What I Wish People Knew About Dementia – by Dr. Wendy Mitchell
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We hear a lot from doctors who work with dementia patients; sometimes we hear from carers too. In this case, the author spent 20 years working for the NHS, before being diagnosed with young-onset dementia, at the age of 58. Like many health industry workers who got a life-changing diagnosis, she quickly found it wasn’t fun being on the other side of things, and vowed to spend her time researching, and raising awareness about, dementia.
Many people assume that once a person has dementia, they’re basically “gone before they’re gone”, which can rapidly become a self-fulfilling prophecy as that person finds themself isolated and—though this word isn’t usually used—objectified. Talked over, viewed (and treated) more as a problem than a person. Cared for hopefully, but again, often more as a patient than a person. If doctors struggle to find the time for the human side of things with most patients most of the time, this is only accentuated when someone needs more time and patience than average.
Instead, Dr. Mitchell—an honorary doctorate, by the way, awarded for her research—writes about what it’s actually like to be a human with dementia. Everything from her senses, how she eats, the experience of eating in care homes, the process of boiling an egg… To relationships, how care changes them, to the challenges of living alone. And communication, confusion, criticism, the language used by professionals, or how things are misrepresented in popular media. She also talks about the shifting sense of self, and brings it all together with gritty optimism.
The style is deeply personal, yet lucid and clear. While dementia is most strongly associated with memory loss and communication problems, this hasn’t affected her ability to write well (7 years into her diagnosis, in case you were wondering).
Bottom line: if you’d like to read a first-person view of dementia, then this is an excellent opportunity to understand it from the view of, as the subtitle goes, someone who knows.
Click here to check out What I Wish People Knew About Dementia, and then know those things!
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Goji Berries vs Blueberries – Which is Healthier?
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Our Verdict
When comparing goji berries to blueberries, we picked the goji berries.
Why?
As you might have guessed, both are very good options:
- Both have plenty of vitamins and minerals, and/but goji berries have more. How much more? It varies, but for example about 5x more vitamin C, about 25x more iron, about 30x more calcium, about 50x more vitamin A.
- Blueberries beat goji berries with some vitamins (B, E, K), but only in quite small amounts.
- Both are great sources of antioxidants, and/but goji berries have 2–4 times the antioxidants that blueberries do.
- Goji berries do have more sugar, but since they have about 4x more sugar and 5x more fiber, we’re still calling this a win for goji berries on the glycemic index front (and indeed, the GI of goji berries is lower).
In short: blueberries are great, but goji berries beat them in most metrics.
Want to read more?
Check out our previous main features, detailing some of the science, and also where to get them:
Enjoy!
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People with dementia aren’t currently eligible for voluntary assisted dying. Should they be?
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Dementia is the second leading cause of death for Australians aged over 65. More than 421,000 Australians currently live with dementia and this figure is expected to almost double in the next 30 years.
There is ongoing public discussion about whether dementia should be a qualifying illness under Australian voluntary assisted dying laws. Voluntary assisted dying is now lawful in all six states, but is not available for a person living with dementia.
The Australian Capital Territory has begun debating its voluntary assisted dying bill in parliament but the government has ruled out access for dementia. Its view is that a person should retain decision-making capacity throughout the process. But the bill includes a requirement to revisit the issue in three years.
The Northern Territory is also considering reform and has invited views on access to voluntary assisted dying for dementia.
Several public figures have also entered the debate. Most recently, former Australian Chief Scientist, Ian Chubb, called for the law to be widened to allow access.
Others argue permitting voluntary assisted dying for dementia would present unacceptable risks to this vulnerable group.
Inside Creative House/Shutterstock Australian laws exclude access for dementia
Current Australian voluntary assisted dying laws exclude access for people who seek to qualify because they have dementia.
In New South Wales, the law specifically states this.
In the other states, this occurs through a combination of the eligibility criteria: a person whose dementia is so advanced that they are likely to die within the 12 month timeframe would be highly unlikely to retain the necessary decision-making capacity to request voluntary assisted dying.
