If anyone has an idea to get my husband moving again, I would love it hear about it.It appears that keeping up with exercise is so very important, but the great media don't say just how to make that happen. My husband..marathoner, ski patrol, tri-athelete now takes our pup for a 20 minute morning stroll and that is his "exercise'! He gets very upset with me when I challenge him to do more. Gave up the gym membership, gave away all of our own heavy duty work out equipment...he is 6'6" and is wasting away..lost 25 pounds in the last few months. Hasn't been able to taste or smell food for some time, so could care less about eating...huge loss as i am a cook, and that has been my "entertainment" of late. i thought our kids could get him going again as he always did his thing with them,but not! he isn't so far down the hill that he can't understand the importance of this, but tonight he told me he just wants to die... not right now, but before stuff" happens. Any ideas gratefully acceptd.
My husband did major workouts at least 4 days a week up until last January. His last stress test in January showed him stronger than most 50 year olds. He is 70. He got a cold and the flu in the winter and hasn't been to the gym since then. I'm not sure if he has forgotten that we have a gym at our clubhouse, or if he knows he no longer knows how to use the equipment. Or both.
He is taking long walks. Too long frankly because it scares me silly to have him away from the house for a couple of hours in the kind of heat we have had. Physically he is still in much better shape than cognitively or verbally. But that is not going to last.
According to his doctor he has not lost weight in the last year, but I think he gained weight at first from not working out, and is now losing and it just is not obvious to the doctor yet. I asked at his last visit with the family doctor because he has records. I think we will see a difference on the next visit in 4 months.
I think this is just part of the disease. Especially if he is already losing weight. And I don't think there is a whole lot you can do about it.
I agree with bluedaze, check with the doctor to see if an antidepressant might help.
However, your husband may be developing physical/mental problems that make it difficult for him to exercise. AD can affect his sense of balance, his coordination, his ability to process visual signals, his ability to remember what to do and why. It can also affect his initiative.
If you can, encourage him to help you with things that involve physical activity -- working in the garden, vacuuming the house, going shopping at the mall. He may need you to "jump start" him, and he may need you to help him follow through on "complex" activities, so that he doesn't get confused about the next step in the process.
We've been talking on another thread about how important it is to help our LOs feel that they can still make contributions ... praise them for anything they can do to help (even if it isn't done quite the way it should have been), and even praise them for having helped you learn to do the things you have to do by yourself now.
on the contrary i think my Dh is losing some weight due to overexercise. he starts his 'pacing' at 4pm everyday, you can set your watch by it, and goes for at least 2hrs around our atrium which are 4hallways connected, like a mini indoor track. he must burn lots of calories and eats most everything i give him and still loses lbs. he started out at 175lb and down today 159 over 9+yrs.i think maybe the metabolism gets messed up as well with this disease at some point and the weight loss is inevitable. i agree a dr visit for something to stimulate appetite and/or counter depression. divvi
Kathi - Will your husband go on errands with you? That is really the only way I get my DH to get any exercise at all. We move "slow", but any movement is better than none at all. I also walk "with him" if we take our dog out. I know that seems like you never get any "alone time", but, it's better than just "sitting". What I have found with my DH is that his appetite never did change & he's GAINED 20 lbs since last June. Of course, that means larger shorts, pants, etc. I've been dealing with the issue, but sounds like you have it in the opposite direction. My DH also takes an anti-depressant, but even with that, still no desire to really "exercise", unless of course I am helping him & even then, most days are met with "no" as the response to 'wanna walk on the treadmill'...so, also cumbersome, errands (in & out of the car ALOT) are our form of exercise.
Yes, we do most errands together..frankly I LOVE being able to just go to the store alone, but it doesn't happen often. Since we have a pup, she goes with us also..a real family affair. It was mentioned that he might be ready for meds to help depression, but I know he would refuse to even discuss it. He takes so many pills already for his heart and other stuff, he freaks at the thought of more. As for the weight loss (I think i have gained what he lost), he simply isn't hungry at all ever! He isn't having his normal vino a night which makes a huge difference with the weight...maybe that's why I'm gaining...anesthetic.
Kathi, what medications is your husband taking? Some of them can cause a loss of appetite. Let me know. And if that isn't the problem, I have a whole bunch of suggestions that I've compiled from reading here and there about how to get him to eat.
