Social worker explains 5 behaviors common in dementia and how to deal with them

Some common behaviors of people with dementia can be a challenge to their loved ones and caregivers. The strategies outlined below can help all involved to deal with these behaviors.

Whitney Hadley

Five classic behaviors that typically arise in someone who has Alzheimer’s disease or another type of dementia can be confusing and frustrating to caregivers.

Understanding what drives those behaviors may help.

“Most of the behaviors that become common when someone enters the middle stages of the disease are really just ways of communicating needs or discomforts or emotions,” says Whitney Hadley, a social worker at the Central New York Chapter of the Alzheimer’s Association.

Here’s a rundown from Hadley:

Behavior: Anxiety or agitation

Looks like: Restlessness and pacing, or over-reliance on a caregiver.

Explanation: If the person is feeling anxious or uncertain about something while losing control due to the disease, he or she is likely seeking out what’s most familiar, to feel safe.

Action: Recognize and act on any physical or emotional needs tied to their behavior. If they pace at dinnertime, make sure they wear shoes that fit well.

Behavior: Confusion or suspicion

Looks like: Accusation that a lost item was stolen.

Explanation: With dementia, people lose the ability to retrace their steps. If you are sitting near where they usually place their keys, and they cannot find their keys, they may logically believe you took them.

Action: Instead of arguing that you don’t have their keys, say, “Let me help you find your keys. That must be very stressful for you. Let’s look for them together.”

Behavior: Repetition

Looks like: Asking what time is lunch, over and over.

Explanation: They may want to engage and talk to someone, they may be having trouble processing information, or they may be forgetting that they have asked already.

Action: Consider whether they are hungry; did they eat a small breakfast several hours ago and now they need a snack? Are they thirsty? Answer the same way each time, and briefly. Say, “Lunch is at noon.” Then redirect with something such as, “Let’s go take a walk,” or “Let’s fold these towels.”

Behavior: Aggression or anger

Looks like: Sudden verbal or physical outburst.

Explanation: An aggressive episode is usually more scary than it is dangerous.

Action: After things have settled down, piece together what prompted the outburst for clues of how to prevent more. Consider what factors frustrated them. Are they in pain? Did the tone of your voice provoke them? Could they be overly tired? What about medication side effects?

Behavior: Wandering

Looks like: Becoming lost, from disorientation or confusion.

Explanation: About 60 percent of people with dementia will wander at some point, and usually without warning. It may be tied to boredom, the person trying to follow old habits, trying to find something or someone, or trying to get away from something unpleasant or stressful.

Action: Have safety precautions in place, including a list of places the person may wander to, such as previous job locations, former homes, places of worship or favorite restaurants. Also, the Alzheimer’s Association offers MedicAlert + Safe Return. Learn more at 800-272-3900.

A piece of advice

“Keep a notebook,” says Hadley.

“Taking notes is one of the best things a caregiver can do. It helps you identify a progression of symptoms, helps you to work through, if you start to see a behavior more frequently, what could be causing it.

“If you start to write these things down — What time of day is it happening? What’s going on that could be triggering it? — you’ll start to see patterns, and that will help you in the future.”

This article appears in the summer 2017 issue of Upstate Health magazine. Click here to hear a podcast/radio interview with Hadley about communicating with people who have dementia.

 

Posted in aging/geriatrics, Alzheimer's/dementia, mental health/emotional health | Tagged , , , , , ,

2 questions to ask if you’re told you have multiple sclerosis

Dominic Carone, PhD, at Upstate’s Institute for Human Performance, where the Neuropsychology Assessment Program is located. (PHOTO BY SUSAN KAHN)

Among patients treated for multiple sclerosis, up to 10 percent have been mistakenly diagnosed and treated for the disorder. “In many cases they are treated for 10 years or longer, causing for them financial, emotional and physical hardship,” says Upstate neuropsychologist Dominic Carone, PhD.

Carone wrote in the journal Applied Neuropsychology: Adult about a middle-aged woman who for five years was treated for MS, a disease of the central nervous system, and for a hereditary and rare form of stroke. When her condition declined, her neurologist referred her to Carone, the coordinator of the Neuropsychology Assessment Program at Upstate.

