Self-Compassion in Taking & Giving Care. Objectives

Transcription

1 Self-Compassion in Taking & Giving Care Tiffany Chow, MD, MSc, FAAN Senior Scientist, Baycrest Health Sciences Associate Professor, University of Toronto Neurology and Geriatric Psychiatry Objectives Is there a way to prevent Alzheimer s disease? How do you cope with it, as a caregiver or as a patient? Buddhist concepts of compassion 1

2 From this Point Forward? Make choices that help you maintain or even keep building on top of existing cognitive reserve Self-compassion as the basis for: More successful care for the patient AND More successful self-care What is Cognitive Re$erve? 2

3 What is Cognitive Reserve? Allows you to compensate for brain injuries i and insults Not just content/fund of knowledge How did this information get there? Trafficking Mental flexibility Adaptability in problem solving, emotion, and behaviour inflammatory reaction ** ** ** free radicals neurofibrillary tangles Tau or other proteinopathy plaques ß-AP 3

4 56 yr old attorney was still ing and working at time of this MRI scan How do you build up reserve? 4

5 Are your genes your destiny? Oui mais non! Combination of genes Gene x gene interactions! Partial effects of polymorphisms Other Building Blocks Early in Life Formal education Diversity of experience (bilingualism) Different Kinds of Intelligence Later in Life Social Networking Leisure reading [maintenance of existing Cognitive Reserve] 5

6 Different Kinds of Intelligence Verbal Logic/reasoning i Visuospatial Orienting body to space Musical Interpersonal, EQ Intrapersonal Natural, physical What am I loading into my body? Immune system Toxins Stress 6

7 The Brain as Glucose Diva Brain = 2% of body mass & consumes 20% of glucose intake But how sweet it ain t! Glycemic index HIGH ice cream, croissants, dried fruit, bananas, carrots MODERATE pasta, baked beans, sweet potatoes, OJ, blueberries LOW beans, high-fiber, low-sugar cereals, low-fat unsweetened plain yogurt, fresh fruit 7

8 Sugar Insulin Alzheimer s Disease glucose pancreas releases more insulin Hyperinsulinemia = diabetes but risk of BMI, HTN, diabetes and AD! The AD Side Insulin receptor activity promotes amyloid and tau machinery Insulin degrading enzyme, if too busy with insulin, can t degrade β amyloid Hyperinsulinemia doubles risk of AD, multiplies additional risk factors While other AD risk factors are not similar across ethnic grps, hyperinsulinemia is color blind 8

9 The Mediterranean Diet Good dietary dd ay habits start EARLY!!! Scarmeas, Arch Neurol 2006 Fish Fruit Olive oil Legumes Vegetables Grains Stress reduction biggest proportional impact on hippocampus at the very beginning of life (birth!) and from mid to late life During parenting years, can reduce performance efficiency, but reversible 9

10 Regular PHYSICAL ACTIVITY should start by midlife Best exercise benefit for women comes from early adulthood activity! Reduces stress Enhances cerebral blood flow Contributes t to obesity mgmt Creates social interactions Cerebrovascular disease & AD Brain = 2% of body mass & gets 10% of cardiac output Smoking Diabetes Elevated cholesterol Hardening of the arteries 10

11 Components of enduring love Metta Karuna Muditha Upekkha Loving Kindness Compassion Joy Equanimity 11

12 Quality of Life For Cgr: Meaningful for Patient: Pain free Safe Meaningful activities +/ meaningful social interactions Maximal autonomy interaction with patient Emotional connection Doing for ~feeding g Good downtime together (rest) Everything that can be done IS being done Am I the problem? What exactly is s/he doing vs. my interpretation of it No self, no problem Are my expectations fair? What have I lost? What can I do about it? How am I doing? Safe? Loved? Happy? Healthy? For D. Rewilak s guidelines, see lab 12

13 un learning the basics Rishi Sativihari ih i Open up your narrative "I'm the kind of person who ALWAYS..." Let s get back to YOU Manage Your Stress before It M Y Manages You Think before You Eat Mind-Body Connection: Exercise Social Networks 13

14 Take Home Point Recommended Annual Check-In What am I doing now that I want to stop? What did I just say yes to that I want to stop? What do I want to start doing? What do I want to keep doing? What am I going to do in the next 6 months to reduce the Stop list and increase the Keep doing list, given that no one else will do this for me? To Read or Hear More The Memory Clinic Huffington Post [Dr. Tiffany Blog for caregivers: drchowftd.wordpress.com Archived talks/podcasts: 14

15 andrew-solomon-on-book-far-from-the-tree- ClgjWlKkRA67OYxpVzIc7g.html 15