The Slow Fade of Dementia, Ambiguous and Anticipatory Loss, Grief

Caregivers bear the tremendous burden of witnessing the early signs of change in the behavior of their loved one and dealing with the anger and denial of trying to get through to the rest of the family. One very important thing family members don't understand is that unless you actually live with someone day in and day out you just don't see the same person as does the caregiver. The social stimulation of visits and the fussing from loved ones brought out conversation and smiles, only to return home and sink right back down under that black cloud.

Taking care of my mother for over two years has left me a puddle of tearful grief for the slow fading of my precious Mom and the bewildering, questioning of my own sanity. Changes in behavior brought the constant questions of what is normal for her personality, what is part of her condition, what could be a side effect from medications? Dealing with memory loss and confusion is bad enough for a person, but to add a chronic condition such as COPD on top of that and the resulting depression was enough to pull her down into a pit of despair. My desperation for her to fight only resulted in the wall between us to build brick by brick.




Together, we went through all the stages of grief: denial, anger, bargaining, depression and acceptance. Accepting this "new normal" as her life, having no choice but to leave her home and give up control and independence, was incomprehensible.  My reaction was to push, nag, beg, cry, whatever it took to get her to fight to maintain her strength, physically and mentally.  It was all- consuming, while my Mom continued to slowly lose a bit more of her spirit with each new day she woke to realize she had to get through another day. Fast forward three years and now that another sibling is caring for our mother, she is a medicated, zombie of her former self. The solution to the constant anxiety of struggling to breathe is that if the anxiety is relieved we can avoid the tendency to hyperventilate and thus panic. Welcome to the world of narcotics.

The stage of acceptance has arrived and she just doesn't care anymore. The version of Mom that is in the present is what the siblings actually interpret as her being "better". There is quiet and peace in the household only because there is no longer anyone "making waves" by pushing for alternatives and therapies. Palliative care is all there is now.

Gone is the frustration between what she "won't" versus "can't" do for herself. Now it is just the tender care as though she were our child. Now we deal with the guilt associated with our past reactions and emotions while dealing at that time with the craziness. But at that time we didn't understand what was going on. To reflect back now, bits and pieces make more sense. But that war of guilt continues to rage within our own minds, struggling for self-forgiveness for whatever we imagine we did so wrong.

Ambiguous loss and Anticipatory grief can be described as unresolved grief. It is different from the loss and grief surrounding a death. Closure is not possible and there is no peace because the loved one is still physically alive. This is the world surrounding and consuming a family dealing with dementia. This is the world of the patient herself as she must accept the slow loss of her own self and be very aware of it while it is happening.

There is confusion of the use of the words dementia and Alzheimer's disease. They are used interchangeably, but are not the same thing. Alzheimer's is a disease, dementia is not. Dementia is group of symptoms that affect mental tasks like memory and reasoning. Dementia can be caused by a variety of conditions, with Alzheimer's being the most common.

One of those conditions is called Vascular Dementia which is problems with the blood vessels. The brain needs a good supply of oxygen rich blood and if this supply is hindered and the brain is deprived of enough oxygen, as is with COPD, the brain cells could die. Symptoms may appear suddenly or gradually. A major stroke will cause symptoms to appear suddenly, while a series of mini strokes that may have happened over time, will cause a slower progression of symptoms.

There are several ways that COPD may affect thinking and memory. As less air is taken into the lungs, over time the blood oxygen levels in the blood become too low. Low levels of oxygen to the brain may cause neural damage with could increase the risk for memory problems. One big problem with a condition like COPD is that there is inflammation not just with the lungs, but inflammation of the entire body. Elevated levels of certain body chemicals related to inflammation can be linked to memory problems. Another issue is that because the body is working so hard to breathe and get enough oxygen there is the need to sleep more. If a person has trouble sleeping, the resulting fatigue can further interfere with thinking straight.

Since behavior changes can be so subtle, they may only be noticed by the patient himself/herself or by those who live with him or her. So the battle can begin with getting the message across to other family members that something is wrong and getting them to respect the patient or the caregiver's suspicions. It is interesting how differently people react to a physical condition versus something being wrong with the mind. At a time when family should be sticking together and supporting one another, it can become a nightmare when denial, fear, and/or the need for control over decisions, interferes with the big picture of what is best for the loved one.