It turns out that MS and this rare stroke disorder have never been known to occur in the same person. Since genetic testing, imaging scans and other evidence proved the woman had the rare stroke disorder, Carone convinced her neurologist that she did not have MS.

This case highlights how neuropsychological consultations can help improve diagnostic decision-making and stresses the importance of doctors distinguishing a particular disease or condition from others with similar features.

It also provides two lessons for patients who receive an MS diagnosis. Carone suggests asking: “On what criteria is my diagnosis based?” and “Can I have a second opinion?”

This article appears in the summer 2017 issue of Upstate Health magazineClick here for a podcast/radio interview in which Carone talks about MS,  the role of a neuropsychologist and the individual case outlined above.

Posted in brain/neurology, health care, HealthLink on Air, psychology/psychiatry, research, stroke | Tagged , , ,

How breast cancer affected three Central New York women

Surgeons work together to provide mastectomy, reconstruction

Paula Galecki (PHOTO BY SUSAN KAHN)

Paula Malecki, 47, of Cicero

Diagnosed: July 3, 2015

Concern: A red spot on her breast seemed to get brighter in the shower. A friend insisted she see a doctor, who sent her for a mammogram and sonogram on a Thursday.

She returned the next day for a biopsy of an area of concern in one breast.

That Monday she learned she had estrogen positive breast cancer.

“I felt like my Grandma was looking out for me,” she says. “It was almost like someone gave me a sign to get to the doctor.”

History: Breast cancer killed her grandmother. Also, 13 years prior, Malecki underwent a lumpectomy to remove suspicious tissue in one breast.

Treatment: Malecki underwent a double mastectomy three days after her diagnosis, with Scott Albert, MD.

Breast surgeon Scott Albert, MD

“I had to, for my kids. I have twin boys who were 8 at the time, and I have a daughter who was 18. I had to be strong.”

Later she had reconstructive surgery. Then she had her ovaries removed, since she was at an increased risk for ovarian cancer.

Advice: “If you have dense breast tissue, don’t go without a sonogram. A 3-dimensional mammogram did not show my cancer, but a sonogram did.”

Crystal Combs (PHOTO BY WILLIAM MUELLER)

Crystal Combs, 44, of Syracuse

Diagnosed: Feb. 26, 2016

Concern: A routine mammogram revealed two tumors in one breast and three in the other. Five biopsies helped provide Combs with a diagnosis of an aggressive cancer that has required extensive treatment.

History: There has been some cancer in her family.

Treatment: Combs underwent a double mastectomy in July 2016, after several months of chemotherapy. She has had radiation therapy, and is currently being treated with a third type of chemotherapy,, which she will be on until March 2018.

Combs plans to complete treatment before she considers whether to have reconstruction surgery.

“I look at it like I’m fortunate,” she says of her young age and healthy heart, which has allowed her to withstand the rigors of treatment. She also credits her surgeon, Scott Albert, MD, with being compassionate and taking the time to explain her treatments. Combs is grateful that her daughter has been with her every step of the way.

Advice: “Talk about it. We owe it to ourselves, our children and grandchildren, and our community to break the silence. It’s OK to say ,’I have breast cancer. I am here. I’ll get through it.’ It gets hard, but have faith.”

Elva Greene (PHOTO BY SUSAN KAHN)

Elva Greene, 41, of Bernhards Bay

Surgery: August 2015

History: Green’s grandmother, mother and two aunts had – and survived — breast cancer. “After I divorced and became a single mom, just kind of looming over my head was the fear of potentially having breast cancer.”

Action: Considering her family history, and her personal history of benign lumps being discovered and removed, Green’s risk of developing breast cancer was increased. So, she elected to have both breasts surgically removed before cancer could develop.

“It was a super-tough decision, but once I made the decision, I have been so happy…just knowing that I have my three kids, and this is not something I will have to worry about.”

Breast surgeon Prashant Upadhyaya, MD

She says before the surgery and reconstruction, her lifetime risk of developing breast cancer was more than 30 percent. Afterward, her risk dropped to below 1 percent.