This does not mean people who have dementia cannot access voluntary assisted dying if they also have a terminal illness. For example, a person who retains decision-making capacity in the early stages of Alzheimer’s disease with terminal cancer may access voluntary assisted dying.
What happens internationally?
Voluntary assisted dying laws in some other countries allow access for people living with dementia.
One mechanism, used in the Netherlands, is through advance directives or advance requests. This means a person can specify in advance the conditions under which they would want to have voluntary assisted dying when they no longer have decision-making capacity. This approach depends on the person’s family identifying when those conditions have been satisfied, generally in consultation with the person’s doctor.
Another approach to accessing voluntary assisted dying is to allow a person with dementia to choose to access it while they still have capacity. This involves regularly assessing capacity so that just before the person is predicted to lose the ability to make a decision about voluntary assisted dying, they can seek assistance to die. In Canada, this has been referred to as the “ten minutes to midnight” approach.
But these approaches have challenges
International experience reveals these approaches have limitations. For advance directives, it can be difficult to specify the conditions for activating the advance directive accurately. It also requires a family member to initiate this with the doctor. Evidence also shows doctors are reluctant to act on advance directives.
Particularly challenging are scenarios where a person with dementia who requested voluntary assisted dying in an advance directive later appears happy and content, or no longer expresses a desire to access voluntary assisted dying.
What if the person changes their mind? Jokiewalker/Shutterstock Allowing access for people with dementia who retain decision-making capacity also has practical problems. Despite regular assessments, a person may lose capacity in between them, meaning they miss the window before midnight to choose voluntary assisted dying. These capacity assessments can also be very complex.
Also, under this approach, a person is required to make such a decision at an early stage in their illness and may lose years of otherwise enjoyable life.
Some also argue that regardless of the approach taken, allowing access to voluntary assisted dying would involve unacceptable risks to a vulnerable group.
More thought is needed before changing our laws
There is public demand to allow access to voluntary assisted dying for dementia in Australia. The mandatory reviews of voluntary assisted dying legislation present an opportunity to consider such reform. These reviews generally happen after three to five years, and in some states they will occur regularly.
The scope of these reviews can vary and sometimes governments may not wish to consider changes to the legislation. But the Queensland review “must include a review of the eligibility criteria”. And the ACT bill requires the review to consider “advanced care planning”.
Both reviews would require consideration of who is able to access voluntary assisted dying, which opens the door for people living with dementia. This is particularly so for the ACT review, as advance care planning means allowing people to request voluntary assisted dying in the future when they have lost capacity.
The legislation undergoes a mandatory review. Jenny Sturm/Shutterstock This is a complex issue, and more thinking is needed about whether this public desire for voluntary assisted dying for dementia should be implemented. And, if so, how the practice could occur safely, and in a way that is acceptable to the health professionals who will be asked to provide it.
This will require a careful review of existing international models and their practical implementation as well as what would be feasible and appropriate in Australia.
Any future law reform should be evidence-based and draw on the views of people living with dementia, their family caregivers, and the health professionals who would be relied on to support these decisions.
Ben White, Professor of End-of-Life Law and Regulation, Australian Centre for Health Law Research, Queensland University of Technology; Casey Haining, Research Fellow, Australian Centre for Health Law Research, Queensland University of Technology; Lindy Willmott, Professor of Law, Australian Centre for Health Law Research, Queensland University of Technology, Queensland University of Technology, and Rachel Feeney, Postdoctoral research fellow, Queensland University of Technology
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Make Your Saliva Better For Your Teeth
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A new study has highlighted the importance of lifestyle factors in shaping the oral microbiome—that is to say, how the things we do affect the bacteria that live in our mouths:
Nepali oral microbiomes reflect a gradient of lifestyles from traditional to industrialized
Neither the study title nor the abstract elucidate how, exactly, one impacts the other, but the study itself does (of course) contain that information; we read it, and the short version is:
In terms of the extremes of “most traditional” to “most industrialized”, foragers have the most diverse oral microbiomes (that’s good), and people with an American industrialized lifestyle had the least diverse oral microbiomes (that’s bad). Between the two extremes, we see the gradient promised by the title.