He is on sotalol, mavik, warfarin, zocor..some of these twice a day..plus heavy doses of fish oil. He was taking magnesium for supposed help with smell and taste, but we finally bid that goodbye. Any and all suggestions welcome.
My DH used to exercise a lot, weights, tennis, walking 18 holes of golf. With the knee replacement, he gave up tennis. After that he walked 18 holes when he played golf. During the last year he was home, I used to get him to walk by telling him that the dog needed it. Up until the time that I placed him he would walk the dog around the small block 3-4 times a day. If I caught him starting to get agitated, I would suggest a walk - he was always much easier to deal with and a lot calmer after that.
therrja, that is why I'm letting my husband go out on his 90 minute to 2 hour walks. It is within his range. He always comes back on his own, and it stopped the pacing that was driving me nuts this winter. He can't, or won't, or doesn't remember the gym any more, but he used to do an extensive workout 4 or 5 days a week. He needs that walk.
Re the medicines your husband is taking -- sotalol can cause a decrease in appetite, also nausea, dyspepsia, and other digestive track upsets. One woman whose husband was taking aricept lost his appetite. She had been giving it to him in the morning; when she switched to giving it in the evening, he perked right back up. So if you only give the sotalol in the mornings, ask your doctor if it's OK to switch to evenings.
Your husband may have a UTI, or be suffering from constipation. Again, check with his doctor.
Your husband may have a tooth problem, and he wants to stop eating because it hurts. Or if your husband wears dentures, they may be irritating the gums so he doesn't want to chew. Also, if he loses a lot of weight, dentures may no longer fit properly. It might be a good idea to make a trip to the dentist.
If he isn't joining the family at meals, he may simply need the encouragement of you helping him eat. Sometimes, ADLOs eat better when they have company.
Put food on a brightly-colored plate. For example, use a bright red or yellow plate -- those seem to be the ones that work best. The color often fascinates the ADLO, and they will get closer and closer, and eventually start eating. When your husband begins to get used to the color, switch to another one.
Most taste sensations start to fade over time in AD patients. The taste of sweet and the taste of strong spice (like Curries or Carribbean flavors) are the last to go usually. So try to punch up the flavors with a lot of spices, not much salt, but very flavorful spices and herbs. ADLOs often like sweets, so top foods with jelly or honey, or serve small cakes with the meal. Cooking with fruit is a great way to get in both fiber AND sweet. Any time you cook a fruit (like an apple, peach, banana, etc) it intensifies the sugars in the fruit. So cook chicken with apples, a fruit salsa over chicken or fish, or grilled fruit as a side dish. Try apple salads with chopped apples, maybe some celery, some dried fruit... blueberries, craisins, etc... chopped nuts. Sprinkle with sugar and just a little lemon juice... and if you want a little creamier dressing, add a tablespoon of whipped cream.
Another thing that can help is to COOK with color. Use a lot of red, yellow, orange or green peppers, sweet potatoes instead of white potatoes (and it adds sweetness, too) grapes, carrots, tomatoes, spinach... lots of contrasting pretty colors!
If you grill for the summer, it's really easy to slice a pear or an apple to toss on the grill... or a sweet potato. Also colorful peppers become pretty sweet when you grill them. Just toss them in a plastic bag with a little olive oil and some herbs, shake well and take the veggies out and place them on the grill.
Or try cubed tomatoes, avocado and mozzarella cheese dressed with a bit of honey mustard dressing.
Try high-calorie, nutritious foods -- such as almond butter and peanut butter for calories and protein; pudding (some people have suggested freezing protein shakes just to the thickness that they'll stay on the spoon); mashed potatoes (sometimes mashed with other foods he might like, cheese, sour cream, onions or scallions, etc); milkshakes made with real ice cream plus something like Carnation Instant Breakfast or protein powder to add nutrients.
Add calories to everything he eats. Try using a high-calorie supplement such as Boost shakes, Ensure Plus, etc, perhaps blended with ice cream.
Serve several small meals and snacks scattered throughout the day. Try to have something sweet to end the meal, such as a favorite fruit, fresh or frozen.
Serve small portions. For example, cut a sandwich into four pieces. Give your husband one. When he eats it, act as if he hasn't had a meal yet, and give him another piece.