Treatment: “My doctors did such an amazing job that my scarring is minimal.” Her surgery team included Scott Albert, MD, and Prashant Upadhyaya, MD.

Advice: “Join a support group, or find someone who has been through the experience. Just finding someone to talk to really takes away the scariness.”

This article appears in the spring 2017 issue of Cancer Care magazine.

Posted in cancer, drugs/medications/pharmacy, health care, medical imaging/radiology, patient story, surgery, women's health/gynecology | Tagged , , , , , ,

Recipe: Roasted Vegetable Dip

Healthy dips like this one are good for sharing – and surrounding yourself with friends and family can help lift your spirits, says Kris Ghosh, MD, author of the “Betty Crocker Living With Cancer Cookbook.”

This particular dip is high in vitamins A and C. Preparation from start to finish is about 45 minutes. This makes seven ¼-cup servings.

Ingredients

1 medium zucchini, sliced (2 cups)

1 medium yellow summer squach, sliced (1½ cups)

1 medium red bell pepper, sliced

1 medium red onion, thinly sliced

2 cloves garlic, peeled

cooking spray

½ teaspoon salt

¼ teaspoon ground red pepper (cayenne)

dippers (such as baby carrots, cucumber slices, green bell pepper strips, toasted pita bread wedges and/or baked tortilla chips)

Preparation

  1. Heat oven to 400 degrees. In a 15-by-10-by-1-inch pan, spread zucchini, yellow squash, red pepper, onion and garlic. Spray vegetables with cooking spray. Sprinkle with salt and red pepper.
  2. Bake about 30 minutes, turning vegetables once, until vegetables are tender and lightly browned.
  3. Place vegetables in blender or food processor. Cover. Blend on high speed about 1 minute — stopping blender occasionally to scrape sides — until smooth.
  4. Serve warm. Or, refrigerate at least 2 hours until chilled. Serve with dippers.

Nutritional information

One ¼-cup serving contains:

25 calories

0 grams fat

0 milligrams cholesterol

170 milligrams sodium

210 milligrams potassium

5 grams carbohydrates

1 gram dietary fiber

1 gram protein

Source: “Betty Crocker Living With Cancer Cookbook”

This article appears in the spring 2017 issue of Cancer Care magazine.

Posted in health care, recipe

Brains against brain tumors

Experts from several scientific fields join forces to accelerate fight against brain cancer

BY JIM HOWE

To better meet the challenges of treating brain cancer, Upstate’s Precision Neuro-Oncology Program pools the expertise of the best minds in a variety of scientific fields.

The newly formed Brain Tumor Research Group involves neurosurgeons, pathologists and neuroscientists from Upstate Medical University and biomedical scientists from Cornell University to analyze and test brain tumors with the goal of increasing the number of available brain cancer treatments.

Working as a multidisciplinary team, the experts store tumor samples in a unique tumor bank, perform molecular profiling and biological assays and work toward predicting the progression of brain cancer and its outcome. In addition, the group works to develop clinical trials that could lead to new cancer treatments and possibly to applications for other diseases as well.

This team draws on a special resource — Upstate’s brain tumor cell bank, which has been maintained by the department of neurosurgery for more than 25 years to support its research. Hundreds of tissue samples from brain tumors are carefully stored in a deep freeze at the Neuroscience Research Building. These samples can be thawed, cultured and studied to help understand how tumors behave.

The spirit of collaboration behind this project has already been established. One of Upstate’s newest faculty members, Mariano Viapiano, PhD, came from Harvard University to continue working with Upstate faculty members he had long associated with, including neuroscience professor Russell “Rick” Matthews, PhD, and pathologist Robert Corona Jr., DO, and now neurosurgeon Lawrence Chin, MD.

This collaboration integrates the work done at Upstate’s Neuroscience Research Building with that taking place in the Central New York Biotechnology Accelerator, the Cancer Center, the Cord Blood Bank and Molecular Genetics Laboratory and the laboratory of Charles Danko, PhD, at Cornell University’s Baker Institute.

Working together, neurosurgeons can become involved in basic science, neuroscience researchers can pursue topics in oncology, and pathologists can help develop molecular diagnostics.

