Reminiscing and dementia (part 2)

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Benevolant Society

Provide an opportunity to learn about the pastA way of finding a connection with another person and sharing similar It is important to recognise that your view of someone else brings with itWe are all seen by others in different ways.

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The Benevolent Society, 2005,

ABN 95 084 045

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There are many ways you can view an older person e.g. as a mother,The way you think about someone else can also be influenced by yourYou may find yourself relating easily to one person but not another for aIt is important to look at the approach you take when engaging with anReminiscing Manual version 1,

Tips on approaching reminiscing

When engaging in a reminiscing activity with an older person use the following

approach:

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A person centred approach used with sensitivity, flexibility, awareness andA focus on positive interaction with emphasis on brief, high qualityIt does not matter if the enjoyment is for a short time or fleeting as it is stillBe aware of attempts to communicate as what we see as ‘difficultBe person focused and let the person talk about what is important to them.

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Give everyone the opportunity to interact:

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their experiences and feelings were most likely to be given

opportunities for conversation.

In one study it was found older people who were able to talk about

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have withdrawn completely as they may have given up altogether

on communication.

This same study emphasised the need to focus on those who may

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Spending time listening to a person with dementia says to them they areThe use of humor as a means of communication can catch a person’sIt is important to recognise the many factors that influence one’s life.

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It’s all in the approach: Engaging older people

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Follow up:Tricial Pursuit Activity

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Trivial Pursuit: Junior Edition

Thank you Lorelei for your suggestion of Trivial Pursuit. If you find that the standard games are not appropriate for your audience,make your own game. Thatcan be an activity in itself.

If you need help doing this, leave a question in the comment ares

Cognitive reserve and dementia

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Alzheimer's Caregivers Guide

Bruce Miller, director of the Memory and Aging Center at the University of California, San Francisco, and a leading memory loss researcher.

The work is based on research showing that people with dementia who participate in cognitively stimulating activities and are socially engaged have a better quality of life and suffer less depression.

At the same time, patients build up what is called "cognitive reserve," a resilience in the brain that seems to slow down or stop the disease's onset. said Joe Verghese, a leading neurology researcher at Yeshiva University's Albert Einstein School of Medicine in New York. So, for instance, people with large amounts of cognitive reserve might begin showing symptoms of Alzheimer's at 75, instead of at 70, he said.

The most common form of dementia, Alzheimer's is believed to be caused by abnormal deposits of proteins, called plaques and tangles, that may damage and destroy cells and nerves inside the brain. These deposits usually start in the part of the brain that plays an important role in memory and then affect the lobe responsible for planning, ordering and thinking. Eventually, they spread to the parts of the brain that regulate bodily functions, Verghese said.

Patients in the early and middle stages of the disease probably still have the brain plasticity to create new neurons and synaptic connections that might provide something of a bulwark against the disease or might shift functioning to areas of the brain that are unaffected or less affected, Verghese said.

Participants in Northwestern's eight-week project reported feeling more confident and able to cope with their diagnoses, as well as less isolated and depressed, according to Darby Morhardt, an associate professor and director of education at the medical school, who co-founded the project with Christine Mary Dunworth of Lookingglass.

"Alzheimer's disease doesn't completely eradicate the ability to think, create, form friendships and have fun," Morhardt said. "The images people have of Alzheimer's is devastating, but that's not how it starts."

This fall, Morhardt and Dunworth hope to write a curriculum manual so the improv program can be replicated across the country.

Therapies involving the creative arts might be especially effective because they infuse mentally challenging activities with meaning, emotion and a social connection, said Helga Noice, a psychology professor at Elmhurst College,

Noice and her husband, Tony Noice, an actor and adjunct faculty member at Elmhurst, recently received a $1.9 million grant from the National Institutes of Health to use functioning magnetic resonance imaging, or FMRI, to measure whether classes in the theater arts cause measurable changes to seniors' brains.

It is the first such study to look at the physical impact of the arts, and it builds on previous work they have done that shows acting classes improve cognitive functioning in the elderly, many of whom have memory loss.

