Berberine For Metabolic Health

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Is Berberine Nature’s Ozempic/Wegovy?

Berberine is a compound found in many plants. Of which, some of them are variations of the barberry, hence the name.

It’s been popular this past couple of years, mostly for weight loss. In and of itself, something being good for weight loss doesn’t mean it’s good for the health (just ask diarrhoea, or cancer).

Happily, berberine’s mechanisms of action appear to be good for metabolic health, including:

  • Reduced fasting blood sugar levels
  • Improved insulin sensitivity
  • Reduced LDL and triglycerides
  • Increased HDL levels

So, what does the science say?

It’s (mostly!) not nature’s Wegovy/Ozempic

It’s had that title in a number of sensationalist headlines (and a current TikTok trend, apparently), but while both berberine and the popular weight-loss drugs Wegovy/Ozempic act in part on insulin metabolism, they mostly do so by completely different mechanisms.

Wegovy and Ozempic are GLP-1 agonists, which mean they augment the action of glucagon-like-peptide 1, which increases insulin release, decreases glucagon release, and promotes a more lasting feeling of fullness.

Berberine works mostly by other means, not all of which are understood. But, we know that it activates AMP-activated protein kinase, and on the flipside, inhibits proprotein convertase subtilisin/kexin type 9.

In less arcane words: it boosts some enzymes and inhibits others.

Each of these boosts/inhibitions has a positive effect on metabolic health.

However, it does also have a slight GLP-1 agonist effect too! Bacteria in the gut can decompose and metabolize berberine into dihydroberberine, thus preventing the absorption of disaccharides in the intestinal tract, and increasing GLP-1 levels.

See: Effects of Berberine on the Gastrointestinal Microbiota

Does it work for weight loss?

Yes, simply put. And if we’re going to put it head-to-head with Wegovy/Ozempic, it works about half as well. Which sounds like a criticism, but for a substance that’s a lot safer (and cheaper, and easier—if we like capsules over injections) and has fewer side effects.

❝But more interestingly, the treatment significantly reduced blood lipid levels (23% decrease of triglyceride and 12.2% decrease of cholesterol levels) in human subjects.

However, there was interestingly, an increase in calcitriol levels seen in all human subjects following berberine treatment (mean 59.5% increase)

Collectively, this study demonstrates that berberine is a potent lipid-lowering compound with a moderate weight loss effect, and may have a possible potential role in osteoporosis treatment/prevention.❞

(click through to read in full)

Is it safe?

It appears to be, with one special caveat: remember that paper about the effects of berberine on the gastrointestinal microbiota? It also has some antimicrobial effects, so you could do harm there if not careful. It’s recommended to give it a break every couple of months, to be sure of allowing your gut microbiota to not get too depleted.

Also, as with anything you might take that’s new, always consult your doctor/pharmacist in case of contraindications based on medications you are taking.

Where can I get it?

As ever, we don’t sell it, but here’s an example product on Amazon, for your convenience.

Enjoy!

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  • The Conquest of Happiness – by Bertrand Russell

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    When we have all our physical needs taken care of, why are we often still not happy, and what can we do about that?

    Mathematician, philosopher, and Nobel prizewinner Bertrand Russell has answers. And, unlike many of “the great philosophers”, his writing style is very clear and accessible.

    His ideas are simple and practical, yet practised by few. Rather than taking a “be happy with whatever you have” approach, he does argue that we should strive to find more happiness in some areas and ways—and lays out guidelines for doing so.

    Areas to expand, areas to pull back on, areas to walk a “virtuous mean”. Things to be optimistic about; things to not get our hopes up about.

    Applying Russell’s model, there’s no more “should I…?” moments of wondering which way to jump.

    Bottom line: if you’ve heard enough about “how to be happy” from wishy-washier sources, you might find the work of this famous logician refreshing.

    Click here to check out The Conquest of Happiness, and see how much happier you might become!

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  • What happens to your vagina as you age?

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    The vagina is an internal organ with a complex ecosystem, influenced by circulating hormone levels which change during the menstrual cycle, pregnancy, breastfeeding and menopause.

    Around and after menopause, there are normal changes in the growth and function of vaginal cells, as well as the vagina’s microbiome (groups of bacteria living in the vagina). Many women won’t notice these changes. They don’t usually cause symptoms or concern, but if they do, symptoms can usually be managed.