The aim is to create new brain cancer treatments derived from the intensive research and analysis of the tumor samples. The program hopes to become a national reference institution for precision diagnostics and personalized treatment of brain cancer.

This article appears in the spring 2017 issue of Cancer Care magazine.

 

 

 

 

 

 

 

 

Posted in brain/neurology, brain/spine/neurosurgery, cancer, genetics, health care, pathology, research, surgery, technology | Tagged , , , , , , , , , ,

Pictures of cheer: Young photographers aim to brighten days of kids at Upstate Cancer Center

Ashton and Jordan Miller at the Rosamond Gifford Zoo at Burnet Park in Syracuse. They like to photograph animals and have raised money for the zoo’s Adopt an Animal program. (PHOTO BY SUSAN KAHN)

BY JIM HOWE

A recent patient and his 8-year-old twin are using their love of animals to spread cheer to other youngsters being treated at the Upstate Cancer Center.

Ashton Miller, a third-grader from Fayetteville, has received drug infusions at the center for childhood nephrotic syndrome, a noncancerous kidney condition.

He and his sister, Jordan, both love to visit the zoo and photograph the animals. They got the idea to print the pictures as cards to brighten the days of young patients, and they provided a supply earlier this year for the staff to hand out.

Included with the cards is a message: “Hi, I’m Ashton. I like to take photos at the Rosamond Gifford Zoo, and I visit here, too. Here’s a photo to help cheer you up. You can keep it or be very generous and give it to someone else who needs cheering up.”

Ashton is in remission and doing well after his treatments last year, according to his father, Mark Miller, who does research in orthopedic surgery at Upstate.

The twins have also done odd jobs and sold some of their photos to family and friends to raise money for the Adopt an Animal program at the zoo.

Ashton’s favorite animal to photograph is Natida, the zoo’s female clouded leopard. “Sometimes I’ll wait 15 to 30 minutes for her to go up on this one big log,” he explains. “It’s the only spot in the whole exhibit you can get a good shot of her, but I spend a lot of time just waiting for her to get up on that log.”

Jordan says she likes to photograph turtles, caimans and iguanas.

The twins, who share a camera, plan to keep up their photographic efforts.

One of the photos the Miller twins took at the zoo. They have provided their photos to children undergoing treatment at the Upstate Cancer Center.

This article appears in the spring 2017 issue of Cancer Care magazine.

 

Posted in cancer, community, entertainment, fundraising, health care, kidney/renal/nephrology, patient story, Upstate Golisano Children's Hospital/pediatrics

He’s grateful for ‘fantastic job’ by his surgeon; she celebrates end of her chemo

Ora Germany, 79, of Syracuse (holding the pink teddy bear) celebrated her last round of chemotherapy on Feb. 22 by ringing a bell in the Upstate Cancer Center, surrounded by loved ones including her four daughters and several grandchildren. She was diagnosed with stomach cancer in August 2016 and underwent 12 rounds of chemotherapy. She says her tumor got smaller during treatment. The Upstate Cancer Center features a bell on each of three treatment floors. Patients are invited to ring it when they finish treatment or reach a milestone.
(PHOTO BY SUSAN COLE)

When Patrick Mohr, managing partner of Eastwood Litho Inc., oversaw the printing of the first issue of Upstate’s Cancer Care magazine, he did not expect to be featured on its pages.

But in December 2015, Mohr was treated for thyroid cancer. His symptoms had started with a lump at the back of his throat, and a biopsy confirmed the presence of cancer. Ear, nose and throat surgeon Mark Marzouk, MD, removed the thyroid and the cancerous tumors on it and followed the surgery with internal radiation therapy.

Through the placement of radioactive iodine directly on the tumor site, to eliminate any remaining cancer cells, Mohr was able to avoid chemotherapy and further radiation treatments.

“Dr. Marzouk did a fantastic job, for which I am forever grateful,” Mohr said. “I saw him for my regular checks in November 2016, and Dr. Marzouk told me the cancer is gone. It doesn’t get much better than that.”

Mark Marzouk, MD (left), the chief of head and neck cancer surgery at Upstate, chats with Patrick Mohr. Prior to becoming Marzouk’s patient, Mohr’s only contact with the Upstate Cancer Center was printing its magazine. (PHOTO BY SUSAN KAHN)

This article appears in the spring 2017 issue of Cancer Care magazine.