Aside from going on and on with that, what it all boils down to is the fact that we miss our Mom. I miss the phone calls to rehash whatever event just happened in the family. I miss rambling on and on about the busy lives of our children. Gone is the interest she used to have in our world. Our children are going through the most exciting times in their lives with graduations, weddings, new careers, new homes...and though their beloved Nana is physically here, there is no longer the two way street of sharing in all those precious moments. The conversation is sadly one sided and often forgotten by the next day.
The strain to maintain a close relationship is becoming more difficult and though they call and visit, their lives are going on and their Nana is being left behind.

Witnessing the slow fade of someone we love is heart wrenching and everyone reacts differently in terms of their personal loss. Some hover and some run. We all deal with grief and loss in our own way and we need to respect one another without judgement. The emotional strain and pain of losing someone bit by bit is such a crazy state of limbo to have to go through. Though the mind may come to terms with the realities of the disease and expected outcome, it is unrealistic to expect the heart to be on the same time schedule. We have no choice but to anticipate that final loss, but to have to play the waiting game can be a horrendous, surreal roller coaster ride.


The best medicine in this world is love. When there is little else anyone can do, it is time to up the dose!

The Battle of the Flea is Not just what's On your Pet

Fleas are tenacious critters and their ability to persevere regardless of all of our ways to get rid of them is amazing. We cannot solely blame our pets for the presence of fleas in our homes. Being attracted to warm blooded animals they will make your pet their temporary home for a food source, but there is also a very real possibility they are hitching a ride into your home by way of your shoes or clothing.

The key to flea control is quick action. If you see signs and ignore them, even for a few days, the situation could become a nightmare. Telltale signs of the presence of fleas go beyond actually seeing the buggers. Observe your pet. If he starts with the twitching and sudden jerks to lick, especially areas like the belly, groin area, under the neck and behind the tail along the backbone, it is time to pay attention. 
If you see black specks laying on the areas where your pet spends its time sleeping, that is a good sign that your pet has fleas even if they don't appear to be bothering him. Those specks are "flea dirt" which is actually dried pre-digested blood. 
If you see little, rice shaped worms on your pets back end or on their bedding, that means they have tapeworms (Dipylidium caninum).  Fleas are notorious for transmitting  tapeworms to your pets. When your pet itches, they lick and when they lick they ingest the flea, and once the flea is ingested the tapeworm can complete it's life cycle. Adult tapeworms can be several inches in length living in your pet's intestinal tract. What you see are the sections that break off.

It is important to understand the life cycle of the flea. There are four stages: egg, larva, pupa, and adult. The typical life cycle will take anywhere from a couple weeks to months. It depends on the temperature in their environment and humidity levels. Fleas like conditions between 70 to 85 degrees Fahrenheit and 70% humidity.

So let's start with the females that hitch a ride into your home. Those adult females lay eggs following a blood meal from the host animal. Without blood the flea is unable to reproduce and being that is their goal in life they can very quickly make your pet miserable. The eggs are slightly smaller than a grain of sand and white in color. They are laid in the fur in bunches of about 20. One adult female flea can lay about 40 eggs every day. As your pet moves around those eggs fall off which is how the problem can suddenly appear all over the house. Eggs represent 50% of the entire flea population in a home.

With optimal conditions the eggs can hatch in only two days. If the temperatures are cold and dry it'll take a bit longer, perhaps up to two weeks. If the temperatures are warm with high humidity, the eggs will hatch in a few days.

The larvae that emerge from those eggs need to avoid light, so will nestle in carpets, dark corners, clothing lying around and upholstery. What they live on is the flea dirt that is found amidst other organic debris in their environment. The larvae make up about 35% of the population. This is why it is ultra important to wash all bedding your pet uses and to have a good vacuum cleaner. Strongly recommended is a vacuum with a microfiber bag or the type of vacuum using water such as a Rainbow. With a bagless vacuum there is good chance that when you empty the canister into your trash, you will just release those fleas and eggs back into your home. Microfiber bags are made to trap allergens, dust and fleas debris with no escaping. Water canisters need to be emptied each time but the fleas are dead from drowning.
If left to their own devices, those larvae will spin cocoons in 5 to 20 days from the time of hatching from their eggs.