Finger foods may be more "fun" to eat, easier to handle, or appear to be smaller servings. For example, offer tiny individually wrapped cheeses (monterey jack, string, and cheddar) served with fruit as a snack, or ice cream sandwiches cut into small pieces.
Use something he likes as a bribe to get him to eat -- taking a nap, going for a walk, playing a game, whatever. Tell him he can do "x" when he's finished eating.
Make sure you get a decent multi-vitamin in your husband every day, since he isn't getting enough nutrition if he isn't eating well.
Manay thanks for your fine imput...perhaps a bit of our background would clairfy things. Garv is a retired dentist..so no tooth problems yet. Before going to work as front desk in his office (25 years) I taught cooking as well as other middle school curriculum, and still have a fairly large influence with cooking clubs and friends, etc....so...the cooking part i have down pat, I'm pretty sure. He isn't at the point where I play games to get him to do things yet, but no doubt will be coming up. His Sotalol is twice daily, so that doesn't work. He couldn't tolerate Aricept or Namanda, so is on Exelon patches..due to increase dosage next week. Everytime he blows, he attributes it to "the meds I make him take". He really fights adding to his pharmacy list!
In any case, my ongoing thanks for any and all info.
Oh, now, you didn't tell me he's on exelon. That can do a real number on the digestive tract, as can aricept. If this continues to be a problem, talk with his doctor about switching to huperzine A. It is in the same class of drug, but is reportedly much better tolerated and more effective, as well. It's available over-the-counter (and costs about $5 per month). Look for preparations that contain nothing but the huperzine A ... some companies put in all sorts of other supplements, vitamins etc, and you want to be able to control what he's taking. Source Naturals Huperzine A is the one suggested for my husband by the ADRC; it's available on-line through VitaCost.com. (Probably lots of others, I haven't bothered to look.)
As for your cooking skills ... your husband's tastes these days may not match anything you've trained for. Some caregivers put a dollop of honey or jam on absolutely anything, for example, and the ADLO will eat it.
The exelon patch causes stomach issues? My DH has been on aricept for 3 years now and we are thinking of switching to the patch to see if aricept is causing his stomach problem. He spends a lot of time in the bathroom!
The most common adverse side effects are predictable from the cholinergic effects of aricept or exelon. These include nausea, vomiting, anorexia, dyspepsia, and asthenia. Exelon given *orally* is more likely than aricept to cause such side effects. However, because it is administered by patch (through the skin), it bypasses the gastrointestinal track, which helps mitigate the effects; and so it can be better for some patients than aricept.
In general, patients get used to exelon and the adverse reactions from become less frequent/less intense. Nevertheless, some patients have to discontinue the drug because their side effects are too unpleasant.
www.rxlist.com is one of the best sites for checking into side effects, drug interactions, etc. Their warnings for Exelon patch include:
Gastrointestinal Adverse Reactions
Exelon® (rivastigmine tartrate) use is associated with significant gastrointestinal adverse reactions, including nausea and vomiting, anorexia, and weight loss. For this reason, patients should always be started at a dose of 1.5 mg BID and titrated to their maintenance dose. If treatment is interrupted for longer than several days, treatment should be reinitiated with the lowest daily dose to reduce the possibility of severe vomiting and its potentially serious sequelae (e.g., there has been one post-marketing report of severe vomiting with esophageal rupture following inappropriate reinitiation of treatment with a 4.5-mg dose after 8 weeks of treatment interruption).
Nausea and Vomiting: In the controlled clinical trials, 47% of the patients treated with an Exelon dose in the therapeutic range of 6-12 mg/day (n=1189) developed nausea (compared with 12% in placebo). A total of 31% of Exelon-treated patients developed at least one episode of vomiting (compared with 6% for placebo). The rate of vomiting was higher during the titration phase (24% vs. 3% for placebo) than in the maintenance phase (14% vs. 3% for placebo). The rates were higher in women than men. Five percent of patients discontinued for vomiting, compared to less than 1% for patients on placebo. Vomiting was severe in 2% of Exelon-treated patients and was rated as mild or moderate each in 14% of patients. The rate of nausea was higher during the titration phase (43% vs. 9% for placebo) than in the maintenance phase (17% vs. 4% for placebo).
