The Aging Brain

September, 2005 – Geriatric Nurse Practitioner

I am enjoying my new job immensely working as a geriatric Nurse Practitioner in a 500 bed nursing home providing primary care to 64 patients currently. It is like a breath of fresh air compared to working for the insurance company in the same facility. I am also feeling much better physically since I only work four days per week again and have every Friday off. I volunteered to work the late shift so my hours are 9:30 a.m. to 6 p.m. The rest of the providers leave between 4 and 5 p.m. so I cover the entire home for emergencies until the night shift doctor arrives at 6 p.m. I like these hours better because I don’t need to get up as early, avoid driving in rush hour , eat lunch and dinner in the cafeteria, and get out in time to attend evening activities at my church. The food in the cafeteria is healthy and inexpensive so it also cuts down on my grocery bills.

I cover one dementia unit, and two long-term care units that are not locked. I share an office with three other nurse practitioners which works well. It’s nice to be able to discuss our most difficult patients and get input from others with more experience. I also like the dictation which is much easier than typing into the insurance company laptop. They have live transcriptionists that type our notes and put them in the cue for us to proofread and correct any mistakes before it goes into the electronic record permanently. In general, the typists are very accurate. The nursing home is so large that it also has a small restaurant, gift shop, auditorium for programs, board room, and beautiful grounds for walking at lunch time on good weather days. They have monthly continuing education for all the providers which is also helpful. I work with three different physicians and they are all enjoy sharing their expertise with me.

Dr. R., the medical director, meets with each provider privately once a month to review our productivity goals and discuss any concerns we may have. He is the kindest and best boss I have ever had. This preventive type management style works so much better than the authoritarian critical style I have had for much of my career. So far, he said I’m doing a good job and meeting all my monthly goals. How I thank God for giving me this job and giving me this schedule.

“Giving thanks always for all things unto God and the Father in the name of our Lord Jesus Christ.” Ephesians 5:20

The Aging Brain

One of the benefits of this job is that they give me 4 days per year and $1200 annually to attend continuing education outside of the facility. I attended a seminar yesterday entitled “The Aging Brain” that was very interesting taught by a geriatrician. The research shows that people who keep their brains active, exercise, socialize, and eat a healthy diet helps prevent Alzheimer’s disease (memory loss). Since my grandmother died of Alzheimer’s, this is of particular interest to me. Daily, I sadly witness the decline of my patients with end stage dementia.

Ways to keep one’s brain active is to travel because you are constantly problem solving and meeting new people. Learning a new language, playing a musical instrument, teaching, doing aerobic exercise, and working jigsaw or crossword puzzles stimulates the brain. If a person lives alone, it’s also important to participate in regular social activities so as not to isolate. Eating healthy foods like blueberries, salmon, sweet potatoes, and other colorful fruits and vegetables is important.

Eating healthy foods like blueberries is good for your brain.

 

Solving puzzles stimulates brain function.

 

Traveling and using other languages is great brain stimulation!

After hearing this seminar, I will definitely continue to travel, keep up with my painting, and try and play my violin more often. I’m glad I see my friends at church several times weekly. Since I live alone, guarding against isolation is my biggest challenge.

Reflection

I continued to work in geriatrics the remainder of my career and witnessed the use of Aricept and Namenda, two medications which slow down the progression of dementia. When I was a home care Nurse Practitioner for the federal government, I took care of our veterans who had early dementia and were being managed by their family members at home. I had many conversations with the caregivers who were usually a spouse or adult child about keeping the veteran safe at home as long as possible while preventing caregiver burnout. I guided them in making the difficult decision of when to place the person on home hospice, when to hire help, or when it was best to transfer the patient to a nursing home for 24 hour care.

Frequently I took young physicians with me on my visits. One doctor from India told me that there is no Alzheimer’s disease in India and people live long lives. I asked her how that can be? She attributes it to the daily consumption of curry in their foods. The main spice in curry is turmeric. So I began taking a turmeric capsule daily and adding curry powder to my vegetable juice every morning. .

When my dear Dad came to help me after I had surgery, I noticed that he was having trouble remembering things and driving me to appointments. I asked him if he was willing to go to the geriatric assessment center where I worked and have his memory checked? He willingly agreed since he recalled how his mother died of dementia, and he had to place her in a nursing home the last year of her life. Dr. R. , my boss and the director of the geriatric assessment center, did a full 4 hour assessment with the team including a CT scan of my Dad’s brain. Since my dad was an inventor and probably at the genius level, Dr. R. said it was difficult to assess his memory because he was so good at covering up his memory deficits. Their conclusion was that Dad had Mild Cognitive Impairment (MCI) which means it could stay at that level or progress to dementia. Dr. R. did not recommend starting my Dad on Aricept or Namenda as they were not recommended to prevent dementia.

It was sad to see my brilliant Dad slowly decline from dementia. He had 19 patents in paper products at the conclusion of his career.

As the years progressed, my dad did progress to dementia, had to stop driving, and moved to a retirement center with his wife to be closer to my sister. As Nancy Reagan said about President Reagan after he was diagnosed with dementia, “It’s the long good-bye.” My stepmother became his caregiver. Sometimes he wandered around the large building or got lost walking to the dining room. He stopped reading and slept most of the day. He needed a home health aide to help him with his shower. After his wife broke her hip and had to go to rehab, Dad also had to be transferred to the nursing home. He began having trouble swallowing which is common with dementia patients, and food went into his lungs and caused pneumonia. He died quietly alone in the nursing home from pneumonia at the age of 89, nine years after he was diagnosed with Mild Cognitive Impairment. It was sad to see such a brilliant man slowly lose his mental capacities.

