregiver Solutions for iOS; Alzheimer Society), sundowning, and managing difficult behaviours are all discussed in this half-hour video.

Check out my video interview with Nancy Baker from Healing Healthy with Nancy called “Caring for Parents with Memory Issues.”

 

Angela G. Gentile, MSW, RSW

 

Keywords: Dementia, Alzheimer’s, Book, App, Essential Oils

Chair Exercises for Older Adults or those with Mobility Limitations

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Photo credit: jill111 – pixabay.com

I was approached by Joseph Jones at California Mobility to provide my recommendation on how to help an older adult with dementia stick to an exercise routine. My comments are in the article 21 Chair Exercises for Seniors: A Comprehensive Visual Guide.

This extensive guide on chair exercises for older adults (or anyone with mobility issues) includes easy-to-follow videos, helpful images, and lots of great tips on chair exercises. These exercises can be adapted for anyone! Please check out the article for helpful tips on keeping active, at any age.

Age well my friends!

Angela G. Gentile, MSW, RSW

 

 

 

“Improving Your Memory” –– A Great Handbook for Those Concerned About Memory Changes (Book Review)

What do you get when two clinical social workers who work in a geriatric centre write a handbook on how to improve your memory skills? A fine little guide for helping older people who are concerned about the changes in their memory!

Janet Fogler and Lynn Stern team up in “Improving Your Memory: How to Remember What You’re Starting to Forget” (2014) in this fourth edition. Originally published in 1988, these social workers have created the book that I have been looking for. In this fourth edition, they have included the smartphone and other technologies that are helpful to us as we manage our daily tasks and are challenged by our aging minds and bodies.

The paperback (168 pages) is medium-sized and is packed with real-life stories and examples to help the reader understand the concepts. There are also quizzes throughout to help the reader apply the knowledge learned (to help one remember!). It is divided into four parts:

  1. How memory works
  2. How memory changes as we age
  3. Factors that affect memory
  4. Techniques for improving your memory

I cracked open the book and dived into section four, as I was eager to see what techniques the authors were recommending. They offered some great ideas, and even ones I had not heard of before. One of them had to do with switching your ring or watch to your other hand or wrist, as an indicator that you had something to remember. It is much like the classic “tying a string around your finger” trick. I found some of the mental exercises fun and a little tricky, and I enjoyed trying out some new skills to help me remember things. The one example for myself that comes to mind is when I am attending an appointment and I have to park in a large parkade. I will use an “active observation” technique so I won’t forget where I left the car!

The first three parts of the book are very easy to understand and come with an illustration of “A Model For How Memory Works.” For us visual learners, these kinds of diagrams are helpful. Encoding (getting something to stick) and retrieval (being able to recall something) can become a little more difficult as we get older, for a variety of reasons. The authors explain, in simple language, why these things happen and how we can try to combat them. Whether our forgetfulness is due to stress, grief, depression, poor concentration, medications, or illness, memory problems can cause added stressors. The authors give some good advice in the appendix on Alzheimer’s Disease and Related Dementias; “What is good for your heart is also good for your brain, so monitoring heart disease, diabetes, stroke, high blood pressure, and high cholesterol is important” (page 142).

I was surprised to learn the book doesn’t talk about “mild cognitive impairment” and the prevalence rates of Alzheimer’s disease and other related dementias. Knowing that the risk of Alzheimer’s disease increases with age is important to know, but not knowing the level of risk does not allay any fears or concerns one may have. (The World Health Organization estimates, of those 60 and over, 5 to 8 people per 100 will develop dementia.)

I also noticed the absence of the terms “mindfulness” and “meditation,” as those two terms are used quite often in most of the current brain health literature I have been reading. Fogler and Stern mention how alcohol can negatively affect your memory, but they omitted any mention of drugs. Interestingly the nutrition section has no reference to supplements. I also observed God, higher power, and spirituality are not discussed.

Overall, a highly recommended guide and workbook for those who want to learn about: how the brain stores and retrieves information (in our “working” and “long-term” memory); what happens to the aging brain; what may cause memory problems; and tips and techniques on how to maximize your chances of remembering things. I’ll leave you with these two tips: “Much of what is called ‘forgetting’ is a lack of paying attention” (p. 137); and “Study after study shows that increased fitness levels result in improvement on cognitive tests” (p. 64).

Angela G. Gentile, MSW, RSW
Author/Specialist in Aging

www.AngelaGGentile.com

“Brain Rules for Aging Well” Misses the Mark – Book Review

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Dr. John Medina’s book, “Brain Rules for Aging Well: 10 Principles for Staying Vital, Happy, and Sharp” (2017), disappointed me. Perhaps I had high expectations as I was impressed with his first book “Brain Rules.” He has labeled himself the “grumpy neuroscientist” and his writing in this book shows. The hefty price of the hardcover ($36.99 CAD) made me believe that the information contained within must be good. As a specialist in aging, and someone who is very interested in the concept of “aging well,” I had to take a look.