    Here’s what happens to your vagina as you age, whether you notice or not.

    Let’s clear up the terminology

    We’re focusing on the vagina, the muscular tube that goes from the external genitalia (the vulva), past the cervix, to the womb (uterus). Sometimes the word “vagina” is used to include the external genitalia. However, these are different organs and play different roles in women’s health.

    What happens to the vagina as you age?

    Like many other organs in the body, the vagina is sensitive to female sex steroid hormones (hormones) that change around puberty, pregnancy and menopause.

    Menopause is associated with a drop in circulating oestrogen concentrations and the hormone progesterone is no longer produced. The changes in hormones affect the vagina and its ecosystem. Effects may include:

    • less vaginal secretions, potentially leading to dryness
    • less growth of vagina surface cells resulting in a thinned lining
    • alteration to the support structure (connective tissue) around the vagina leading to less elasticity and more narrowing
    • fewer blood vessels around the vagina, which may explain less blood flow after menopause
    • a shift in the type and balance of bacteria, which can change vaginal acidity, from more acidic to more alkaline.

    What symptoms can I expect?

    Many women do not notice any bothersome vaginal changes as they age. There’s also little evidence many of these changes cause vaginal symptoms. For example, there is no direct evidence these changes cause vaginal infection or bleeding in menopausal women.

    Some women notice vaginal dryness after menopause, which may be linked to less vaginal secretions. This may lead to pain and discomfort during sex. But it’s not clear how much of this dryness is due to menopause, as younger women also commonly report it. In one study, 47% of sexually active postmenopausal women reported vaginal dryness, as did around 20% of premenopausal women.

    Other organs close to the vagina, such as the bladder and urethra, are also affected by the change in hormone levels after menopause. Some women experience recurrent urinary tract infections, which may cause pain (including pain to the side of the body) and irritation. So their symptoms are in fact not coming from the vagina itself but relate to changes in the urinary tract.

    Not everyone has the same experience

    Women vary in whether they notice vaginal changes and whether they are bothered by these to the same extent. For example, women with vaginal dryness who are not sexually active may not notice the change in vaginal secretions after menopause. However, some women notice severe dryness that affects their daily function and activities.

    In fact, researchers globally are taking more notice of women’s experiences of menopause to inform future research. This includes prioritising symptoms that matter to women the most, such as vaginal dryness, discomfort, irritation and pain during sex.

    If symptoms bother you

    Symptoms such as dryness, irritation, or pain during sex can usually be effectively managed. Lubricants may reduce pain during sex. Vaginal moisturisers may reduce dryness. Both are available over-the-counter at your local pharmacy.

    While there are many small clinical trials of individual products, these studies lack the power to demonstrate if they are really effective in improving vaginal symptoms.

    In contrast, there is robust evidence that vaginal oestrogen is effective in treating vaginal dryness and reducing pain during sex. It also reduces your chance of recurrent urinary tract infections. You can talk to your doctor about a prescription.

    Vaginal oestrogen is usually inserted using an applicator, two to three times a week. Very little is absorbed into the blood stream, it is generally safe but longer-term trials are required to confirm safety in long-term use beyond a year.

    Women with a history of breast cancer should see their oncologist to discuss using oestrogen as it may not be suitable for them.

    Are there other treatments?

    New treatments for vaginal dryness are under investigation. One avenue relates to our growing understanding of how the vaginal microbiome adapts and modifies around changes in circulating and local concentrations of hormones.

    For example, a small number of reports show that combining vaginal probiotics with low-dose vaginal oestrogen can improve vaginal symptoms. But more evidence is needed before this is recommended.

    Where to from here?

    The normal ageing process, as well as menopause, both affect the vagina as we age.

    Most women do not have troublesome vaginal symptoms during and after menopause, but for some, these may cause discomfort or distress.

    While hormonal treatments such as vaginal oestrogen are available, there is a pressing need for more non-hormonal treatments.

    Dr Sianan Healy, from Women’s Health Victoria, contributed to this article.

    Louie Ye, Clinical Fellow, Department of Obstetrics and Gynecology, The University of Melbourne and Martha Hickey, Professor of Obstetrics and Gynaecology, The University of Melbourne

    This article is republished from The Conversation under a Creative Commons license. Read the original article.

