The holidays can be a stressful time for Alzheimer's patients and their caregivers. Here are some things to consider.

Alzheimer's Caregiving During the Holidays

The holidays can be a particularly stressful time both for caregivers and for people with Alzheimer's. Many caregivers choose to spend the holidays with the person they care for, whether they live with them year round or invite them to stay over the holiday period. Others have a loved one living in a care home. The following information is intended to help everyone concerned to have a relaxing and enjoyable break.

Forward planning

If a person with Alzheimer's is visiting you over the holidays, there are many ways in which you can prepare for the visit and make things easier for both yourself and for your guest.

If the house is unfamiliar to your guest, or they become disoriented easily, putting labels on doors could help - for example, the bathroom, the kitchen, the person's own room. You could also label kitchen cupboards and drawers to help your guest find their way around more easily and feel more at home.

Think about any specialist equipment you might need, and buy or borrow it well in advance. For example, does the person need slip-proof mats or large-handled cutlery? Do you need to get extra supplies of incontinence pads?

Asking for help

Don't be afraid to ask your friends and neighbors for help. They may be happy to bring over a cooked meal for you, do a little bit of shopping, or sit with your guest for an hour or so while you have some time to yourself. Don't refuse help if somebody offers it - they may not think to offer again. If you have children, try to enlist their help - give them some tasks that they can be responsible for and explain what a difference their help makes.

Safety and security

The house may become quite noisy and busy over the holiday season, making it easier for people to leave the house unnoticed. If you are worried about your guest leaving the house alone and getting lost, talk to other members of your family and decide on a plan of action. Can you remember to keep doors leading onto busy roads closed, or even locked? Try to enlist someone to accompany the person outdoors if they 'wander'.

Remember to keep spare keys in a safe place. Check the house in the evening to make sure that doors are locked and that no windows have been left open etc.

Check your house carefully for anything that might be dangerous. Consider the following points:

• If your guest is likely to get up at night, leave a light on in the hall when you go to bed and a night light in the bedroom.
• Make sure there is a light on in the bathroom or toilet so they can find their way at night.
• Tidy away or tape down any trailing flexes, remove rugs that a person could trip on, and remove clutter or objects lying on the floor. Make sure that nothing is ever left on the stairs.
• Lock away any medicines and dangerous substances such as bleach and paint.
• If your guest no longer seems to recognize danger make sure that potentially dangerous implements, such as sharp knives, are removed from the kitchen.
• If you have an open fire, make sure that a fixed fireguard is fitted.

Food and mealtimes

Food and eating plays a large part during the holidays, and you may feel anxious about how to fully involve your guest in this, especially if they have lost their appetite or they have difficulties eating. Here are some tips:

• Don't overload your guest's plate; although many people eat a lot over the holidays, a very full plate can be quite daunting for someone who has difficulties eating.
• If they eat very slowly, consider buying an insulated plate to keep their food warmer for longer, or heating it up in the microwave if it gets too cold.
• Check whether they are happy to eat with the rest of the family; they may prefer to eat in a different room, at a different time or on their own. If at all possible, be flexible and try to accommodate this.
• Try to be open minded about any unusual food combinations that your guest chooses. They may also enjoy their food with strong or spicy sauces or seasonings that seem strange to you - if this is the case, try not to object.

Sources:

• Therapeutic Caregiving: A Practical Guide for Caregivers of Persons with Alzheimer's and Other Dementia Causing Diseases, Barbara J. Bridges, R.N., M.S.N., M.S.H.C.M., M.B.A., 1998.
• Alzheimer's Society - UK - The Christmas Holidays

Treating the Alzheimer's patient with respect and making them feel valued are important parts of the Alzheimer's caregiver's job.

Understanding and Respecting the Person with Alzheimer's

It's very important that people with Alzheimer's are treated with respect. If you can understand what the person is going through, it might be easier for you to realize why they behave in certain ways. It is important to remember that a person with Alzheimer's is still a unique and valuable human being, despite their illness.

When a person with Alzheimer's finds that their mental abilities are declining, they often feel vulnerable and in need of reassurance and support. The people closest to them - including their caregivers, friends and family - need to do everything they can to help the person to retain their sense of identity and feelings of self-worth.

Feeling Valued

The person with Alzheimer's needs to feel respected and valued for who they are now, as well as for who they were in the past. As a caregiver, there are many things you can do to help:

• Try to be flexible and tolerant.
• Make time to listen, have regular chats, and enjoy being with the person.
• Show affection in a way you both feel comfortable with.

Things to remember

• Each person with Alzheimer's is a unique individual, with their own very different experiences of life, their own needs and feelings, and their own likes and dislikes.
• Although some symptoms of Alzheimer's are common to everyone, Alzheimer's affects each person in different ways.
• Everyone - including friends, family members, caregivers, and the person with Alzheimer's - reacts to the experience of Alzheimer's in their own way. Alzheimer's means different things to different people.