I was encouraged by most of the reviews that this book was full of useful and helpful strategies to help one age well. As I dug in, I quickly realized that the book’s premise was inspired by the findings of an experiment from 1979 known as the “counterclockwise study” (Langer).  This was a very small study based on the experience of eight seventy-year-old men who were “stereotypically old.” For one week they were subjected to a time warp –– and lived as if it were 1959. After being immersed in the happy days of old, they came out seemingly younger –– happy with improved postures, hearing, and vision. Their hand grips strengthened and they moved with improved ease. As a woman in my fifties, I started to doubt how this book could adequately cover the topic of aging well – and my doubts were confirmed.

The book is divided into four sections, with the proposed “10 Brain Rules for Aging Well” which Medina starts and ends with as the guiding principles. Parts called Social Brain, Thinking Brain, Body and Brain, and Future Brain with a handy index at the end comprises the layout of the book. He refers to many scientific studies and other resources, and he directs us to “Extensive, notated citations at http://www.brainrules.net/references.” I found this style of referencing quite odd, and it was difficult to find what I was looking for. When I sit down to read a book, I don’t want to have to go to the internet to find the references. Also, the way the references are listed doesn’t make it easy to find what you are looking for.

I found myself bored with all the scientific jargon and his stories to help explain some of the complicated workings of the brain didn’t hit the mark. I ended up skim reading through quite a bit. Some of his aging well advice, such as engaging in friendly arguments and playing certain video games were quite surprising to me. I have yet to understand how a specialist in brain research would suggest arguing with people and playing video games as part of a good plan for overall brain health.

I liked the summaries at the end of each chapter. Medina’s advice about exercise, healthy diet, friendships and “say no to retirement” were well-taken. I found the discussion on the updated term “working memory” for the outdated term “short-term memory” interesting.  The personal stories he shares were endearing, especially the one about nostalgia, reminiscing and the “our song” syndrome he and his wife share.

The book was apparently well-proofed and edited (as Medina notes in his acknowledgments); however, I found two glaringly obvious errors. The first was on page 104, where Medina mistakenly tells us that reading from books 3.5 hours a DAY will help reduce our risk of dying by a certain age when compared to those who didn’t. In actuality, the research states it is a 30-minutes-a-day activity, which translates into 3.5 hours WEEKLY.

The second error, which I was astonished by (as an author and editor myself), was on page 164. Medina was talking about research on exercise done with people with limited mobility. He said that the participants were “assessed by a test called” and there was a blank space after that. The next paragraph started with a period. Perhaps that was the period that he deliberately omitted back in the introduction on page 7? I’d be pretty ticked if I were Medina, knowing this one slipped by all the reviewers.

I believe this was a good attempt by Medina to write a book on Aging Well; however, his dated references to works from 30-40 years ago (e.g., Hauri’s book No More Sleepless Nights, and the movie Cocoon) made me less confident in thinking he was using fresh and current research. This book was a good attempt at starting the conversation about brain health and aging well, but I think he has a lot more reading and researching to do on the subject. One last thought –– I wish he’d avoid using the term “elderly.” That’s a term we are getting away from in the aging well literature when discussing older adults. I believe mainstream media is also moving away from using that term.

Angela G. Gentile, MSW, RSW

www.AngelaGGentile.com

 

 

 

 

 

 

Memory Rescue by Dr. Daniel Amen (2017) – Book Review

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I am a geriatric mental health clinician, and frequently I am asked: “How can I improve my memory skills?” The usual recommendations from doctors are, “Exercise and learn new things.” I have been on a quest to find some other tips and tools that people can use to help improve or maintain their brain and memory functions as they age. This need has led me to try to find the perfect book to recommend to those who are looking for more information. “Memory Rescue” has some useful information but it’s not the book I was looking for.

I purchased a copy (Amazon) of psychiatrist Dr. Amen’s book “Memory Rescue: Supercharge your brain, reverse memory loss, and remember what matters most” which has a second subtitle, “The official program of the Amen Clinics.” The Amen Clinics are found all over the USA, and the services and programs offered there are to help people with various mental health and brain health concerns (such as memory loss, ADD, and traumatic brain injury).

This book starts out with 20 testimonials and reviews which is very impressive until I realized they were all from men. The male-dominated view about memory problems and the Amen Clinic program was very strong. The only female presence I felt was from Dr. Amen’s wife, Tana, which was very sparse. There were also a handful of case studies that were about females. As a woman reader and professional, I wish there had been a more balanced perspective.