    The Conversation

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  • How To Make Drinking Less Harmful

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    Making Drinking Less Harmful

    We often talk of the many ways alcohol harms our health, and we advocate for reducing (or eliminating) its consumption. However, it’s not necessarily as easy as all that, and it might not even be a goal that everyone has. So, if you’re going to imbibe, what can you do to mitigate the harmful effects of alcohol?

    There is no magical solution

    Sadly. If you drink alcohol, there will be some harmful effects, and nothing will completely undo that. But there are some things that can at least help—read on to learn more!

    Coffee

    It’s not the magical sober-upperer that some would like it to be, but it is good against the symptoms of alcohol intoxication, and slightly reduces the harm to your body, because it is:

    • Hydrating (whereas alcohol is dehydrating)
    • A source of antioxidants (whereas alcohol causes oxidative stress, which has nothing to do with psychological stress, and is a kind of cellular damage)
    • A stimulant, assuming it is not decaffeinated (it’s worth noting that its stimulant effects work partly by triggering vasoconstriction, which is the opposite of the vasodilation caused by alcohol)

    To this end, the best coffee for anti-alcohol effects should be:

    • Caffeinated, and strong
    • Long (we love espresso, but we need hydration here and that comes from volume!)
    • Without sugar (you don’t want to create an adverse osmotic gradient to leech water from your body)

    As for milk/cream/whatever, have it or don’t, per your usual preference. It won’t make any difference to the alcohol in your system.

    Antioxidants, polyphenols, flavonoids, and things with similar mechanisms

    We mentioned that coffee contains antioxidants, but if you want to really bring out the heavy guns, taking more powerful antioxidants can help a lot. If you don’t have the luxury of enjoying berries and cacao nibs by the handful, supplements that have some similar benefits are a perfectly respectable choice.

    For example, you might want to consider green tea extract:

    L-theanine 200mg (available on Amazon)

    Specialist anti-alcohol drugs

    These are somewhat new and the research is still ongoing, but for example:

    Dihydromyricetin (DHM) as a novel anti-alcohol intoxication medication

    In short, DHM is a flavonoid (protects against the oxidative stress caused by alcohol, and has been found to reduce liver damage—see the above link) and also works on GABA-receptors (reduces alcohol withdrawal symptoms after cessation of drinking, and thus also reduces hangovers).

    Once again: the marketing claims of such drugs may be bold, but there’s a lot that’s not known and they’re not a magic pill. They do NOT mean you can take them alongside drinking and drink what you like with impunity. However, they may help mitigate some of the harmful effects of alcohol. If you wish to try them, these can be purchased at pharmacies or online, for example:

    Alcohol Defense Capsules (available on Amazon)

    Bottom line

    Alcohol is bad for your health and none of the above will eliminate the health risks. But, if you’re going to have alcohol, then having the above things as well may at least somewhat reduce the harm done.

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  • Dandelion: Time For Evidence On Its Benefits?
  • Do you have knee pain from osteoarthritis? You might not need surgery. Here’s what to try instead

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Most people with knee osteoarthritis can control their pain and improve their mobility without surgery, according to updated treatment guidelines from the Australian Commission on Safety and Quality in Health Care.

    So what is knee osteoarthritis and what are the best ways to manage it?

    Pexels/Kindelmedia

    More than 2 million Australians have osteoarthritis

    Osteoarthritis is the most common joint disease, affecting 2.1 million Australians. It costs the economy A$4.3 billion each year.

    Osteoarthritis commonly affects the knees, but can also affect the hips, spine, hands and feet. It impacts the whole joint including bone, cartilage, ligaments and muscles.

    Most people with osteoarthritis have persistent pain and find it difficult to perform simple daily tasks, such as walking and climbing stairs.

    Is it caused by ‘wear and tear’?

    Knee osteoarthritis is most likely to affect older people, those who are overweight or obese, and those with previous knee injuries. But contrary to popular belief, knee osteoarthritis is not caused by “wear and tear”.

    Research shows the degree of structural wear and tear visible in the knee joint on an X-ray does not correlate with the level of pain or disability a person experiences. Some people have a low degree of structural wear and tear and very bad symptoms, while others have a high degree of structural wear and tear and minimal symptoms. So X-rays are not required to diagnose knee osteoarthritis or guide treatment decisions.

    Telling people they have wear and tear can make them worried about their condition and afraid of damaging their joint. It can also encourage them to try invasive and potentially unnecessary treatments such as surgery. We have shown this in people with osteoarthritis, and other common pain conditions such as back and shoulder pain.