"Theater is an especially powerful medium of expression for people with Alzheimer's, because it enables them to stand up in front of an audience and tell the people, both who care for them and who love them, how they feel," said Anne Basting, executive director of the Center for Aging and the Community at the University of Wisconsin at Milwaukee.

Basting, who has a doctoral degree in theater, looked into using the arts to help Alzheimer's sufferers as far back as 1996, when, she said, researchers were focusing on improving memory through reminiscence.

"I said forget memory and go to the imagination," Basting said. "It's about making it up in the moment, not about remembering the chronology of a life."

Basting created TimeSlips, a collaborative, improvisational storytelling process that emphasizes imagination over memory or logic. Even if a person in the advanced stages of Alzheimer's has just a syllable or a gesture left, that can be woven into the story, enabling him or her to contribute and bond with the group, she said.

"You can feel the connection, the sense of accomplishment and fun," Basting said. "For people with dementia living in nursing homes, that doesn't often happen."

At House of Welcome Adult Day Services in Northfield, where the staff is trained in the TimeSlips method, a book of stories recently was compiled and published with help from participants with memory loss.

"It validated them as people, their thoughts and feelings and their ability to be creative," said facility director Julie Lamberti.

More fun and active ideas for engaging an Alzheimer’s patient

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Alzheimer's Caregivers Guide

Gear activities to the patient’s ability to participate
Plan activities that the patient is interested in, such as art, cooking, walking, swimming, or gardening. Focus on enjoyment, not achievement.
If the person is lucid enough, involve them in making music, doing puzzles or crosswords, or playing memory games, card or board games. Or, the patient may passively enjoy hearing music, contact with pets, or sitting outside in the garden.

Use humor
Even when Alzheimer's patients no longer have the cognitive ability to understand your humor, they can still appreciate it. They may still smile or laugh and sharing that laughter can be a relief to both you and your charge. Use the same modes of humor as you always have: teasing, nonsense, clowning. Be even more silly than usual!

Get outdoors
Go for walks in the neighborhood, go for a drive, or spend time at a park.
Walking is often therapeutic, although the pace may not be as vigorous as you might like. Develop a style of paying more attention to the beauty and novelty of your surroundings as you walk.

Maintain an active social life
To counteract isolation and loneliness, encourage family and friends to stay involved. Take the patient to family gatherings if it’s comfortable to do so. Schedule visitors, to avoid surprises and have something to look forward to. Even if the elder with dementia does not recognize those who visit, the contact is nonetheless valuable for them.

Seek out organized group activities.
Senior centers and adult day care facilities usually provide opportunities for structured activities such as exercise, sharing meals, group games and socializing. Some programs are set up specifically to meet the needs of dementia patients. This will provide social stimulation for the patient and respite for you, the caregiver.

Join in
Sometimes the caregiver will want to join the patient in family gatherings or stay in the home when visitors are present. Caregivers can start feeling isolated and lonely themselves as more and more of their time is built around the elder’s needs. If the patient feels safe with the visitors, the caregiver can use the visiting time as an opportunity for relief and respite. Adult day care has similar benefits: social stimulation for the patient and free time for the caregiver.

Some Fun and Stimulating Dementia Activities

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Nursing Home Activities Resource

Dementia activities should focus on enjoyment rather than achievement. A caregiver would want these dementia activities to reduce boredom but not to over stimulate either.

Laughter is always the best medicine. Though the patient may not always understand your humor, they can appreciate a good tease, a little nonsense and some clowning around.

Movement is very important for many dementia patients, as they can become prone to sit for long periods in one place doing seated activities like board games and crosswords. Walks outside or mild exercises, either seated or standing, can help to get the blood moving again and ward off boredom and a sense of isolation if they've been without much group activity.

With Alzheimer's and dementia activities care should be taken to eliminate expected outcomes and focus primarily on the activity itself. Cognitive dysfunction makes remembering game rules, sequences and strategies very difficult, if not impossible in later stages of the diseases. Slower paced activities involving simple repetition can prove most effective. Sometimes it is just a fidgeting type of activity that can best keep these seniors occupied.