The overall takeaway of this book, for me, was that this was a big advertisement for his Memory Rescue Program that he offers through his Amen Clinics and the MyBrainFitLife.com website. There were case examples of how his clinics help people, and there were lots of “SPECT” (single photon emission computed tomography) scan photos to “prove” it. Even after looking at numerous SPECT images, I still wasn’t 100% sure what I was looking for. I felt these images were a bit overkill.

Here in Canada, we don’t have access to Amen Clinics, and SPECT scans are reserved for those exceptional cases (which I am still not sure what those cases are.) We tend to favour CT, MRI and PET scans.

Ultimately I was looking for concrete tips on “how to improve memory skills” and “how to improve memory problems.” Amen’s program is intended to enhance your mood and memory skills using the BRIGHT MINDS risk factor approach, with each letter standing for a component of the “ultimate memory formula.” Blood Flow, Retirement and Aging, Inflammation, Genetics, Head Trauma, Toxins, Mental Health, Immunity/Infection Issues, Neurohormone Deficiencies, Diabesity, and Sleep Issues. There was quite a lot of repetition throughout the book, with the main recommendations being: Exercise, Nutrition, Nutraceuticals (and supplements).

On pages 28-30, you can take the “Amen Clinics’ Early Warning Signs Questionnaire.” Your score will provide you with a risk of “significant memory issues,” from low to high. Amen states, if you are at moderate to high risk, it is important to get a thorough medical evaluation.

This book brought up some new terms and concerns. Those including my need for nutraceuticals (which Amen sells on his BrainMD website), getting tested for the APOE gene (related to Alzheimer’s disease), an integrative medicine doctor (but doesn’t say where I can find one). He was heavy on the recommendation of Gingko Biloba (a natural supplement that has limited research evidence to help prevent memory problems, see GEM study). He was anti-marijuana use and wasn’t that clear on what the recommendation was for alcohol use (was it 2-4 servings a week or only 2?).  He suggests coconut oil is good for our brains, but I have read that it is not good for our bodies. There is a lot of reference to the Memory Rescue Diet, but it is not discussed until chapter 16. There are a lot of references to the Bible, which surprised me. He also suggested that “praying to release your worries and to rejoice over the good things around you can help reduce your risk of mental health problems” (p. 337).

Ultimately, as I mentioned earlier, I was looking for specific tips and techniques to help people improve their memory skills. The most helpful part of the book in this regard is found in Chapter 17 “Sharpen Your Memory––Brain Workouts for a Richer Life.” He provides a lot of suggestions of what activities can help strengthen the different areas of the brain such as playing Scrabble, completing crossword puzzles, and learning to play a new musical instrument. He suggests engaging in “map reading” without a GPS device. He’s a big fan of table tennis and other coordination activities, such as dancing, yoga, and tai chi. He says we should travel to new and interesting places and develop relationships with smart people. Music, especially classical, can enhance memory and cognitive function. Surprisingly, I didn’t find the instruction to “pay attention” to what we are doing, which I believe is an essential tip for being able to remember things in the first place. He doesn’t speak to word-finding difficulties, either, which is one thing a lot of older folks are initially concerned about.

The book is well-referenced, and he claims to walk the talk. The index is sub-par, and it could have been enhanced to make finding things a lot easier to find. Some of the reviews online of Amen Clinics state it is a very costly program. There is no mention of costs, but there is mention that the process of improving cognition or mental health often takes months. It’s assumed the program costs thousands of dollars. The MyBrainFitLife.com online program also has a cost, a yearly fee of USD 99. There are some free Brain Assessments (which I completed) which can help one decide on the level of risk one is at. If someone already has memory impairment, a caregiver or loved one will need to read this book as it tends to have some jargon and technical language, and there is lots to read and learn about.

I would recommend this book to anyone who is interested in the Amen Clinic Memory Rescue Program. For specific information on brain health and tips for improving memory skills, Chapter 17 is where you want to start. If you believe in God or a higher power, this will also confirm your faith in how prayer and scripture can support your mental health. The book is somewhat repetitive, however, it drives home the main message––that having a healthy body means better chances for a healthy brain.

I’ll leave you with this: Amen provides hope––“Yet new research suggests that a ‘memory rescue’ program, like the one presented in this book, can dramatically improve memory and can prevent and sometimes even reverse some forms of dementia. Given how most doctors approach this issue, however, you cannot count on traditional medicine to rescue your memory.” (p. 4).

Angela G. Gentile, MSW, RSW (Specialist in Aging)