The cocoon or pupae stage is the last developmental stage before the adult emerges that we usually see. The purpose of the cocoon stage is to protect the pupae for as long as it takes for conditions to be ideal for the adults to emerge. This can take from just a few days to years. The cocoons have a sticky coating that allows them to attach to carpet fibers so having a powerful vacuum cleaner is paramount.

What triggers the adult flea to emerge once developed is a rise in nearby body heat, higher levels of carbon dioxide and vibrations. All these are associated with the nearby presence of a warm-blooded body nearby, be that a pet or a person. Once fleas emerge they need to eat within a few hours. After feeding they'll begin to breed, lay eggs and the cycle starts all over again. Adult fleas account for only about 5% of the entire population in the house, but while on your pet they'll continue to feed, breed and lay eggs.

Before dousing your home with toxic flea bombs and chemicals there are other safer weapons of destruction against them: Borax, Diatomaceous Earth and Vinegar and the all important Vacuum Cleaner!



Use borax, Not boric acid!
What you want is Disodium Tetraborate or Sodium Tetraborate which is Borax. Borax is mined from the earth as a complex form of boron bound with other minerals. Boric acid does not occur naturally in nature, but is made from borax by adding hydrochloric acid and water. This increases the toxicity level so it is not a good thing to have around your pets or children.

Borax looks like salt, has no smell and doesn't get absorbed by the skin when touched. It kills fleas by dehydrating them as it makes small cuts in their exoskeleton. This works on the larvae but won't help you get rid of the eggs. Vacuum, vacuum, vacuum to get rid of the eggs.

Borax is also good for killing ants, bed bugs and roaches.
Borax is safe to have in your home and is much less toxic than insecticides.
If you are pregnant, avoid using any Borate substance which includes borax.
You don't want small children crawling around on the floor if there is borax still in the carpet.
Keep your cats away from the borax powder. Breathing in the fumes could cause health problems.
Don't put borax directly onto your pets. You don't want prolonged skin contact.
Keep borax away from your plants.

How to use:
Sprinkle borax liberally all around your carpeted areas.
Use a stiff brush or broom to work the borax down into the carpet fibers.
Wait at least six hours before vacuuming up the borax.

An alternative to borax is Diatomaceous Earth. 

Borax may give quicker results, but diatomaceous earth (DE) is completely natural and much safer for the family and pets. It is a simple mineral-silica. The steps for application are the same as for the borax. It kills similar to the borax by cutting into the exoskeleton and sucks the fluids out of the fleas' bodies. The action is physical rather than chemical. Hundreds of microscopic DE get all over the insect's body, and as the bug moves the DE scratches off their waxy coating and they dehydrate.  

Diatomaceous earth comes in two forms, pool grade and food grade. The type you want is food grade! 

Diatomaceous earth is formed from algae with siliceous shells. When extracted, they are already dead, but the shells remain. Though these shells are sharp they are too small to have any effect on humans. A totally safe, non-toxic method to kill not only fleas but bed bugs and chiggers.

If you don't have carpets, diatomaceous earth can also be used on hardwood floors. Don't forget to apply to the corners and along baseboard edges. 

Don't use in areas with fans blowing. A high draft will send the fine granules all over into the air and may be irritating to breathe it in.

When purchasing diatomaceous earth, read the label and besides making sure it is food grade and not pool grade, also check to make sure the concentration is around 99%. Any other formulation may not be as pure and safe for your family and pets. The other blends may kill fleas faster, but may contain insecticides.

Once the fleas come into contact with the powder, they usually die about 4 hours later. If possible, leave the powder on the floor overnight to ensure the fleas are dead before vacuuming.

Since flea eggs hatch after about a week after the eggs had been laid, it is best to repeat the process once a week for a month. You need to get to all four stages of the flea's life cycle.

Don't be concerned if you feel you did breathe in some of the DE powder. Unless you are dusting a garden and expect to be exposed to the dust for a period of time (in which case you should wear a mask) you should be fine. However, those with asthma may want to wear a face mask.

Diatomaceous earth is also used internally to treat for parasites, so don't be concerned as long as you are using food grade DE.

DE can be used as a way of flea treating your dog, but in moderation. If applied to your pet on a daily basis it can cause dry skin. Also, don't use on kittens, puppies, rabbits, guinea pigs or hamsters. Their small body mass could be a problem. 

To use on a pet for fleas:

Once a week application.

Put a towel over the head so the powder doesn't get into their eyes irritate their lungs.