More next time

Using Humor for those with Alzheimer's disease

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Chicago Tribune
by Lisa Pevtow

To an Alzheimer's patient, there's nothing funny about forgetting to turn off the oven, losing a telephone number or misplacing books from the library. But turning those mishaps into punch lines might turn out to be therapeutic.

The idea that improvisational comedy might help those in the early to middle stages of Alzheimer's cope with their disease is being tested by the Cognitive Neurology and Alzheimer's Disease Center of Northwestern University's Feinberg School of Medicine and Chicago's Lookingglass Theatre Company

Not having to memorize lines or remember a story narrative might spur confidence by freeing patients from worry over lost words or thoughts, and actually stimulate their brain chemistry to forge new protections against further onslaught of the disease, researchers say.

A possible role for creative arts in improving life for those with memory loss is being studied nationwide. In the region, besides Northwestern's Memory Ensemble project, which will continue in the fall, Elmhurst College researchers are looking at whether theater classes have a measurable effect on seniors' brains, and in Northfield, a day services facility is encouraging spontaneous storytelling.

At a recent improv session, skits progressed unexpectedly: A pair of lovers morphed into a mushroom hunting expedition; an ice skating adventure became a camping trip.

"I don't know what I'm doing," one of the performers confided, "but it's freeing."

Susan Walsh-Haggerty, 63, of Oak Lawn, appreciated the experience.

"I've learned that I am imaginative, playful and creative," said Walsh-Haggerty, pausing to search for the right word. "I can be funny."

Mary Beth Roth, whose husband, Wolfgang Roth, 80, participated, said he couldn't tell her 10 minutes later what he'd done, but, "Every day after class, there was a lightness in his spirit. There was a buoyancy about him, a more positive attitude."

Wolfgang Roth, a former dean of Garrett-Evangelical Theological Seminary in Evanston and a retired Hebrew scripture scholar, was diagnosed with Alzheimer's in 2007. His wife said the class "opened an avenue of new experience for him." She recalled that during a skit about a student and teacher, her husband accidentally used the wrong word, but everyone laughed, because it was funny, and the skit just went in another direction.

The improv work is a........come back for more

Growing Connections: Gardening with Seniors

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Aging Care
By June Fletcher,

