Webinar Replay Pillar 3: Brain-healing Activities
This is part 3 in a 4-part series on the 4 Pillars of the Marama Alzheimer’s reversal lifestyle.
We employ physical trainers, life coaches and lifestyle coaches. We are all about encouraging people and making sure that they are seen and heard, and are participating in activities. A big part of this, in addition to our brain-healing activities, we also exercise and move our bodies.
So what we do in the morning is after breakfast, we start off with a morning walk and we get our bodies moving. We socialize, we’re talking, we’re looking at the sky, we’re looking at plants, noticing the details. We’re talking about the morning routine and getting excited for the day. This is a really great way to start your morning.
We live in a beautiful, really calm and quiet neighborhood. The residents comment that there is no traffic. They feel safe walking up and down the street and in the neighborhood. It is so important for them to feel safe where they’re walking. We want them to do plenty of it!
Meditation and Daily Chronicles
Every morning we do a 12 minute meditation, after our walk when we come inside. It relieves stress, reduces tension, and supports a healthy mood. It supports healing changes in brain patterns and there is scientific evidence that it supports cognitive function. You may have heard someone doing it. It sounds like this: “sata-nam-ah” and it is called ‘Kirtan Kriya.’ At home you can play a YouTube video of it to guide you through the 12 min meditation.
The Daily Chronicles. We orient everyone to the date and day of the week. We also talk about important things that happened on this day in history. For some residents, it is personal. They have a child or spouse who was born that day or a wedding. Other days have important historical significance like the moon landing and our residents remember where they were and share their stories with each other. We have them write in little booklets to make sure that we are practicing writing and also to help jog memory later on in the day. The act of writing things down and using the muscle memory of writing supports memory.
When Marama residents write in their own handwriting and they refer back to it later—it helps them to remember a little bit more and realize, I actually wrote this! I wrote this down. And then they can talk to their families about it later in the day when they ask, like, what did you do throughout the day?
Art, Crafts and Gardening
Arts and Crafts
We also do a lot of arts and crafts. This helps get creative juices flowing and multiple senses involved. Residents enjoy collage making, scrapbooking, painting—and it’s really fun and engaging for them. We usually have music from the 50’s, 60’s and 70’s playing. It is a social activity where the residents connect over a shared project all while helping with fine motor skills. It is really fun.
We collect all of the artwork the residents have done and it is fun to see the progress over time. They get better at it. Their spatial awareness on a blank canvas sharpens. It is inspiring to see progress and how individuals improve through the whole program. Some residents paint more clearly, do more painting on their own. It’s really fascinating to see the progress.
We have a greenhouse which is incredible with all organic produce. Our residents love going down there, because some of them have gardens of their own. They will take charge and tell us about all the things they learned about gardening and give us tips about what to plant where, what needs sun or more water. They pull weeds, harvest greens and veggies, and get excited about what will be in their next meal. It is so fun to see them engage in getting their hands dirty and connecting with the soil.
We have several guests who come and help us with yoga, meditations several times a week. Jodi leads our residents in yoga. She comes specifically for meditations once per week, and yoga twice a week. She is a retired attorney who has a long history of working with the elderly. She understands who needs extra support and will adapt her class to be sure everyone gets the most out of it. Another local yoga studio also sends an instructor once per week. They rotate and because they are younger than the residents, it adds variety to the day. The residents love interacting with young people and sharing wise life advice!
We host a live musician a couple times per month. We love seeing everyone get up and dance to Elvis or the Beatles. Live music is always something the residents really look forward to. Who wouldn’t?
Case Study: The G’s
This gentleman moved in and he had pretty progressive dementia. He wasn’t talking much because like many of us, he believed there was nothing you could do about dementia. He was really trying to hide it. He would answer with just one and two words instead of a full complete sentence.
And now he speaks in paragraph form describing his work as a biologist and his work at the NIH. He is a really impressive human being who had become a shell of himself for quite a while. He works hard at Marama. He exercises hard. He stays very engaged even when we can tell arts and crafts aren’t his favorite. His hard work has paid off and we have seen some of the incredible benefits.
His wife who’s there with him—she is so fun to see. They’ve been there since May of 2020, and now we’re in September of 2021. So they’ve been there for over a year. And what we’ve noticed is that the longer they stay, the better they get. They are pioneers. Two of the first people to move into Marama and have this experience. It is so impressive to us what is possible.
I have a daughter. And Mrs. G remembers—has long remembered—that I have a child because sometimes she will come to Marama with me. For the past year and a half Mrs. G will say, “Oh, hi Doctor! Do you have a boy or a girl?” And “How old is she?” Recently, in the past couple of months she says, “Hi Dr. Sandison. How’s Nadya? She’s still going to be three—three in December, right?”
I couldn’t believe it. I’m still in a bit of shock. She remembers my daughter’s name, her birthday. She is remembering so much! Her short-term memory loss is almost gone! She completes her daughter’s sentences when they talk on the phone and reminds us all that we’ve already told her things.
Mrs. G is remembering everyone’s names. She’s remembering activities from the day before. She doesn’t even need to look at her book. She now supports other residents, reminding them of staff’s names, other residents’ names, what’s next on the agenda for the day. It’s just really exciting.