    This has led to a global call for a change in the way we think and communicate about osteoarthritis.

    What’s the best way to manage osteoarthritis?

    Non-surgical treatments work well for most people with osteoarthritis, regardless of their age or the severity of their symptoms. These include education and self-management, exercise and physical activity, weight management and nutrition, and certain pain medicines.

    Education is important to dispel misconceptions about knee osteoarthritis. This includes information about what osteoarthritis is, how it is diagnosed, its prognosis, and the most effective ways to self-manage symptoms.

    Health professionals who use positive and reassuring language can improve people’s knowledge and beliefs about osteoarthritis and its management.

    Many people believe that exercise and physical activity will cause further damage to their joint. But it’s safe and can reduce pain and disability. Exercise has fewer side effects than commonly used pain medicines such as paracetamol and anti-inflammatories and can prevent or delay the need for joint replacement surgery in the future.

    Many types of exercise are effective for knee osteoarthritis, such as strength training, aerobic exercises like walking or cycling, Yoga and Tai chi. So you can do whatever type of exercise best suits you.

    Increasing general physical activity is also important, such as taking more steps throughout the day and reducing sedentary time.

    Weight management is important for those who are overweight or obese. Weight loss can reduce knee pain and disability, particularly when combined with exercise. Losing as little as 5–10% of your body weight can be beneficial.

    Pain medicines should not replace treatments such as exercise and weight management but can be used alongside these treatments to help manage pain. Recommended medicines include paracetamol and non-steroidal anti-inflammatory drugs.

    Opioids are not recommended. The risk of harm outweighs any potential benefits.

    What about surgery?

    People with knee osteoarthritis commonly undergo two types of surgery: knee arthroscopy and knee replacement.

    Knee arthroscopy is a type of keyhole surgery used to remove or repair damaged pieces of bone or cartilage that are thought to cause pain.

    However, high-quality research has shown arthroscopy is not effective. Arthroscopy should therefore not be used in the management of knee osteoarthritis.

    Joint replacement involves replacing the joint surfaces with artificial parts. In 2021–22, 53,500 Australians had a knee replacement for their osteoarthritis.

    Joint replacement is often seen as being inevitable and “necessary”. But most people can effectively manage their symptoms through exercise, physical activity and weight management.

    The new guidelines (known as “care standard”) recommend joint replacement surgery only be considered for those with severe symptoms who have already tried non-surgical treatments.

    I have knee osteoarthritis. What should I do?

    The care standard links to free evidence-based resources to support people with osteoarthritis. These include:

    If you have osteoarthritis, you can use the care standard to inform discussions with your health-care provider, and to make informed decisions about your care.

    Belinda Lawford, Postdoctoral research fellow in physiotherapy, The University of Melbourne; Giovanni E. Ferreira, NHMRC Emerging Leader Research Fellow, Institute of Musculoskeletal Health, University of Sydney; Joshua Zadro, NHMRC Emerging Leader Research Fellow, Sydney Musculoskeletal Health, University of Sydney, and Rana Hinman, Professor in Physiotherapy, The University of Melbourne

    This article is republished from The Conversation under a Creative Commons license. Read the original article.

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  • Eating For Energy (In Ways That Actually Work)

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    Snacks & Hacks: The Real Energy Boosters

    Declining energy levels are a common complaint of people getting older, and this specific kind of “getting older” is starting earlier and earlier (even Gen-Z are already getting in line for this one). For people of all ages, however, diet is often a large part of the issue.

    The problem:

    It can sometimes seem, when it comes to food and energy levels, that we have a choice:

    • Don’t eat (energy levels decline)
    • Eat quick-release energy snacks (energy spikes and crashes)
    • Eat slow-release energy meals (oh hi, post-dinner slump)

    But, this minefield can be avoided! Advice follows…

    Skip the quasi-injectables

    Anything the supermarket recommends for rapid energy can be immediately thrown out (e.g. sugary energy drinks, glucose tablets, and the like).

    Same goes for candy of most sorts (if the first ingredient is sugar, it’s not good for your energy levels).

    Unless you are diabetic and need an emergency option to keep with you in case of a hypo, the above things have no place on a healthy shopping list.

    Aside from that, if you have been leaning on these heavily, you might want to check out yesterday’s main feature:

    The Not-So-Sweet Science Of Sugar Addiction

    …and if your knee-jerk response is “I’m not addicted; I just enjoy…” then ok, test that! Skip it for this month.