To grow a more meaningful and healthy connection with an elderly loved one, put on some rubber clogs and head out together to the garden.
At any age, gardening is one of the best activities we can do outdoors, several experts told AgingCare.com. It stimulates all of the senses; awakens our connection with nature and with each other; and rewards us with fresh flowers and juicy tomatoes. "It's restorative, even if you have dementia," says Dee McGuire, a horticultural therapist at Levindale Hebrew Geriatric Center and Hospital in Baltimore.
Gardening is also an excellent way for aging bodies to get a moderate-intensity aerobic workout, shed calories and stay flexible, according to a Kansas State University study. That's one reason why gardening remains popular with Americans well into their golden years. Indeed, about three-quarters of households age 55 or older participated in some form of lawn and garden activity in 2010, according to the National Gardening Association (NGA).
Still, there's no question that bending, lifting, kneeling, squatting, weeding and pruning—not to mention dealing with sun, heat and bugs-- all become more challenging as we grow older.
But there are ways to cope. Bruce Butterfield, the NGA's research director, says his mother was able to garden until her death at age 96 by growing flowers in about 70 big pots connected to an automatic irrigation system. "She placed them around the patio so she could get to them easily using her walker," he says.
Protection against pests and the elements is important, too, both for caregivers and seniors. New York dermatologist Arielle Kauvar says gardeners should slather on sunscreen and insect repellents before putting on clothes, so no area is overlooked. "And don't forget to protect your lips," Dr. Kauvar says, suggesting a lip balm with an SPF of at least 30.
Here are more tips for aging gardeners from these and other experts:
Rethink the Landscape
-- Reassess the yard with an eye to lowering maintenance. Wherever possible, remove lawn and replace it with ground covers, mulched beds, and paved areas or paths.
-- Add benches or chairs under shady trees.
-- Create raised beds to improve drainage and make harvesting easier. Lightweight plastic landscape timbers can be stacked to form raised beds at waist or wheelchair height, if necessary. Make the beds narrow, so anyone can reach into the center without straining.
-- Make vertical gardens by growing vining plants upward using trellises, tomato cages, bamboo stakes, fences, walls or arbors as supports. It will cut down on bending and make harvesting easier.
-- Change steps to wide, curving, gently sloping paths. Use pavers or fine gravel to line paths rather than wood chips or river rocks. Paths should be at least four feet wide to allow walker and wheelchair access, and wider at the end so wheelchairs can turn around.
-- Build high fences to keep out deer and other pests. Add latches and locks to gates if the gardener has memory problems and is prone to wandering.
-- Install an irrigation system to cut down on watering, and low-voltage lighting to improve visibility on paths and steps in the evenings.
-- Plant in containers using lightweight "soil-less" mixtures and resin or foam-walled pots to reduce weight. Put pots on casters.
-- Avoid hanging baskets, since they dry out quickly, require frequent fertilization, and can be difficult to reach.
Tend to the Gardener
-- Work in the morning and evening, when it's coolest.
-- Bring a water bottle to prevent dehydration.
-- Wear sturdy shoes, a broad-brimmed hat and gardening gloves.
-- Bend at the knees and hips to avoid injury.
-- Move from one activity to another to avoid stressing any particular muscle group.
-- Paint tool handles in neon colors or wrap them in brightly colored tape so they're easy to find if dropped.
-- Use manual shears instead of power hedge clippers to avoid accidents.
-- Hire labor (or commandeer adult children and grandchildren) to do the heaviest lifting, digging and grading.
-- If there's no room for a backyard garden, join or form a community garden.
-- If a garden-loving senior becomes bedridden, bring the outdoors inside. Plant a mini-garden in pots on the windowsill, or create a maintenance-free terrarium in an old glass or plastic container

Why socializing may delay dementia

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A recently concluded five-year study of a thousand initially healthy seniors yielded some remarkably upbeat findings (The Week, May 13). Go to church, volunteer for a charity, have lunch with friends – in other words, get out of the house and interact with your neighbors – and you’re 50 percent more likely to ward off signs of dementia. For the most socially active seniors, the ones getting out of the house all the time and doing more for and with others, the statistics are even better. They are 75 percent more likely to fight off mental impairments.