There are lots of things you can do to help the person with Alzheimer's feel good about themselves. Here are some suggestions.

As someone caring for a person with Alzheimer's, you need to take account of the person's abilities, interests and preferences. These may change as the Alzheimer's progresses. It's not always easy, but try to respond flexibly and sensitively.

Supporting other people

If anyone else is involved in caring for the person with Alzheimer's, give them as much background information as possible, as well as information about their present situation. This will help them see the person they're caring for as a 'whole person' rather than simply 'someone with Alzheimer's'. It may also help them to feel more confident about finding conversation topics or suggesting activities that the person may enjoy.

If someone is not used to being around people with Alzheimer's, here are a few things to emphasize:

• Alzheimer's is nothing to be ashamed of. It is no one's fault.
• If the person tends to behave in ways that other people find irritating or upsetting, this may be because of the Alzheimer's - it's not deliberate.
• The person with Alzheimer's may remember the distant past more clearly than recent events. They are often happy to talk about their memories, but anyone listening needs to be aware that some of these memories may be painful.

What's in a name?

Our sense of who we are is closely connected to the names by which we call ourselves. It's important that people address the person with Alzheimer's in a way that the person recognizes and prefers.

• Some people may be happy for anybody to call them by their first name or nickname.
• Others may prefer younger people, or those who do not know them very well, to address them formally and to use courtesy titles, such as Mr. or Mrs.

Source:

Alzheimer's Society UK - Carers' advice sheet 524

Memory loss creates a host of problems in late-stage Alzheimer's patients. Some suggestions for coping with that.

People with memory problems find it very hard to take in new information and remember it.

• Keep information simple and repeat it frequently.
• Break down new activities into small stages.

Avoiding extra stress and Alzheimer's

If the person is tired, unwell, anxious or depressed, they will find it even more difficult to remember. Memory problems will also become more apparent if they try to do more than one thing at a time or if they are distracted by noise or bustle.

• If you think that the person may be ill or depressed consult the GP.
• Make sure the person has plenty of support. Try to reduce stress as much as possible.
• Help them concentrate on one thing at a time.
• Try to make sure that there are no distractions.
• Provide verbal cues rather than ask questions. For example: 'Here is David, your nephew, come to see you', rather than 'Do you remember who this is?'

Maintaining independence and Alzheimer's

• The person should be helped to remain independent for as long as possible. However, you will need to take certain precautions if the person is at risk because of their forgetfulness.
• Help the person to continue to do things for themselves, using frequent reminders and doing things 'with' them instead 'for' them.

Regular routine and Alzheimer's

Although variety and stimulation are important, too many changes will be confusing.

• A regular routine will help the person feel more secure and make it easier for them to remember what usually happens during the day.
• Leave things in the same place so that the person can find them easily.

Memory aids and Alzheimer's

In the early stages, memory aids such as lists, diaries and clear, written instructions can be helpful in jogging memory if the person is willing and able to make use of them. However, you need to be aware that, as the Alzheimer's progresses, they may not be able to understand what the aids are for.

Loss of sense of time and Alzheimer's

You may find that the person begins to lose their sense of time quite early on in Alzheimer's. The person may find it hard to judge how much time has passed because they can't remember what they have done or what they are going to do that day.

Try to keep to a regular routine. Tactful reminders of the day and time and what you are going to do next may help.

Fact and fiction and Alzheimer's

As Alzheimer's progresses, facts may become confused with imagination. It is usually best not to argue with the person. Try to put yourself in their situation and understand what they might be trying to say or what they are feeling and relate to that.

If you do have to contradict the person or correct them do so in a way that saves face and shows that you are not being critical.

Living in the past and Alzheimer's

As the person's short-term memory gradually deteriorates they may find memories, feelings and routines associated with the past more real than those in the present.

Sometimes they may even seem to be living in the past and insist, for example, that they have to wait for their mother to take them to school. Try not to contradict. Use this as an opportunity to relate to what they may be remembering or feeling. You might encourage them to talk about the past or comfort them if they seem sad.

Lack of recognition and Alzheimer's

People with Alzheimer's may eventually lose the ability to recognize people, places or things because their brain can no longer remember or put information together. They may even fail to recognize their own reflection in a mirror and think it someone else, or they may worry that a relative or close friend is an intruder in their home.

Tactful explanations and reminders can often help to reassure the person and enable them to continue to make some sense of their environment and the people around them.

It is very distressing if the person no longer recognizes you or others close to them. Talk to someone you trust about how you feel.