That is why it is so important, dear Reader, to receive the Lord Jesus Christ as your personal Savior now, while you still have your mental capacities. No one knows how many days he has left here on earth. The 29 year old son of one of my doctors suddenly passed on last week. Thankfully, he had received Christ as his Savior and is now rejoicing in God’s presence.

For God so loved the world, that He gave His only begotten Son, that whoever believes in Him should not perish, but have everlasting life. For God sent not His Son into the world to condemn the world, but that the world through Him might be saved. John 3:16-17

For God has not given us the spirit of fear, but of power, and of love, and of a sound mind. 2 Timothy 1:7

 

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Come Aside and Rest A While

Summer – 1976 – Midwest USA

I started out the summer working as a Nursing Assistant at Children’s Hospital where I had my clinicals last summer. They floated me one day to the burn unit and the nurse asked me to watch her do the dressings on a 2 year old so I could do them the next time with her watching. As a senior nursing student, they allowed me to do some procedures under close supervision. The little boy stood in his crib as she began to unwind his dressings. As the burned skin was exposed, his blood ran down his legs and arms and he began to scream. I felt myself begin to black out and turned and sank into a nearby chair and put my head on my knees. After the blackness cleared, I stood up and went out into the hallway. The nurse finished the dressings and came out into the hallway to speak with me. I said, “I’m so sorry, but I thought I was going to faint. I have never witnessed anything like that before.” She said she understood and told the supervisor not to assign me to the burn unit again. They sent me back to the orthopedic unit where I was last summer. I guess I deal better with the kids in traction than the burned ones.

After 4 weeks of arising at 5 a.m. in order to catch the 6:30 a.m. bus to work, the dizziness, nausea, and weariness was almost unbearable. I could not smile at anyone and my soul was crying in agony to God. I felt like Elijah under the juniper tree crying out to God to take him home. (I Kings 19:4-7) My Pastor was very concerned about me and asked me to take a walk with him before church Sunday night. “Pam, I think you are so rigid right now and have planned everything so much that God can’t work. Let go, and let God do whatever He wants! For one week, don’t plan anything. Take every day as it comes and do everything the opposite you usually do. Go out to a restaurant and eat a meal, listen to the birds, take long walks in the woods. Don’t study your Bible for one week except to read a few verses in the morning.  It will make you a better Bible student in the long run.”

His words were quite a shock to me, but I was willing to try anything since I had lost all joy in the Lord. The next weekend, I drove up to see Jane for one night and we went hiking at the state park. I had to stop every 30 feet to rest a little. When I awoke on Monday, I was still so dizzy and exhausted that I called in sick. After praying about it the rest of the day, I decided I needed to resign and return to my parents’ home to rest the remainder of the summer. I called the head nurse and told her the situation, and she said she understood. After 7 quarters straight of school, with the last one in psychiatry and the demanding classes, my body was beyond exhausted.

My parents were very concerned about me also and were extremely kind to me. After 2 weeks of total rest, I began to feel like myself again and could smile and laugh! I just finished reading a little book by M. R. DeHaan MD called Broken Things. He said, “The Lord only breaks those whom He is going to make.” “Sunshine all the time makes a desert.” I understand better now that I don’t need to strive and push doors open, but just relax and let the Lord open or close the doors. His tenderness in giving me 2 months just to meditate and enjoy Him brings tears to my eyes.

My Dad kindly drove our travel trailer to the state park a couple hours away and set it up so my Mom and I could stay for the week while he returned to work. God has given my Mom and me very precious times together. I so enjoy walking through the woods listening to the rustling leaves, watching the butterflies and dragonflies fly from flower to flower. At night, the chirping crickets lull me to sleep, and the singing birds awaken me every morning. How I thank God for these precious blessings and restoring my health!

Camping at the State Park was so relaxing!

Camping at the State Park was so relaxing!

Reflection

Since 1976, I have had several other times in my life of total exhaustion when I have simply burned the candle at both ends and pushed my body too far.  As I read the passage in I Kings again about Elijah, he had just run for his life 93 miles to flee wicked Queen Jezebel who was trying to kill him! No wonder he was exhausted. After he said to God, “It is enough! Now, O Lord, take away my life; for I am not better than my fathers.” And as he lay and slept under a juniper tree, behold, an angel touched him and said unto him, Arise and eat. And he ate and then slept some more and ate some more. He was able to go 40 days and nights after that. Now I realize I am certainly not Elijah, but the cure was the same for me. Sleep and eat, sleep and eat.

The disciples were deeply grieving after burying their beloved friend, John the Baptist, who was beheaded by wicked King Herod. I love the passage in Mark 6:30-31which says And the apostles gathered themselves together unto Jesus, and told Him all things, both what they had done, and what they had taught. And He said unto them, Come aside into a desert place, and rest a while; for there were many coming and going, and they had no leisure so much as to eat.” It’s so wonderful that our dear Savior sees when we need to rest and provides it for us!

trillium

3 petaled trillium wild flower reminds me of the Trinity!

A restful walk in the woods.

A restful walk in the woods with my sister, Marsha.

January, 2018

I am currently recovering from pneumonia and a horrific reaction to a medicine that put me in the hospital for 12 days. As I slowly regain my strength, I will repeat some of my most popular posts. Please pray for me to learn all the lessons God has for me during this time of recovery. I praise Him that He has made the Bible extremely precious to me as I lean hard on Him. The medicine caused some short term memory loss which was terrifying to me, but God quieted my heart when I remembered 2 Timothy 1:7, “For God has not given us the spirit of fear, but of power, and of love, and of a sound mind.” 

If you have any encouraging Bible verses that you want to share with me and other readers here, please post them in the Comments section. May you have a blessed week of “Looking unto Jesus, the author and finisher of our faith.” Hebrews 12:2.

Pamela, APRN