Whether or not the findings of this study stand the test of scrutiny, it is always a good idea to heed what Christ Jesus saw as the two great commandments. The second of the two is perhaps especially applicable here: “Thou shalt love thy neighbour as thyself” (Mark 12:31).
True, neighbor-to-neighbor love might, on the surface, appear as pretty casual – a friendly chat over the back fence, the get-together of a few friends for a barbecue, or a neighborly game of cards. Beneath those superficial niceties, however, is the truth of that second commandment. It goes deeper and involves harnessing thought to a holy purpose, to a healing action.
Living real neighborly love at times pushes an individual beyond his or her comfort zone, while fulfilling that holy purpose and meeting that neighbor’s need. One might, for instance, seek out practical ways to buttress someone’s hope that they are not forgotten, that life has not passed them by, that unhappy events have not drained their life of meaning.
Both the giver and the receiver of second-commandment-impelled actions are blessed. Both parties may even feel as if they’ve reaped a spiritual bonus – that hopeful feeling of having done something good for another. The defeating of old limitations and the winning of new freedoms is furthered.
One characteristic of various mental afflictions is their claim to march on unopposed, as if no power could halt them. Look at that claim closely though, and you realize it is a bid – albeit an unsuccessful one – to break the first commandment. It is a bid to pass itself off as all-powerful. But wait! Just because the carnal mind claims a disease has power does not make it a valid claim.
Look at what Jesus said of the first commandment: “Thou shalt love the Lord thy God with all thy heart, and with all thy soul, and with all thy mind, and with all thy strength: this is the first commandment” (Mark 12:30). There is one God. One ever-active Mind and Life. One power that is pure Spirit, and one creation that is purely spiritual. Your role is to love the one true God. Then the delusion that there are other powers begins to loosen, eventually to fall away entirely.
Consider a few truths that originate in the Mind that is God, and that abide at the core of your being – the truths of your spiritual clarity and focus; of your inerasable vitality and recall; of your God-given capacity for crisp and clear reasoning. These are native to who you truly are as the idea of pure Mind, the expression of unfading Life.
When you are out of the house and socializing with friends, it’s a great time to realize these spiritual truths. When you are in the house and alone, it’s another great time to realize them. Each spiritual truth lets in the light. The right resolve to remain active and alert comes into focus.
Monitor founder Mary Baker Eddy, because of the extraordinary demands on her time, had little opportunity for an active social life, especially during her later years. Yet she remained keenly active, purposeful, and alert all the way through a long and uniquely productive career. (For instance, for several years she gave a free pair of shoes to each needy child in her community.) Her primary work, “Science and Health with Key to the Scriptures,” has been the cornerstone to the prayers of countless readers, many of whom have sought, and found, freedom from a whole range of mental impairments.
Whether the book is new to you, or you come to it as an old friend, here is a passage to launch you, or launch you anew, on your journey to see healing for yourself, a loved one, or a neighbor. A marginal heading next to the passage announces it’s about “Immortal memory.” The passage itself reads, “If delusion says, ‘I have lost my memory,’ contradict it. No faculty of Mind is lost. In Science, all being is eternal, spiritual, perfect, harmonious in every action. Let the perfect model be present in your thoughts instead of its demoralized opposite. This spiritualization of thought lets in the light, and brings the divine Mind, Life not death, into your consciousness” (Science and Health, p. 407).
With this, the haze retreats. Your God-bestowed capacities come into sharper focus. Healing dawns.
From an editorial in the Christian Science Sentinel.

Preparing for sundowners

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TBO.com

By GARY JOSEPH LeBLANC

Common sense caregiving

If you have a loved one or client with Alzheimer's whose confusion appears to increase during the latter part of the afternoon, you're not alone. This is a symptom which many Alzheimer's patients will go through. It is called, "Sundown Syndrome"—also known as "Sundowning." This descriptive term describes the onset of heavier confusion and intensified agitation. Usually, this begins anywhere from late afternoon to dusk. But in reality, it could happen anytime throughout the day.
Around 4:45 p.m.—everyone in my house got a new name, possibly two. My father, who didn't seem to need a clock for this, went through this change daily toward the end of the moderate stage of Alzheimer's disease.
Experts believe one of the contributing factors is a shift in their biological clock, caused from the change of daylight to dark. Keeping the house well lit during these hours will help immensely.
Physical and mental exhaustion is one of the biggest culprits. An Alzheimer's patients' days consists of coping with who's who, "where am I," and living in the past. This would mentally drain anyone.
Once again, routine is the most helpful thing for memory-impaired loved ones. Evening hours usually become the busiest in a household; people coming and going, cooking supper, phone calls and the list goes on. If the traffic in your home is high volume, try placing them in a quieter
For a caregiver, one of your best stands for defense will be to be prepared beforehand.
As the hours of daylight change with the seasons, always have you house lights turned on an hour before day's end, never allowing shadows to invade your home. Also, when you sense that a heavy bout of confusion is advancing, try to keep them preoccupied with some kind of activity. Place a photo album in their lap, anything that will redirect their jumbled thoughts. This may call for a little trial and error before you find something that is truly effective.
There were days when I swore my father's Sundowners would last morning 'til midnight. I also recall noticing similar reactions on dispiriting rainy days. Once anxiety builds, it's difficult to turn it around. Keep evenings as calm, routine and simple as possible. You just have to continue doing the best that you can.

Gary Joseph LeBlanc was the primary caregiver of his father for a decade after he was diagnosed with Alzheimer's disease and has published a new expanded edition of his book, "Staying Afloat in a Sea of Forgetfulness", due to release on July 15.

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Posted by (alzheimersideas) on 07/10/2011 at 02:04 pm.