Sources:

• Alzheimer's Society - UK
• Alzheimer Society of Canada. Practical help

A ketogenic diet and ADHD treatment have, up until recently, rarely been discussed in conjunction with one another. While research on new ways to manage the symptoms of ADHD is ever emerging, much of that research is now focused on the connection between nutrition and ADHD, and, more specifically, the use of a ketogenic diet and ADHD. Although there are mixed opinions in the mental health field, many have experienced the behavioral and cognitive benefits of following a ketogenic diet for ADHD.

The Ketogenic Diet and ADHD

How would the ketogenic diet be helpful to a person with ADHD? First, it’s important to understand how the ketogenic diet works.

The ketogenic diet was named as such based on the origin of the word ketogenic. “Keto” comes from the naturally occurring process within the body where small fuel molecules called “ketones” are produced. Ketones essentially “take over” to fuel the body when a person’s blood sugar (also referred to as glucose) is too low. Glucose levels often dip when a person is sleeping or during periods of dieting/fasting.  Ketones are capable of fueling the entire body, including the brain. Ketones are produced in the liver from the breakdown of fats.

Following a ketogenic diet, the body switches almost entirely to running off of fat. This causes insulin levels to dip to very low levels, and facilitates the quick burning of fat. Of course, if someone is trying to lose weight, the ketogenic diet can be hugely beneficial, but there are other benefits as well. A ketogenic diet can promote increased sustenance of energy, improved focus and capacity to focus. Thus, it is not surprising people have found success when it comes to the ketogenic diet and ADHD.

Initially, much research regarding the ketogenic diet was done on children with epilepsy. These studies not only showed improvement in epileptic behaviors, but also in hyperactivity levels, attentiveness, and cognitive abilities (Neal, Chaffe, Schwartz, et. al., 2008).

What to Eat on a Ketogenic Diet?

As with any food for ADHD regimen, there are variations to the ketogenic diet. But, in general, to follow a ketogenic diet, one should focus on consuming low levels of carbohydrates, high amounts of healthy fats, and adequate protein.

• Meat – grass-fed beef, dark meat chicken
• Oil and Fats – the ketogenic diet incorporates high-fat oils and foods such as olive oil, coconut oil, heavy cream, nuts, avocado, butter
• Eggs – eggs are considered one of the most wholesome ketogenic foods, due to the healthy fat and micronutrients contained.
• Veggies – leafy greens (spinach, arugula), celery, asparagus
• Fish and other seafood – fatty fish such as salmon

What to Avoid on a Ketogenic Diet?

• Refined fats/oils - sunflower, corn, grapeseed, and canola oils, and trans fats such as margarine should be avoided.
• Grains – in terms of a ketogenic diet and ADHD, the consumption of grains (even whole grains such as wheat, rye, etc.) should be kept to minimal levels
• Sugar – sugar triggers the secretion of insulin from the pancreas, which can result in an increase in epinephrine.  Increased epinephrine can lead to the activation of reactions in the nervous system, causing in hyperactivity (ADHD and Sugar: How Sugar Affects Your ADHD Child’s Behavior).

Although more evidence is needed to provide a conclusive picture of the benefits of a ketogenic diet for ADHD, the current research points to its effectiveness in symptom management.

If you are thinking about the possible advantages of a ketogenic diet and ADHD for either yourself or your child, it is important to consult a medical professional or dietitian. This way, any potential nutrient deficiencies (or other medical complications) can be monitored.

article references

As Alzheimer's disease progresses, the patient may face severe difficulties with communication, reasoning, and memory loss. Find out some ways to cope with that.

As their Alzheimer's advances, the person you are caring for will still be able to carry out some tasks that are very familiar to them. However, they will probably be more interested in the process of doing the activity than in the end result.

• Break directions for an activity into small, manageable chunks, and make sure each task is very simple.
• Try to think of activities that have just one step, such as sweeping, dusting or winding wool.

Sensory stimulation and Alzheimer's

During the later stages of their Alzheimer's, the person you are caring for may have severe difficulties with reasoning and language, but they will still have their sense of taste, touch and smell. Find ways of stimulating these senses.

• As their condition progresses, some people with Alzheimer's find comfort in touching or stroking pieces of fabric or cuddly toys.
• Try giving the person a hand massage, using a scented oil such as lavender. This can be very soothing.
• A fish tank, a mobile or a window with a nice view may have a calming effect.

Tips for finding an activity

• Look for activities that are stimulating but that don't involve too many challenges or choices. People with Alzheimer's can find it difficult to process options.
• A sense of humor survives in many people with Alzheimer's, so look for activities that you will both find entertaining. Having a good laugh will do you both good!
• Alzheimer's often affects people's concentration, so that they can't focus on what they are doing for very long; they may need to do activities in short bursts.
• Alzheimer's can affect a person's motivation, so you may have to help them get started - don't be disheartened.