 

Posted in cancer, ear, nose and throat/otolaryngology, medical imaging/radiology, surgery

She brings music to her fellow patients

Melissa Clark performing in the Upstate Cancer Center. (PHOTO BY SUSAN KEETER)

Singer/songwriter — and cancer patient – Melissa Clark, 68, of Hamilton is among the musicians who are scheduled to perform in the lobby of the Upstate Cancer Center. She plays a variety of folk songs, including one she wrote called “Heart of a Champion.’ A retired postal worker, Clark performs at farmers’ markets, senior residences and restaurants. She was diagnosed with lymphoma in December 2016 and regularly has appointments with medical oncologist Stephen Graziano, MD, or radiation oncologist Paul Aridgides, MD.

This article appears in the spring 2017 issue of Cancer Care magazine.

Posted in cancer, entertainment, health care | Tagged

Grant money fuels cancer research

In this kidney cell image from Mira Krendel, PhD, an epithelial cell shows the protein scaffolding that is important for maintaining cell shape and supporting cell migration. The red staining highlights actin filaments that act as struts to support cell shape, while the adhesive plaques attaching the cell to the underlying surface are shown in green.

Grendel

Luo

Mira Krendel, PhD, associate professor of cell and developmental biology, and Juntao Luo, PhD, assistant professor of pharmacology, each received $360,000 grants from New York state to further their research into breast cancer treatments.

Krendel is exploring how a particular protein contributes to tumor progression and metastasis in breast cancer. Luo is developing a targeted drug delivery system that relies on nanocarriers.

Hall

Lu

Luo also was the recipient of a $50,000 grant from the Upstate Foundation’s Cancer Center annual fund and its Michael Connolly Endowment for Lung Cancer Research.

He and Walter Hall, MD, professor of neurosurgery, are working on a nanocarrier that would be used in the treatment of melanoma and its brain metastasis.

Two additional studies underway at Upstate received $50,000 grants.

John

Sheikh

Landas

Hong Lu, PhD, assistant professor of pharmacology, is working with Savio John, MD, assistant professor of medicine, on tumor suppressors in liver and/or pancreatic cancer and pre-cancerous liver tissues.

Saeed Sheikh, MD, PhD, professor of pharmacology, is paired with Steve Landas, MD, professor of pathology, to identify tumor markers and a target for cancer therapy.

This article appears in the spring 2017 issue of Cancer Care magazine.

 

Posted in cancer, health care, pathology, research

Her diagnosis leads to career

Katherine Frega was a high school junior in Westfield, N.J., in May 2010 when she was diagnosed with Hodgkin lymphoma.

Upstate medical student Katherine Frega, right, with her sister, Jennifer. Jennifer donated stem cells as part of Katherine’s treatment of Hodgkin lymphoma.

She transferred her cancer care to Upstate when she became a student at Syracuse University in 2012.

Frega graduated from SU with degrees in biology and public policy. In fall 2016 she started medical school at Upstate with the goal of becoming a pediatric oncologist.

Two of her former cancer doctors, Jody Sima, MD, and Andrea Dvorak, MD, are among her mentors now, and her history as a cancer patient provides a unique context for her studies.

“I took an active approach to my treatment, asking ‘sciency’ questions,” Frega recalls. “It’s really cool now, as a first-year medical student, seeing the chemo drugs I was on in clinical trials now being taught to me.”

Frega finds time to volunteer as a leader in Upstate’s “Peds Pals” program, which matches a first- and second-year medical student with a pediatric cancer patient for regular tutoring and companionship. Frega’s “pal” is a teen girl who helps provide Frega with perspective.

“I never really wanted to be known as a person who had cancer,” she realizes. “I wanted to be known for what I want to do for others. I’ve been sick, and I’ve been through some terrible things, but I want to make things better for others.”

This article appears in the spring 2017 issue of Cancer Care magazine.

Posted in cancer, health care, health careers, medical education, medical student, patient story, Upstate Golisano Children's Hospital/pediatrics