Weight Loss: In the controlled trials, approximately 26% of women on high doses of Exelon (greater than 9 mg/day) had weight loss equal to or greater than 7% of their baseline weight compared to 6% in the placebo-treated patients. About 18% of the males in the high-dose group experienced a similar degree of weight loss compared to 4% in placebo-treated patients. It is not clear how much of the weight loss was associated with anorexia, nausea, vomiting, and the diarrhea associated with the drug.
Anorexia: In the controlled clinical trials, of the patients treated with an Exelon dose of 6-12 mg/day, 17% developed anorexia compared to 3% of the placebo patients. Neither the time course or the severity of the anorexia is known.
Sunshine, Thank you for the info. My DH has not had vomiting or nausea. He had a lot of gas and frequent bowel movements though he says it's not diarrhea. It's hard to say what's causing it.
my DH developed long term side effects after yrs on aricept with stomach issues and diarrhea. same on razadyne, vomiting yellow projectile goop.sorry but it cam on after over 4yrs of taking it! first on reminyl then razadyne..they can develop side effects anytime from any of these meds. check with the dr if you are concerned. divvi
Garv hasn't had an apetite for several months, and he has only been on the patch for one month. He attributes it to no taste or smell...no sense eating. I semi force the issue so he is getting a balanced diet...losts of texture and spicy is his main thing now. He does have a wee sweet tooth (what dentist doesn't?) but nothing out of the norm, Our daughter keeps him happy with her cookies on a regular basis.
The patch doesn't seem to cause any side effects for him...I question him about bathroom problems and upset stomach (i did read the patch info before he started with them after his experiences with the other two drugs.) but he says zero problem. He has never had an adverse physical reaction to any meds except for the Aricept and Namanda...also has never had a headache in his entire life...not fair!
Kathi, if your husband is tolerating the exelon well, that's great. One small word of caution, though ... my husband usually appears pretty capable of telling me if he has a problem ... except sometimes he actually isn't. And I haven't found a way yet to tell whether his answer is "the truth", or if he is having trouble understanding my question, or perhaps not remembering what's really going on, or maybe even embarrassed to discuss it. He'll tell me something is fine, time after time, and then I'll accidentally discover it isn't "fine" at all.
He is tolerating it for now on the low dosage, but after next week,we'll see. Doesn't it take a while for the effects to stabalize? He isn't willing to "tough it out" if he doesn't like how he feels. However, i think that sometimes the anger and temper problems he feels are part of the meds are really just the damned disease.
His brother and sister in law are here now, and i can see a large change in his behavior with others around. His conversation isn't quite there...which is obvious to all except him, of course. Interesting couple of days ahead.
Yes, most patients who have trouble at first develop a tolerance for it. I was just suggesting that you keep an eye ... or maybe a nose ... on his bathroom for a while, just to make sure you know that he isn't having problems.
Having visitors there is a stroke of genius. What a great way to get an AD spouse to behave for a while!!!
We just had an appt with the Neuro Doc, and the Exelon has been upped to the larger dose. Last night he was flying off the walls, but he knew it and was trying to think of something to keep him busy. It seems to happen just before dinner when we normally watch news, so tonight he is heading to our local park for a long walk to see if that alleviates the problem somewhat. His Doc didn't think he would notice the increase at all, but something caused the hyperactivity. He understands ( I think?) that it will take a bit for his system to adjust, but I just hope he'll wait it out. Interesting side bit...his Neuro had never heard of huperzine A. He was going to check it out, but I haven't heard from him . He did suggest getting anti-depressants from his primary care Doc, so tomorrow we will have that appointment.
When the temper flares, I try to talk him down with "It isn't you talking, but your illness"..the last time he began his process, he stopped and told me he didn't mean it, but it was his illness talking!! We'll see what the news meds do.
Sounds like he's starting the 'sundowning' phase, esp if its happening around dinner time. you can read up on this subject too. all part of the disease and NOT a pleasant part i might add . hopefully your added dose of exelon will help but also some find that upping the dose can actually cause a little more aggitation at first. some meds do the actual reverse they are intended to stop. the added anti depressant may be a good move too. good luck! divvi
Just my little plug...if they 'won't take' a medicine that had been cleared for you to give them, ask to have it put in liquid form or compounded. What AD patients don't know about their care will HELP them!!!