Memory loss in Alzheimer's

If you are caring for a person with Alzheimer's you will want to find ways to help them cope with memory problems so that they can retain their confidence and independence for as long as possible. Here are some suggestions.

Loss of memory is often one of the earliest signs of Alzheimer's. In older people it may be mistaken for the normal forgetfulness people experience as they grow older or when they are very stressed. However, it will become apparent later that the person's memory problems are severe and persistent, and are accompanied by changes in thinking and feeling which make it more difficult for them to cope with everyday life.

Everyone is different

Memory has many different aspects and people with Alzheimer's will be affected in different ways. You may find, for example, that the person retains memory for certain skills until quite a late stage, or that they surprise you with particular facts or experiences that they can still recall, though they are very forgetful in other areas.

Try to be flexible and patient and encourage the person to remember what they can without putting pressure on them in any way.

Memory for the past

Most people with Alzheimer's remember the distant past more clearly than recent events. They may have difficulty in recalling what happened a few moments ago but can recall their life when they were much younger in great detail. However, even these long-term memories will eventually decline.

• The person may be anxious about their memory loss, particularly in the early stages of Alzheimer's. Opportunities to share memories of the past can help to restore their sense of coherence.
• Talking about the past can often be enjoyable and help a person retain their sense of who they are.
• Use photographs, souvenirs and other appropriate items to help jog the person's memories of the past.
• If certain memories from the past seem very upsetting, try to give the person the opportunity to express their feelings and show them that you understand.

Sources:

• Activities: A Guide For Carers of People With Dementia (booklet), Debbie King, Alzheimer's Scotland, 2007.
• Alzheimer's Society - UK.

ADHD and stress team up to create problems for people. In addition to external life stressors, the brain-based ADHD increases stress from within. For people with ADHD, frustration and stress levels are almost constantly elevated because the ADHD brain doesn’t filter out stimuli, slow down, or easily concentrate (Ratey, 2017).

Stress isn’t always bad. Reasonable amounts of stress actually help the brain by increasing levels of norepinephrine and, if an activity is rewarding, dopamine. With ADHD, these two chemicals are deficient, so appropriate stress can be helpful. It’s when stress is out of control that it becomes unhealthy and ADHD stress and anxiety skyrockets.

Despite how it can feel, managing stress with ADHD is possible. Stockpile a toolbox of ADHD stress reduction techniques so you have multiple go-to activities that transform stressful moments to peaceful ones.

11 Stress Management Techniques for Adults with ADHD

The following tips are research-based and proven to help reduce and, on an ongoing basis, manage stress when you have ADHD. Everyone is unique, so pick the ones that are a good fit for you.

As you learn how to deal with both ADHD and stress, keep in mind that working with ADHD rather than against it will be the most effective. Allow yourself to remain busy and to take on challenges, for example, but adopt some strategies to keep frustration and anxiety in check.

Embracing your positive traits and strengths will help you reduce stress because you’re not struggling against yourself. As you focus on your strengths, try these 11 ADHD stress management techniques:

1. Think of your wellness in individual parts: physical, emotional, intellectual, spiritual, occupational, and social (Weiss, 2005) so you can take care of yourself in target areas
2. Create daily rituals, even brief ones, for relaxation; ADHD calming techniques for adults can involve movement and range from yoga to running
3. Find your purpose and passions because having meaning in what you do helps change stress from negative to positive
4. Every hour, pause and notice what’s going well; express gratitude
5. Engage in intense daily physical activity/exercise, from a 15-minute power walk or bike ride to time at the gym to participation in sports; martial arts can be especially good when you have ADHD because it decreases impulsivity as it increases self-control (Hallowell & Ratey, 2010)
6. Take breaks throughout the day to decrease the chances of becoming overstimulated
7. Practice deep breathing, as it positively impacts the brain and decreases stress; do it the moment you notice your stress levels rising, and even better, do it regularly to head off stress before it starts
8. Use visualization exercises to reduce stress; closing your eyes, breathing slowly and deeply, and picturing something that is calming to you relaxes muscles and reduces stress
9. Manage your environment by keeping it organized (clutter increases stress) and pleasing to be in; add soothing elements like a lava lamp; studies have shown that lava lamps are calming (ADDitude Magazine editors)
10. Use humor because laughter and lightheartedness reduce stress; hang humorous things where you work, take breaks and listen to a humorous audiobook or watch funny YouTube videos
11. Use ADHD stress toys; when you are stressed, fiddling with things releases pent-up negative energy, so keep things like fidget spinners, stress balls, kinetic sand, Silly Putty, Play-Doh, or any other item you can manipulate close at hand

Reducing stress means shifting aspects of your inner- and outer worlds so you respond both physically and mentally. Discover what makes you happy and helps you feel good in the six areas of wellness. When you’re experiencing stress, break it apart and do things to manage it in the moment and beyond.