If you do feel like checking it out, Figure 3 in the paper illustrates this nicely.
Also illustrated in the above-linked Figure 3 is oral microbiome composition. In other words (and to oversimplify it rather), how good or bad our mouth bacteria are for us, independent of diversity (so for example, are there more of this or that kind of bacteria).
Once again, there is a gradient, only this time, the ends of it are even more polarized: foragers have a diverse oral microbiome rich with healthy-for-humans bacteria, while people with an American industrialized lifestyle might not have the diversity, but do have a large number of bad-for-humans bacteria.
While many lifestyle factors are dietary or quasi-dietary, e.g. what kinds of foods people eat, whether they drink alcohol, whether they smoke or use gum, etc, many lifestyle factors were examined, including everything from medications and exercise, to things like kitchen location and what fuel is predominantly used, to education and sexual activity and many other things that we don’t have room for here.
You can see how each lifestyle factor stacked up, in Figure 5.
Why it matters
Our oral microbiome affects many aspects of health, including:
- Locally: caries, periodontal diseases, mucosal diseases, oral cancer, and more
- Systemically: gastrointestinal diseases in general, IBS in particular, nervous system diseases, Alzheimer’s disease, endocrine diseases, all manner of immune/autoimmune diseases, and more
Nor are the effects it has mild; oral microbiome health can be a huge factor, statistically, for many of the above. You can see information and data pertaining to all of the above and more, here:
Oral microbiomes: more and more importance in oral cavity and whole body
What to do about it
Take care of your oral microbiome, to help it to take care of you. As well as the above-mentioned lifestyle factors, it’s worth noting that when it comes to oral hygiene, not all oral hygiene products are created equal:
Toothpastes & Mouthwashes: Which Kinds Help, And Which Kinds Harm?
Additionally, you might want to consider gentler options, but if you do, take care to opt for things that science actually backs., rather than things that merely trended on social media.
This writer (hi, it’s me) is particularly excited about the science and use of the miswak stick, which comes from the Saladora persica tree, and has phytochemical properties that (amongst many other health-giving effects) improve the quality of saliva (i.e., improve its pH and microbiome composition). In essence, your own saliva gets biochemically nudged into being the safest, most effective mouthwash.
There’s a lot of science for the use of S. persica, and we’ve discussed it before in more detail than we have room to rehash today, here:
Less Common Oral Hygiene Options
If you’d like to enjoy these benefits (and also have the equivalent of a toothbrush that you can carry with you at all times and does not require water*), then here’s an example product on Amazon 😎
*don’t worry, it won’t feel like dry-brushing your teeth. Remember what we said about what it does to your saliva. Basically, you chomp it once, and your saliva a) increases and b) becomes biological tooth-cleaning fluid. The stick itself is fibrous, so the end of it frays in a way that makes a natural little brush. Each stick is about 5”×¼” and you can carry it in a little carrying case (you’ll get a couple with each pack of miswak sticks), so you can easily use it in, say, the restroom of a restaurant or before your appointment somewhere, just as easily as you could use a toothpick, but with much better results. You may be wondering how long a stick lasts; well, that depends on how much you use it, but in this writer’s experience, each stick lasts about a month maybe, using it at least 2–3 times per day, probably rather more since I use it after each meal/snack and upon awakening.
(the above may read like an ad, but we promise you it’s not sponsored and this writer’s just enthusiastic, and when you read the science, you will be too)
Enjoy!
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Dates vs Prunes – Which is Healthier?
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Our Verdict
When comparing dates to prunes, we picked the prunes.
Why?