    • If you succeed, you’ll be in better health.
    • If you don’t, you’ll be aware of something that might benefit from more attention.

    Fruit and nuts are your best friends

    Unless you are allergic, in which case, obviously skip your allergen(s).

    But for most of us, we were born to eat fruit and nuts. Literally, those two things are amongst the oldest and most well-established parts of human diet, which means that our bodies have had a very long time to evolve the perfect fruit-and-nut-enjoying abilities, and reap the nutritional benefits.

    Nuts are high in fat (healthy fats) and that fat is a great source of energy’s easy for the body to get from the food, and/but doesn’t result in blood sugar spikes (and thus crashes) because, well, it’s not a sugar.

    See also: Why You Should Diversify Your Nuts

    Fruit is high in sugars, and/but high in fiber that slows the absorption into a nice gentle curve, and also contains highly bioavailable vitamins to perk you up and polyphenols to take care of your long-term health too.

    Be warned though: fruit juice does not work the same as actual fruit; because the fiber has been stripped and it’s a liquid, those sugars are zipping straight in exactly the same as a sugary energy drink.

    See also: Which Sugars Are Healthier, And Which Are Just The Same?

    Slow release carbs yes, but…

    Eating a bowl of wholegrain pasta is great if you don’t have to do anything much immediately afterwards, but it won’t brighten your immediately available energy much—on the contrary, energy will be being used for digestion for a while.

    So if you want to eat slow-release carbs, make it a smaller portion of something more-nutrient dense, like oats or lentils. This way, the metabolic load will be smaller (because the portion was smaller) but the higher protein content will prompt satiety sooner (so you addressed your hunger with a smaller portion) and the iron and B vitamins will be good for your energy too.

    See also: Should You Go Light Or Heavy On Carbs?

    Animal, vegetable, or mineral?

    At the mention of iron and B vitamins, you might be thinking about various animal products that might work too.

    If you are vegetarian or vegan: stick to that; it’s what your gut microbiome is used to now, and putting an animal product in will likely make you feel ill.

    If you have them in your diet already, here’s a quick rundown of how broad categories of animal product work (or not) for energy:

    • Meat: nope. Well, the fat, if applicable, will give you some energy, but less than you need just to digest the meat. This, by the way, is a likely part of why the paleo diet is good for short term weight loss. But it’s not very healthy.
    • Fish: healthier than the above, but for energy purposes, just the same.
    • Dairy: high-fat dairy, such as cream and butter, are good sources of quick energy. Be aware if they contain lactose though, that this is a sugar and can be back to spiking blood sugars.
      • As an aside for diabetics: this is why milk can be quite good for correcting a hypo: the lactose provides immediate sugar, and the fat keeps it more balanced afterwards
    • Eggs: again the fat is a good source of quick energy, and the protein is easier to digest than that of meat (after all, egg protein is literally made to be consumed by an embryo, while meat protein is made to be a functional muscle of an animal), so the metabolic load isn’t too strenuous. Assuming you’re doing a moderate consumption (under 3 eggs per day) and not Sylvester Stallone-style 12-egg smoothies, you’re good to go.

    See also: Do We Need Animal Products To Be Healthy?

    …and while you’re at it, check out:

    Eggs: Nutritional Powerhouse or Heart-Health Timebomb?

    (spoiler: it’s the former; the title was because it was a mythbusting edition)

    Hydration considerations

    Lastly, food that is hydrating will be more energizing than food that is not, so how does your snack/meal rank on a scale of watermelon to saltines?

    You may be thinking: “But you said to eat nuts! They’re not hydrating at all!”, in which case, indeed, drink water with them, or better yet, enjoy them alongside fruit (hydration from food is better than hydration from drinking water).

    And as for those saltines? Salt is not your friend (unless you are low on sodium, because then that can sap your energy)

    How to tell if you are low on sodium: put a little bit (e.g. ¼ tsp) of salt into a teaspoon and taste it; does it taste unpleasantly salty? If not, you were low on sodium. Have a little more at five minute intervals, until it tastes unpleasantly salty. Alternatively have a healthy snack that nonetheless contains a little salt.

    If you otherwise eat salty food as an energy-giving snack, you risk becoming dehydrated and bloated, neither of which are energizing conditions.