Relaxation techniques for ADHD don’t have to involve sitting still. Doing something active and fun is often relaxing for people with ADHD. Experiment with the above stress management tips and do those that you like. You just might find that ADHD and stress won’t always work against you.

Exercise and activities help both the Alzheimer's patient and the caregiver.

How can activities help you as a caregiver?

• Boredom and frustration are the two most common causes of challenging behavior in people with Alzheimer's. If the person you are caring for is occupied and stimulated, some of the behavior that you find most difficult may lessen or even stop altogether.
• Sharing an activity that you both enjoy benefit you as much as the person you are caring for. It may also bring the two of you closer together, and help you find new ways to relate to each other.
• Discovering new ways to stimulate the person you care for can be satisfying, and may enable you to think differently about your caring role.

Talk with the person you are caring for to work out which activities fit in with their interests. Try to find imaginative ways to adapt their activities to their changing capabilities and moods. Here are some suggestions.

Exercise and Alzheimer's

Exercising together will help you and the person you care for. Exercise burns up the adrenalin produced by stress and frustration, and produces endorphins, which can promote feelings of happiness. This will help both of you relax and increase your sense of wellbeing. Exercise can help you develop a healthy appetite, enjoy increased energy levels and sleep better at night.

• Walking is a great form of exercise that provides a change of scene and some fresh air. Many caregivers find ingenious ways of arranging little trips, even if it is only to a local coffee shop.
• Swimming is another good all-around exercise, and the feeling of being in the water can be very soothing and calming.
• If you want something more sociable, find out if your local leisure or community center offers classes for older people, such as gentle stretching or tai chi.

Reminders of the past and Alzheimer's

People with Alzheimer's can often remember the distant past more easily than recent events. If you can find a way to trigger the more distant, pleasant memories of the person you care for, they may become more lively and interested.

• Talk about the past together, while looking at old family photos or books with pictures, or listening to old music.
• Make up a 'rummage box' of old objects that the person with Alzheimer's is interested in. Physically handling things may trigger memories more effectively than looking at pictures.
• Talking about the past in this way can trigger strong emotions in the person you care for, so it's important to be sensitive. You may uncover painful memories as well as happy ones. Alzheimer's damages the memory and the thinking and reasoning parts of the brain, but the emotions still remain intact.

In the early stages

In the early stages of Alzheimer's, the person will probably want to continue doing the things they have always done. People with Alzheimer's retain memory for some activities, depending on which part of the brain has been damaged. Activities such as reading, typing or playing the piano are not always affected. As their caregiver, you are the best person to help them keep active because you know them so well.

• Encourage the person to enjoy activities on their own.
• Provide encouragement and reminders.
• Put any equipment in a place where the person can see it and reach it easily.
• Use short sentences when you suggest what to do.

Activities and Alzheimer's

Knitting Someone who has been a skilful knitter may still be able to knit squares for a blanket.

Puzzles Someone who has enjoyed doing crosswords may still enjoy a simple puzzle book.

Social activities Play cards or board games, or do some gardening or baking together.

Around the home Men and women alike can enjoy helping with washing and drying up, laying the table or making beds. The end result may not be perfect, but it can give an important sense of achievement.

Music Even when other abilities are seriously affected, many people still enjoy singing, dancing and listening to music. Ask a friend to help you record a tape of the person's favorite pieces of music or songs for them to listen to.

TV and radio Many people with Alzheimer's enjoy listening to the radio. Television, however, can cause problems. Some people with Alzheimer's lose the ability to tell the difference between what is real and what is on screen, and can become distressed. They can also become confused by too much noise. Try watching television together, and choose programs with small sections of action or humor, rather than a program with an involved plot. Even a favorite soap opera may become confusing.

Sources:

• Alzheimer's Society - UK, Carers' Advice Sheet 505, June 2005.
• Keeping a Person With Alzheimer's Active and Happy, Rachel Pickett, web published Feb 2, 2006.

Symptoms of relationship anxiety are signs, sometimes subtle and sometimes glaringly obvious, that anxiety is causing stress, discomfort, and unhappiness in a relationship. Whether it’s one or both partners who have anxiety, relationship anxiety seems to take on a life of its own and causes damage.  Recognizing symptoms of relationship anxiety can help you cope with them and prevent anxiety from ruining your relationship.

In general, symptoms involve partners’ worry about themselves as well as about each other. Additionally, relationship anxiety symptoms involve worrying about the nature of the relationship itself.