First let’s note: we’re listing the second fruit here as “prunes” rather than “plums”, since prunes are dehydrated plums, and it makes more sense to compare the dried fruit to dates which are invariably dried too. Otherwise, the water weight of plums would unfairly throw out the nutrient proportions per 100g (indeed, upon looking up numbers, dates would overwhelmingly beat plums easily in the category of pretty much every nutrient).
So let’s look at the fairer comparison:
In terms of macros, dates have a little more protein, carbohydrate, and fiber. This is because while both are dried, prunes are usually sold with more water remaining than dates; indeed, per 100g prunes still have 30g water weight to dates’ 20g water weight. This makes everything close, but we are going to call this category a nominal win for dates. Mind you, hydration is still good, but please do not rely on dried fruit for your hydration!
When it comes to vitamins, dates have more of vitamins B5 and B9, while prunes have more of vitamins A, B2, B3, B6, C, E, K, and choline. A clear win for prunes here.
In the category of minerals, it’s a similar story: dates have more iron, magnesium, and selenium, while prunes have more calcium, copper, manganese, phosphorus, potassium, and zinc. Another win for prunes.
In short, enjoy either or both, but prunes win on overall nutritional density!
Want to learn more?
You might like to read:
From Apples to Bees, and High-Fructose Cs: Which Sugars Are Healthier, And Which Are Just The Same?
Take care!
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Here’s the latest you need to know about bird flu
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What you need to know
- Although bird flu continues to spread in wild birds, livestock, and humans, the risk to the public remains low.
- The majority of U.S. bird flu cases have been reported in farm workers who had direct contact with infected birds and cattle. Health officials are working to monitor the spread of the virus and improve protections for those most at risk.
- Recent data suggests that mutations in bird flu viruses could make them more dangerous to humans and potentially increase the risk of a pandemic.
- On January 6, Louisiana health officials confirmed the first U.S. death from bird flu.
Throughout 2024, dozens of human cases of H5N1 bird flu were detected as the virus spreads rapidly in livestock. The current risk to humans is low but not nonexistent. Here’s everything you need to know about the current status and future outlook of H5 bird flu in the United States.
Current U.S. bird flu status (as of January 6, 2025)
As of January 6, 66 human bird flu cases have been reported in eight states. Over half of all cases are in California. The state’s governor declared a state of emergency as a “proactive” action against bird flu on December 18.
On January 6, the Louisiana Department of Health reported the first U.S. bird flu death. The patient, a man over age 65, was previously confirmed to be the first severe bird flu case in the U.S. and the first case linked to backyard flocks. The department emphasized that the risk to the public is low and that no new cases or evidence of human transmission have been detected in the state.
All but two human bird flu cases this year were in farm workers who were exposed to infected livestock. The exposure source of the remaining cases—one in California and one in Missouri—is unknown.
The CDC reported on November 22 that a child in California tested positive for bird flu, the first known pediatric bird flu case in the U.S. However, it is unclear how the child contracted the virus, as they had no known contact with infected animals.
To date, there have been no reports of human transmission of bird flu during the current outbreak. Additionally, most human cases have not been severe, and no deaths have been reported. For these reasons, experts are confident that the bird flu risk to humans remains low.
“In the short term, there is very little threat,” Dr. Scott Roberts, an infectious diseases specialist with Yale Medicine said. “The risk for the general public is so low,” he emphasized to Yale Medicine.
How the U.S. is monitoring bird flu
The CDC continues to monitor the circulation of bird flu in humans as part of its year-round flu monitoring. The agency is also working to improve protections for farm workers, who are at the highest risk of contracting bird flu.
In November 2024, the CDC also announced expanded actions and updated guidance for farm workers, including improved access to and training for using personal protective equipment (such as N95 face masks), more rigorous testing procedures, and increased outreach. These updates followed a CDC report finding that 7 percent of participating dairy workers had signs of a recent bird flu infection. A second CDC study, also released in November, found inadequate use of personal protective equipment among dairy workers on farms with bird flu outbreaks.