Rub about 1 Tbsp into the fur of a dog over 35 pounds.

For dogs less than 35 pounds or for cats use about 1 Tsp.

To use on a pet for worms:

Add to food once a day till see no more signs of worms (stool, vomit, coughing, on bedding)

Add 1 Tbsp to the food for dogs.

Add 1 Tsp to the food for cats.

Diatomaceous earth can also be used in chicken bedding boxes to help with mites and lice.

Just sprinkle around the bedding inside the boxes.

Don't let the DE get wet. Moisture will reduce the effectiveness.

Good sites to visit for more information about DE are:

www.earthworkshealth.com

www.morethanalive.com

Last we have yet another use for vinegar!

Vinegar has been used for centuries to clean and deodorize. It has been used to get rid of ants and fruit flies in the kitchen. It has its use in the garden to prevent aphids from destroying plants. Weeds can be controlled with vinegar. 

Our beloved pets can smell fresher with a vinegar rinse and then towel dried. Kill two birds with one stone and send fleas packing as well.

To use as a flea bath:

Use Dawn Dishsoap to lather up your pet. Pour vinegar over your pet and massage it in. Let this mix stay on the pet for at least 10 minutes while you massage it throughout the fur down to the skin. Then rinse it all out.

To repel fleas:

Add a bit of vinegar to your dog's drinking water. This makes the pet's blood and skin more acidic and unfavorable to a flea's taste. 

Vinegar added to a cat's water may be too acidic for a cat's system. 

Another option is to spray vinegar (dilute if too strong) on the fur and massage to distribute it all over your pet.

This is a good method for both dogs and cats.

Spray vinegar onto pet bedding to deter fleas.

It doesn't matter whether you choose to use white or apple cider vinegar for spraying onto the pet or it's bedding. 

But for adding to the drinking water, use apple cider vinegar.

Good prevention also must include a good flea comb. Long-haired dogs and those with thick undercoats can be a challenge to flea comb but for short-haired dogs and cats it is a wonderful, very practical tool. Get in the habit of going over your pet on a regular basis and make it part of your pet's grooming. Flea combing is the best method for cats. Since cats' systems are so touchy with toxins, just running a flea comb over them is ideal. The cat loves the attention, it gets its grooming and you can nip any problems in the bud. Have a bowl of water next to you with a dash of dish soap and drop the fleas into the water as you find them.

Here we have a pet safe flea powder consisting of Diatomaceous earth, Yarrow flower and leaf powder, Neem powder, and Geranium essential oil. The link below the picture takes you into the shop with all the details about this item.

Natural Dog and Cat Safe Flea Powder

Pictured below are two herbal vinegar blends useful for people and their pets to help deter not only fleas but pesty bugs as well. Click on the link below the pictures for more information on them.

Herbal Vinegar Insect Repellent, Plantain, Comfrey, Yarrow

Herbal Vinegar Insect Repellent, Lavender and Plantain

Your dog will enjoy these flea repellent, homemade dog treats! 

Click on this link to take you to the blog post with the recipe.

Thanks to Jennifer Kvamme, DVM for her informative article on flea control

Thanks to Natasha Anderson for her informative article on Diatomaceous Earth and Borax

Thanks to the article from FleaBites on the use of vinegar and as a great source for information and supplies.

Hayfever season! Who to Blame for Your Misery?

Let's stop blaming the lovely Goldenrod for the misery of hayfever.



Here is an article on the usefulness of this autumn beauty.


Many people love summer but dread the season's end because of the onslaught of ragweed pollen in the wind which can cause seemingly endless sneezing, stuffy or runny nose, itchy eyes, nose and throat. Those with asthma often find their symptoms worse during hayfever season. A ragweed plant only lives one season, but those elongated flower heads are loaded with pollen. A single plant can produce up to 1 billion pollen grains. Those grains are light in weight and just float through the air with ease.

Allergies occur when the body’s immune system treats the allergen as a foreign invader. This starts a chemical reaction which produces and sends histamine throughout the blood stream. These chemicals cause allergy symptoms to develop.