Before we explore these in more detail, it’s important to note that there isn’t a set of symptoms that serves as a checklist for the presence of anxiety in a relationship. Each person experiences anxiety differently, and when two people become a couple, new worries come into the mix. Personalities, traits, and styles differ. Each relationship also takes on a life and personality of its own. The symptoms that follow are those that researchers and practitioners have found to be common in relationship anxiety. No one will experience all the symptoms. As you read, identify those that match you and your relationship.

Symptoms of Relationship Anxiety: Traits and Styles

People with relationship anxiety have similar worries (that they’re not good enough, that their partner will leave, or that something terrible will happen to their partner, for example). Not everyone handles those worries in the same way, however. Research conducted at Case Western Reserve University (2011) identified four primary interaction styles found in anxious relationships:

• Intrusive
• Cold
• Nonassertive
• Exploitable

Relationship anxiety symptoms reveal these traits in an anxious partner. Someone who is intrusive has a pattern of interaction like a helicopter, hovering over their partner, excessively checking in to make sure they’re okay or that they want to be in the relationship. A person who tends to be cold is highly critical, expressing worry though negative judgment. Nonassertion leads to avoidance out of fear of rocking the boat. Similarly, anxiety can make someone exploitable. They act warm, loving, and submissive, always giving in to keep their partner happy.

When a person with anxiety exhibits one of these traits, it could be a symptom of relationship anxiety. These behavior patterns, while unhealthy and ineffective in the long run, are an attempt to express concern for a partner and preserve the relationship.

Relationship Anxiety Symptoms: Thoughts and Behaviors

The four traits mentioned above cause specific thought patterns, emotions, and behaviors. The presence of any of these behaviors might indicate that you or your partner is experiencing relationship anxiety.

• Fear of opening up and showing vulnerability
• Fear of intimacy, including sexual
• Clinging
• Fear of conflict leading to avoidance of conversations
• Worry about your partner ending the relationship
• Mistrust
• Anger when worries are confirmed
• Irritability
• Controlling behavior ("How Abusive Relationships Cause Anxiety")
• Low self-esteem/self-doubt
• Overthinking your partner’s words, silence, gestures, expressions
• Projecting worries and fears onto partner and relationship
• Pushing your partner away
• Testing: What can I do wrong and still preserve the relationship
• Over-nurturing, smothering
• Detachment

These worries, fears, and behaviors are symptoms of relationship anxiety and signs that anxiety is coming between you and your partner. Fortunately, there are ways to cope with them and maintain your relationship.

How to Cope with Symptoms of Anxiety in Relationships

Relationship anxiety has a lot of traits and symptoms. To try to address them all at once is overwhelming. The most effective way to cope and manage symptoms is to start with something that is among the most bothersome.

Because these symptoms impact the person with anxiety and their partner, selecting the starting point together is ideal. Despite the discomfort, communicate with each other openly and honestly. Perhaps make a date and set the mood with a favorite meal and background music. Talk about the anxiety and issues in the relationship. What changes are most important to you both? Commit to working on them, and create a plan of action to move forward.

Some other ways to cope with relationship anxiety and move forward:

• Practice self-care. It’s healing and helps you value yourself
• Develop interests and involvement with others so you and your partner aren’t over-reliant on each other
• When you catch yourself avoiding anxiety-provoking situations, acknowledge your discomfort and then face the situation anyway
• Seek professional help for your anxiety  
• Go to couples counseling for help coping with relationship anxiety together

When anxiety consumes you, your partner, and the relationship between you, it doesn’t have to be the end of your relationship. Know your symptoms of relationship anxiety, target them, and reconnect with each other as you work to cope with and overcome these symptoms.

article references

Learn about the different stages of Alzheimer's disease and memory and behavioral changes that occur as Alzheimer's disease progresses.

• Alzheimer's Stage 1: No impairment
• Alzheimer's Stage 2: Very mild decline
• Alzheimer's Stage 3: Mild decline
• Alzheimer's Stage 4: Moderate decline (mild or early stage)
• Alzheimer's Stage 5: Moderately severe decline (moderate or mid-stage)
• Alzheimer's Stage 6: Severe decline (moderately severe or mid-stage)
• Alzheimer's Stage 7: Very severe decline (severe or late stage)

Alzheimer's disease can take between 8 and 20 years to run its course. Experts have documented common patterns of symptom progression that occur in many individuals with Alzheimer's disease and developed several methods of "staging" based on these patterns. Progression of symptoms corresponds in a general way to the underlying nerve cell degeneration that takes place in Alzheimer's disease. Nerve cell damage typically begins with cells involved in learning and memory and gradually spreads to cells that control every aspect of thinking, judgment, and behavior. The damage eventually affects cells that control and coordinate movement.