These are great suggestions. A book with baby photos might be a good diversionary tool

by Susan Berg author of Adorable Photographs of Our Baby-Meaningful Mind Stimulating Activities and More for the Memory Challenged, Their Loved Ones and Involved Professionals a book for those with dementia and an excellent resource for caregivers and healthcare professionals.

 

Non-verbal communication (part 2)

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contimued from July 10

Tell each team that when you say “Go,” they will have five minutes to work as a team to put the picture together. This time period can be flexible based on the level of the group.
9. Ask if there are any questions. And then, as a last minute piece of instruction, tell the group, “Oh, I almost forgot to tell you, you have to complete the task by not talking.”10. Ask if everyone understands what to do. Say “Go,” and let the teams begin to work.
11. As the teams work, move among them to observe how they act as a team. Caution a team or individual team members should they start to talk.
12. Call time.
13. Guide a discussion on communication by asking the following questions.
• Did all of the teams put their puzzle together? (Show of hands)
• First, involve the teams that competed the puzzle. Ask:
�� Do you think that you worked as a team to complete the puzzle?
�� How did you work together?
�� Did you have trouble not talking?
�� Did you want to talk?
�� What were other ways you found to communicate with one another?
�� What did the leader of your group do?
• Second, (if applicable) move to the teams that did not complete the puzzle. Ask:
�� Why do you think your team did not complete the puzzle?
�� What do you think needed to happen for your team to be able to complete the puzzle?
�� What did the leader of your team do?
• Third, work with the pictures involved in the puzzle by asking the following questions.
�� What did your picture show?
�� Were the people in the picture a team?
�� Why were they a team? What were they doing that made them a team?
�� Are the people in the pictures communicating?
�� Is their communication always verbal? If not, what are some examples of people doing their jobs without necessarily talking?
14. Return to your original questions at the beginning of the group.
• What is a team?
• What is the role or responsibility of each person on a team?
• What happens when someone does not do his or her part for a team?
15. Bring closure by asking the participants to think about what happened during their team activity. Ask the following question:
• Do you think you were a good team member?

Non-verbal communication

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Communicate — Without Talking?

Synopsis:
In this activity participants will learn the value of verbal communication and the value of working together. In groups of four, members will have to assemble a puzzle without communicating verbally. After this activity, you will lead a discussion to help them understand the importance of communication and cooperation.

Body:
1. Before starting, select a variety of large pictures that show people working together in various environments. Examples are: scenes involving a construction site, restaurant scene, athletic event, and an accident scene. You need one picture for every four participants in the group. Cut each picture into at least four pieces (one per group member) so that the picture becomes like a puzzle. Depending on the level of the group, you could have more or fewer pieces of a single picture and can also vary the size of the individual puzzle pieces.

Ask the following questions:
• What does communication mean?
• Do you think you can communicate well with other people?
• How do you know that you communicate well?
• What are some of the ways in which you communicate with people?
Now divide the group into teams of four each.

Now ask
• What would you call your group of four people? (Team)
• What does the word “team” mean?
• What is the role or responsibility of each person on a team?
• What happens when someone does not do his or her part for a team?

Focus on: Cultural Competency

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Build your resume and your skills with this excellent course, brought to you by the team at easyceu

Keeping Nursing Home Residents Safe during Outdoor Activities

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Here is a dementia music activity

Activity Director Today

Now that spring is coming to the northern part

of the United States, our thoughts turn to outdoor

activities for the residents. This is a good

time to review some ways to keep the residents

healthy and happy while enjoying some fun in

the sun.

Last year was one of the hottest summers on

record. Having to stay indoors to keep cool was

difficult for the residents with heart conditions

or respiratory problems. Even residents

without these problems were advised to stay

indoors and out of the baking heat and oppressive

humidity. This can be hard when summer is

usually filled with outdoor activities and outings

to the residents' favorite places.

Now is the time to plan outdoor games, picnics,

barbecues, trips to see the residents’ favorite

baseball teams play and other out trips, walks

around the grounds of the facility, sitting outside

talking to visitors or the staff, etc. Now

that the residents are able to spend more time

outdoors, the activity staff needs to build in

some precautions when planning outdoor activities.