    Dehydrated and bloated at once? Yes, the two often come together, even though it usually doesn’t feel like it. Basically, if we consume too much salty food, our homeostatic system goes into overdrive to try to fix it, borrows a portion of our body’s water reserves to save us from the salt, and leaves us dehydrated, bloated, and sluggish.

    For more on salt in general, check out:

    How Too Much Salt Can Lead To Organ Failure: Lesser-Known Salt Health Risks

    Take care!

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  • Is it OK to lie to someone with dementia?

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    There was disagreement on social media recently after a story was published about an aged care provider creating “fake-away” burgers that mimicked those from a fast-food chain, to a resident living with dementia. The man had such strict food preferences he was refusing to eat anything at meals except a burger from the franchise. This dementia symptom risks malnutrition and social isolation.

    But critics of the fake burger approach labelled it trickery and deception of a vulnerable person with cognitive impairment.

    Dementia is an illness that progressively robs us of memories. Although it has many forms, it is typical for short-term recall – the memory of something that happened in recent hours or days – to be lost first. As the illness progresses, people may come to increasingly “live in the past”, as distant recall gradually becomes the only memories accessible to the person. So a person in the middle or later stages of the disease may relate to the world as it once was, not how it is today.

    This can make ethical care very challenging.

    Pikselstock/Shutterstock

    Is it wrong to lie?

    Ethical approaches classically hold that specific actions are moral certainties, regardless of the consequences. In line with this moral absolutism, it is always wrong to lie.

    But this ethical approach would require an elderly woman with dementia who continually approaches care staff looking for their long-deceased spouse to be informed their husband has passed – the objective truth.

    Distress is the likely outcome, possibly accompanied by behavioural disturbance that could endanger the person or others. The person’s memory has regressed to a point earlier in their life, when their partner was still alive. To inform such a person of the death of their spouse, however gently, is to traumatise them.

    And with the memory of what they have just been told likely to quickly fade, and the questioning may resume soon after. If the truth is offered again, the cycle of re-traumatisation continues.

    older man looks into distance holding mug
    People with dementia may lose short term memories and rely on the past for a sense of the world. Bonsales/Shutterstock

    A different approach

    Most laws are examples of absolutist ethics. One must obey the law at all times. Driving above the speed limit is likely to result in punishment regardless of whether one is in a hurry to pick their child up from kindergarten or not.

    Pragmatic ethics rejects the notion certain acts are always morally right or wrong. Instead, acts are evaluated in terms of their “usefulness” and social benefit, humanity, compassion or intent.

    The Aged Care Act is a set of laws intended to guide the actions of aged care providers. It says, for example, psychotropic drugs (medications that affect mind and mood) should be the “last resort” in managing the behaviours and psychological symptoms of dementia.

    Instead, “best practice” involves preventing behaviour before it occurs. If one can reasonably foresee a caregiver action is likely to result in behavioural disturbance, it flies in the face of best practice.

    What to say when you can’t avoid a lie?

    What then, becomes the best response when approached by the lady looking for her husband?

    Gentle inquiries may help uncover an underlying emotional need, and point caregivers in the right direction to meet that need. Perhaps she is feeling lonely or anxious and has become focused on her husband’s whereabouts? A skilled caregiver might tailor their response, connect with her, perhaps reminisce, and providing a sense of comfort in the process.

    This approach aligns with Dementia Australia guidance that carers or loved ones can use four prompts in such scenarios:

    • acknowledge concern (“I can tell you’d like him to be here.”)
    • suggest an alternative (“He can’t visit right now.”)
    • provide reassurance (“I’m here and lots of people care about you.”)
    • redirect focus (“Perhaps a walk outside or a cup of tea?”)

    These things may or may not work. So, in the face of repeated questions and escalating distress, a mistruth, such as “Don’t worry, he’ll be back soon,” may be the most humane response in the circumstances.

    Different realities

    It is often said you can never win an argument with a person living with dementia. A lot of time, different realities are being discussed.

    So, providing someone who has dementia with a “pretend” burger may well satisfy their preferences, bring joy, mitigate the risk of malnutrition, improve social engagement, and prevent a behavioural disturbance without the use of medication. This seems like the correct approach in ethical terms. On occasion, the end justifies the means.

    Steve Macfarlane, Head of Clinical Services, Dementia Support Australia, & Associate Professor of Psychiatry, Monash University

    This article is republished from The Conversation under a Creative Commons license. Read the original article.

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