Staging systems provide useful frames of reference for understanding how the disease may unfold and for making future plans. But it is important to note that all stages are artificial benchmarks in a continuous process that can vary greatly from one person to another. Not everyone will experience every symptom and symptoms may occur at different times in different individuals. People with Alzheimer's live an average of 8 years after diagnosis, but may survive anywhere from 3 to 20 years.

The framework for this section is a system that outlines key symptoms characterizing seven stages ranging from unimpaired function to very severe cognitive decline. This framework is based on a system developed by Barry Reisberg, M.D., Clinical Director of the New York University School of Medicine's Silberstein Aging and Dementia Research Center.

Within this framework, we have noted which stages correspond to the widely used concepts of mild, moderate, moderately severe, and severe Alzheimer's disease. We have also noted which stages fall within the more general divisions of early-stage, mid-stage, and late-stage categories.

Alzheimer's Stage 1:

No impairment (normal function)

Unimpaired individuals experience no memory problems and none are evident to a health care professional during a medical interview.

Alzheimer's Stage 2:

Very mild cognitive decline (may be normal age-related changes or earliest signs of Alzheimer's disease)

Individuals may feel as if they have memory lapses, especially in forgetting familiar words or names or the location of keys, eyeglasses or other everyday objects. But these problems are not evident during a medical examination or apparent to friends, family or co-workers.

Alzheimer's Stage 3:

Mild cognitive decline
Early-stage Alzheimer's can be diagnosed in some, but not all, individuals with these symptoms

Friends, family or co-workers begin to notice deficiencies. Problems with memory or concentration may be measurable in clinical testing or discernible during a detailed medical interview. Common difficulties include:

• Word- or name-finding problems noticeable to family or close associates
• Decreased ability to remember names when introduced to new people
• Performance issues in social or work settings noticeable to family, friends or co-workers
• Reading a passage and retaining little material
• Losing or misplacing a valuable object
• A decline in the ability to plan or organize

Alzheimer's Stage 4:

Moderate cognitive decline
(Mild or early-stage Alzheimer's disease)

At this stage, a careful medical interview detects clear-cut deficiencies in the following areas:

• Decreased knowledge of recent occasions or current events
• Impaired ability to perform challenging mental arithmetic-for example, to count backward from 100 by 7s
• Decreased capacity to perform complex tasks, such as marketing, planning dinner for guests or paying bills and managing finances
• Reduced memory of personal history
• The affected individual may seem subdued and withdrawn, especially in socially or mentally challenging situations

Alzheimer's Stage 5: Moderately severe cognitive decline
(Moderate or mid-stage Alzheimer's disease)

Major gaps in memory and deficits in cognitive function emerge. Some assistance with day-to-day activities becomes essential. At this stage, individuals may:

• Be unable during a medical interview to recall such important details as their current address, their telephone number or the name of the college or high school from which they graduated
• Become confused about where they are or about the date, day of the week, or season
• Have trouble with less challenging mental arithmetic; for example, counting backward from 40 by 4s or from 20 by 2s
• Need help choosing proper clothing for the season or the occasion
• Usually retain substantial knowledge about themselves and know their own name and the names of their spouse or children
• Usually require no assistance with eating or using the toilet

Alzheimer's Stage 6:

No impairment (normal function)

Memory difficulties continue to worsen, significant personality changes may emerge and affected individuals need extensive help with customary daily activities. At this stage, individuals may:

• Lose most awareness of recent experiences and events as well as of their surroundings
• Recollect their personal history imperfectly, although they generally recall their own name
• Occasionally forget the name of their spouse or primary caregiver but generally can distinguish familiar from unfamiliar faces
• Need help getting dressed properly; without supervision, may make such errors as putting pajamas over daytime clothes or shoes on wrong feet
• Experience disruption of their normal sleep/waking cycle
• Need help with handling details of toileting (flushing toilet, wiping and disposing of tissue properly)
• Have increasing episodes of urinary or fecal incontinence
• Experience significant personality changes and behavioral symptoms, including suspiciousness and delusions (for example, believing that their caregiver is an impostor); hallucinations (seeing or hearing things that are not really there); or compulsive, repetitive behaviors such as hand-wringing or tissue shredding
• Tend to wander and become lost

Alzheimer's Stage 7:

Very severe cognitive decline
(Severe or late-stage Alzheimer's disease)

This is the final stage of the disease when individuals lose the ability to respond to their environment, the ability to speak and, ultimately, the ability to control movement.

• Frequently individuals lose their capacity for recognizable speech, although words or phrases may occasionally be uttered
• Individuals need help with eating and toileting and there is general incontinence of urine
• Individuals lose the ability to walk without assistance, then the ability to sit without support, the ability to smile, and the ability to hold their head up. Reflexes become abnormal and muscles grow rigid. Swallowing is impaired.