Exposure to the sun, insect bites, heat exhaustion,

storage and preparation of food, and

dehydration can put the residents and facility

at risk.

Before planning outings, work with the director

of nursing to develop a protocol for the differ-

...read all of Keeping Nursing Home Residents

Safe during Outdoor Activities by subscribing to

Activity Director Today

Keeping residents safe while on the go.(LIABILITY landscape): An article from: Nursing Homes

Even more fish activities: Cooking fish

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Cooking Fish

Fish is finding its way onto more tables than ever before. Everywhere you look, people are singing the praises of seafood. It cooks quickly and is very versatile, not to mention delicious and nutritious. Nowadays, nearly everybody recognizes that fish are a good source of protein and rich in healthy oils. Despite this growing popularity and glowing press reviews, most fish is still eaten out. Many cooks are simply reluctant to try cooking fish at home, and they are unsure about how to buy the right type and handle it properly. This article will give you the facts, and the confidence, you need to start making fish a more regular part of your
home cooking repertoire.

There are so many ways to prepare fish and so many different varieties that you could probably eat a different fish dish every day of the year and not even make a dent. Traditional preparations
are always popular, but with growing interest in global cuisines, more ethnic fish recipes are entering the mainstream. Surprisingly, few of them are complicated or difficult.

It's important not to overcook fish, as this makes the meat tough and destroys flavor. Fish is done cooking when the flesh turns opaque and begins to flake easily when tested with a fork. Cooking times vary with each fish and cut. The following are typical cooking times:

• 10 minutes per inch of fish
• 5 minutes per inch of fish cooked in a sauce
• 20 minutes per inch of fish if frozen

If you simply master a few basic preparation steps and easy cooking techniques, you can cook just about any fish recipe on the planet. Before you delve into each technique, however, take a look at the chart on the next page that provides some helpful information on all types of fish.

Recipes

Tuna with Peppercorns on a Bed of Greens Baked Fish with Thai Pesto Southwest Roasted Salmon and Corn Grilled Red Snapper with Avocado-Papaya Salsa Grilled Fish with Buttery Lemon Parsley Fish Tacos with Yogurt Sauce Grilled Chinese Salmon

Top ten 4th of July activities for those with dementia

Activities directors and other healthcare professionals here is a great dementia resource for caregivers and healthcare professinals,
Here is information on being the best caregiver you can be

Here is a way for nurses administrators, social workers and other health care professionals to get an easyceu or two

I cannot believe the 4th of July is here

Here are some easy, yet fun things to do on or near the 4th of July together

10. Arrange flowers real of fake. You can use red, white and blue flowers to make the bouquet or centerpiece look patriotic.

9. Plan a picnic or a party from beginning to end

8. Have a picnic perhaps using the ideas from your plans. If the person with dementia does not want to go outside, no problem, have the picnic inside.

7. Go to the beach or the park. Go at off times to avoid the crowd. You can always go on different day. Again if you fear a negative reaction to going to the beach, bring the beach to your home. Get some sand, sea shells and other beach paraphernalia.

6 Have a small get together at home. Hire or have someone to assist the ADRD person.

5. Draw some patriotic pictures. You can use paints, magic markers or crayons. Fireworks are easy to draw.

4. Read a patriotic story or poem. Create your own story or poem.

3. Discuss a simple recipe. See how many ingredients you can name. Give hints as necessary. Make a simple dish together.

2. Watch a musical patriotic movie. Suggestions are: Yankee Doodle Dandy and Stars and Stripes Forever
They may have to be watched in segments depending on the attention span of the dementia person Watch the fireworks on TV.

1. Make a list of all the patriotic songs you know. Give hints to the impaired person as necessary. A good book for tips on how to do this is Adorable Photographs of Our Baby-Meaningful,Mind-Stimulating Activities and More for the Memory Challenged,Their Loved Ones,and Involved Professionals Then listen to and sing these songs.

Remember all activities are person appropriate. Therefore knowing their likes and dislikes is helpful.
Also you must be flexible. If things do not go as planned, have a backup plan.