After the H5N1 virus was found in raw milk being sold in California, the U.S. Department of Agriculture announced on December 6 that unpasteurized milk must be tested for bird flu. The USDA order also requires dairy farms with positive bird flu cases to cooperate with health officials in disease surveillance.
Is a bird flu pandemic possible?
In early November, a Canadian teen was hospitalized with bird flu caused by a virus that’s closely related to the H5N1 virus circulating in the U.S. The case has troubled experts for a few reasons.
First, it is Canada’s first human bird flu case where the patient was not infected while traveling, and the source of exposure is unknown. Second, the teen experienced severe symptoms and developed a lung infection requiring critical care, raising concern that bird flu infections may be more severe in younger people.
The final and biggest concern about the case is that genetic analysis revealed several changes in the virus’s DNA sequence, called mutations, that could potentially make the virus better able to infect humans. Researchers say that two of those mutations could make it easier for the virus to infect humans, and another one may make it easier for the virus to replicate after infecting a human. However, it’s unclear if the changes occurred before or after the teen was infected.
Scott Hensley, a professor of microbiology at the University of Pennsylvania, told Nature that “this should serve as a warning: this virus has the capacity to switch very quickly into a form that can cause severe disease.”
Notably, even in this more severe case, there is still no evidence of human transmission, which is necessary for a potential bird flu pandemic. However, the case underscores the risk of new and potentially dangerous mutations emerging as the H5N1 virus continues to spread and multiply.
A study published in Science on December 5 found that a genetic change on a protein on the surface of the virus could make it easier for the virus to attach to and infect human cells. But none of the mutations observed in the Canadian case are those identified in the study.
Importantly, the researchers stressed that the ability of the virus to attach to a specific part of human cells “is not the only [factor] required for human-to-human transmission of influenza viruses.”
How to stay safe
Most people are not at high risk of being exposed to bird flu. The virus is spreading between animals and from animals to humans through direct contact. The CDC recommends avoiding the consumption of raw milk products and direct contact with wild birds and potentially infected livestock.
“Pasteurization kills the bird flu virus and other harmful germs that can be found in raw milk,” says a November 24 California Department of Public Health press release. “CDPH advises consumers not to drink raw milk or eat raw milk products due to the risk of foodborne illnesses.”
Additionally, although the annual flu shot does not protect against bird flu, getting vaccinated helps prevent infection with seasonal flu and bird flu at the same time. In very rare instances, getting infected by two influenza viruses at the same time can result in a combination of genetic material that produces a new virus.
This phenomenon, known as antigenic shift, triggered the 2009 swine flu pandemic.
Learn more about how to protect yourself and your loved ones against bird flu.
For more information, talk to your health care provider.
This article first appeared on Public Good News and is republished here under a Creative Commons license.
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The Hidden Risk of Stretching: Avoiding Hamstring Injuries in Yoga
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What is Yoga Butt
Have you ever experienced a mysterious pain while stretching, or perhaps during yoga? You might be dealing with “yoga butt,” a common—although rarely discussed—injury. In the below video, the Lovely Liv from Livinleggings shares her journey of discovering, and overcoming, “yoga butt”.
Dealing With Yoga Butt
Yoga butt, or proximal hamstring tendinopathy, occurs when the hamstrings are overstretched without adequate strengthening. Many yoga poses help stretch the hamstrings, but often don’t focus on strengthening said hamstrings; this imbalance is what can lead to damage over time.
To help prevent Yoga butt, it’s essential to balance stretching with strengthening. You can look into incorporating hamstring-strengthening exercises like Romanian deadlifts, hamstring curls, and modified yoga poses into your routine.
(If you’re new to strengthening exercises, we recommend reading Women’s Strength Training Anatomy Workouts or Strength Training for Seniors).
Watch the full video to learn more and hopefully protect yourself from long-term injuries:
Let us know your thoughts, and whether you have any other topics you’d like us to cover.
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