Sources:

• U.S. Administration on Aging - Alzheimer's Fact Sheet. Updated 3-26-07.
• Alzheimer's Association

Impulsivity is one of the underlying features of attention-deficit/hyperactivity disorder (ADHD) that disrupts someone’s life. The stereotype associated with ADHD and impulsivity is that of an adult who acts a lot like a hummingbird, flitting from one flower to the next without being able to stop. While this isn’t entirely inaccurate, there’s more to it than that. Understanding more about adult ADHD and impulsivity will help you manage it.

Expand Your Thinking About Adult ADHD and Impulsivity

There’s a misconception that people with ADHD are impulsive because they don’t know any better or don’t understand the consequences of their actions. Lack of understanding isn’t the issue. ADHD is not an intellectual problem, and despite some symptom overlap between ADHD and mild cognitive impairment, ADHD is not a cognitive disorder (Pollack, 2012).

Treating adults who have ADHD as if they were somehow less intelligent not only doesn’t help, but it can do harm. It can lead to low self-esteem and low self-efficacy as well as create problems in relationships, make it hard to stay productive and focused at work, and more. Knowing what impulsivity is not (it’s not stupidity or an inability to understand actions and consequences) is important. Equally important is knowing what impulsivity actually is.

The impulsive behavior of adults with ADHD is related to a lack of “behavioral inhibition mechanisms” (Selikowitz, 2009). Impulsivity is like having a minor little itch that, once noticed, absolutely must be scratched. It becomes the new, albeit temporary, focus.

Adult ADHD and impulsivity is less of an attention problem than it is a problem with maintaining consistent engagement (Surman & Bilkey, 2013). To someone living with ADHD, everything is an itch that must be scratched immediately. Impulsivity isn’t a lack of understanding; instead, it’s a lack of inhibition and engagement. The distinction means that impulsivity can be managed.

Adult ADHD and Impulsivity Control

Impulsivity is all-encompassing. Adults with ADHD can be impulsive in their thoughts, emotions, and actions. Impulsivity is also intense. “People [with ADHD] feel feelings more intensely, feel impulses more deeply, and are always on the verge of action” (Hallowell & Ratey, 2010, p. 264).

With heightened emotions, rapid and wandering thoughts, and an itch to move, concentration and focus can be extremely difficult. Adult ADHD and impulsivity control problems can include, but are not limited to, behaviors such as

• Taking actions or making decisions without thinking
• Engaging in risky behaviors (such as impulsive spending)
• Impatience
• Demanding instant gratification
• Loudness (in voice, in actions)
• General boisterousness and even destructiveness
• Failing to complete work and projects before jumping to something new

Strategies for Managing Adult ADHD Impulsivity

Adults with ADHD typically have a need for a fast pace in whatever it is they’re doing. Managing impulsivity control by attempting to slow things down will likely backfire. Instead, it’s important to work with your ADHD brain rather than against it. Here are some strategies for managing your adult ADHD impulsivity:

• Rather than berating yourself for being impulsive, ask yourself what specific problems you’re having because of impulsivity.
• Jot down those problems so you can return to them.
• Think about what you want instead of the problems caused by impulsivity. In other words, borrow from solution-focused therapy and ask yourself, “What will my life be like when impulsivity isn’t such a problem?”
• Setting a series of short-term goals that are easy to attain is helpful in managing impulsivity because you can experience success without getting bogged down, and you can move on to other goals.
• Also, establish longer-term goals for the bigger picture. Too many small goals can quickly begin to feel pointless and boring, thus creating more impulsivity. Being able to work toward an attainable goal helps keep your progress steady (having ADHD and successful relationships could be a bigger picture goal).
• Establish routines and structure. Knowing how you want and need your day to go as well as the necessary sequence of tasks can help you avoid the urge to scratch a random itch.
• Make meaningful, attainable plans and use lists to keep yourself on track. Write your lists in a way that’s meaningful and attention-grabbling for you.
• Multitask. It might seem counterintuitive at first. If you’re supposed to be concentrating on one thing at a time, wouldn’t multitasking make you more impulsive? Actually, research shows that multitasking can be good for adults with ADHD. It’s a strength-in-numbers concept. If you are focusing on a task and thus holding back an impulse to do something else, you’re activating the inhibitory network in your brain. Multitasking, because you’re focusing on multiple tasks, can strengthen this network and help you develop impulse control (Bank, 2015).

Using these ADHD impulsivity strategies is an effective way to enhance impulsivity control. ADHD and impulsivity in adults can be frustrating and interfere with life; however, you can take charge of your impulsive thoughts, emotions, and actions and prevent impulsivity from ruining your life.