Ragweed is its own remedy for hayfever. Tincture the flowering tops in 100 proof vodka for six weeks. A tincture is when you combine plant material and alcohol to create your own herbal medicine.
Fill a mason jar or glass jar of your choice with the cut flowering tops. Add enough 100 proof vodka to cover the ragweed flowers. Poke a wooden spoon handle around the sides of the jar to release air bubbles and cap. Let the jar sit in a cool location for six weeks, give a little shake daily. Strain off the herbs and put the tincture in smaller glass dropper bottles.
To use:
Add about half a teaspoon of tincture to a glass of water and take daily during allergy season, primarily late July to September.

Below is a video by the very respected Susan Weed on how to make your own allergy remedy.

Here is a Great article on identifying Ragweed.

Ragweeds are flowering plants in the genus Ambrosia in the aster family, Asteraceae.
There are two types of Ragweed in North America:
Common ragweed (Ambrosia artemisiifolia) Grows to about 3 feet.
Great or Giant ragweed (Ambrosia trifida) Grows to a height of about 8 feet.
Common ragweed had much more pinnatifid or deeply cut lobes on its leaves than the Great ragweed.
The Great ragweed's lower leaves have 3 to 5 lobes while the upper leaves are elliptical.
Goldenrod flowers are yellow, whereas Ragweed flowers are green.

Common ragweed

Great or Giant ragweed

Loaded with pollen

In its defense, ragweed is very valuable to wildlife, just showing us that all plants do serve a purpose. Ragweed isn't here just to make people miserable. Doubtful that makes allergy sufferers feel any better. Honeybees collect the pollen from the male flowers, though flower-visiting insects don't usually bother with the plant. There are several moth types who eat the foliage, flowers and seeds and grasshoppers are often very plentiful around ragweed plants. The oil rich seeds are loved by game birds and grain eating songbirds. The spikes of seeds stick up above the snow during the winter, therefore do provide a good food source for not only birds, but squirrels and voles.

Perhaps there is a way to enjoy the end of the summer season without the constant "Sniffle, Sneeze, Tissue Please"!

Ironweed and Joe Pye-Weed, Late Summer Native Beauties

Bees on Joe Pye-Weed

Turns out I'm not the only one who had some confusion in the difference between the majestic New York Ironweed (Vernonia noveboracensis) and Joe Pye-Weed (Eutrochium purpurem). There are numerous perks for including these plants in our landscaping. The fact that they both are natives to North America means that they are low maintenance plants and have long adapted to weather and water conditions to be hardy perennial plants. You'll be pleased to discover that they'll propagate with little help from you, without being invasive. If they seem to be crowding out other plants, it is easy to just thin them out.

Joe Pye-Weed is a wetland plant with several other  names. It can be called by it's genus name which is Eupatorium, or common names Gravel root, Trumpet weed and Queen of the Meadow. There are two stories of how this plant got its name. Some say that an 18th century Native American medicine man named Joe Pye, traveled around New England treating typhoid fever with an infusion made from the plant's leaves. The other version is that the name is a form of the Native American word for typhoid, which is jopi.

Ironweed often can be found growing in the same vicinity as Joe Pye-Weed. There are over 30 species of this beautiful plant. The origins of this name may be because after blooming, the seed heads turn a rusty brown, similar to the color of iron. Other people suggest that the plant gets its name from its tough stems and long taproot, touch as iron.

Planted to the rear of a garden or as a background accent plant, these plants look beautiful with other natives which are blooming at the same time, July and August. The yellows of Helianthus (wild sunflowers), Goldenrod and Black-Eyed Susan look stunning with the mauves and purples of Joe Pye-weed and Ironweed.

The similarities in these two plants are that they both grow in damp, sunny areas. They can be seen in wetlands but also along roadways, utilizing the water that collects in the roadside ditches. Both bloom in July and August and both grow taller than most plants around them.

The differences include Ironweed usually grows to a taller height of up to 8 feet, has slightly darker leaves, and the flowers aren't as spread out or plumy. Ironweed has purple blooms, whereas Joe Pye-Weed has pinkish, mauve flower heads. Once these facts are pointed out, telling these plants apart becomes easy.

 If you want to encourage butterflies, bees and other pollinators, these are ideal choices. By late summer you'll be fascinated by the amount of insect activity taking advantage of these wonderful sources of pollen.

For those of you who try to choose landscaping plants based on which are deer resistant, you'll be pleased to know that deer generally leave these bitter tasting plants alone.

Grab your camera and enjoy the beautiful shots of color you'll be able to get!

Easter Tiger Swallowtail on Ironweed