I recently joined the residents for lunch. I mentioned, “there’s a new resident moving in”. It was taking me a minute to remember his name. There is always a lot going on and I hadn’t met him yet. And Mrs. G said, “oh, yes Norman!” and she had his name right there, ready. She was the one reminding me.
It’s just so phenomenal to see where. Eighteen months ago she had relatively progressed short term memory loss and her MOCA was about 12. She has improved significantly. Watching it happen is such a privilege.
This couple in particular, they moved in, in May of 2020, so as the pandemic was really taking off. They are pioneers who very graciously put their faith in us right when we were getting Marama started in the middle of a pandemic. It is just absolutely phenomenal what we’ve seen with them and really, really inspiring.
Sometimes there is this piece of me that still worries other people are right, there is not much you can do and maybe no one is going to fully recover from Alzheimer’s. I have this nagging doubt. Watching the G’s reinforces how accessible and real this recovery is.
Daily Physical Exercise, Supervised
The resident gets on a stationary bike and we help them put on an oxygen mask. And the bag to the side fills up with concentrated oxygen. On the bike there is a switch that can go from positive to negative. And so we go back and forth between the switches, but the positive is just concentrated oxygen. The negative makes you feel like you are at altitude and it causes your vessels to vasodilate as your body is searching for that oxygen.
We use a pulse oximeter that we put on the finger. When we get it down to about 85-88 percent oxygen we flip the switch back to positive. And there is additional oxygen delivery to their body—to their brain—because of that vasodilation.
Mark Squibb invented this machine. Potential residents called in December of 2019, and they were up in Oregon. They weren’t going to be able to make it to live at Marama but they said, “if you could do one thing at home, what would it be?” And I said, LiveO2!”
So sure enough, they did it and a few months later…the woman was calling for her husband; she’s very concerned about him. And both of them had gotten more mental clarity. She had made more progress with her fibromyalgia than she had in years! I mean, it was just astounding. And they were measuring using brain HQ; they were measuring his cognitive function. So she was giving me impressive measurements of how much he had improved in just three months.
I was turned on to LiveO2 by several of my patients who got great results, phenomenal results, over the course of a couple of months. What is happening is an increase in circulation combined with changes in oxygen levels leads to improved detoxification and a little bit of stress response that you get that actually triggers the recycling of cells that maybe aren’t optimally performing and sends signals to make new cells.
It is very helpful for cognitive function, general health, and we’re thrilled to have it at Marama and have residents using it.
Nikki, you have some great tips about how you engage with residents to help them do something that maybe doesn’t feel comfortable right at first.
NR: Yeah! So what I do with them—especially because we use the bike with a tube and a mask. It’s understandably unfamiliar and uncomfortable. I get them on the bike first, and they are right next to the machine. I turn it on and I’m describing in detail what it is and answering all of their questions even multiple times. As they get on the bike I describe what the machine is, and I show them the mask, and I explain that is how they will get lots of oxygen. I explain the best way to use this device and why they are using it. I tell them each time exactly how to put it on their nose and mouth, and take deep breaths of oxygen. As I’m talking through it with them, they say, “okay! I can try this, I can do this.”
And then I say, “if at any point you want to take it off, this is something you don’t have to keep on.” So I’m constantly talking to them and talking them through it and giving them information and an out that will make them feel more comfortable.
Once they get it on, they realize, oh this is not that bad. I can do this for a little bit. And then we start them on the bike with the mask. We try to do 20 minutes—that’s the goal, but everyone does what they can and over the weeks they build up to more and more. We start with maybe five minutes for some residents.
Caregivers and activities specialists at Marama have been trained to engage fully with the residents, making sure they are clearly communicating, repeating instructions and slowing down. The caregiver’s goal is to be sure the residents feel encouraged and reassured as they try new things. It can be very scary for the residents. They don’t really know what to expect. It can also just be uncomfortable. When the primary goal is more about making the resident feel comfortable all the goals of participation happen soon after.
We see this with our new residents as they move in; there’s a bit of a hump that we have to get over. At Marama we just have one resident move in at a time. We never have more than one unless they are a couple. It really does take extra work on the caregiver’s part, but also has the potential to bring down the feeling in the community if there are too many new residents acclimating to the Marama routines.
The other residents are great at welcoming new residents. Dr. G recently said to me, “We need to have a preamble,” He wanted to write a little synopsis telling new residents to just stick with it. Just get through it. Don’t question everything. Don’t criticize everything. Just get through that hard part because at the other end, there’s clarity and better mood, more energy, better sleep—all of these things are up and over that hump!
We encourage all of you caregivers at home. Thank you for doing the hard work that you are doing because we know that this process isn’t always comfortable. The quicker you can dive fully in, the quicker the discomfort is over. We have that luxury of full immersion at Marama so it only lasts about three weeks or so.
What I see at the clinic is that when people are doing it at home, it often can last a bit longer because it’s a more drawn-out process. It’s not like that quick process when you’re fully immersed.
This is brain therapy via infrared lights on a cap that penetrates through the skull. There’s also a nasal clip and there’s a light in there too. That will go up the nasal sinuses into the brain. This simulates mitochondria to create ATP which is energy for your whole body, and your brain consumes a lot of it. Our brains are energy hogs. They need lots of ATP.
Mike Hamblin, a Harvard researcher has published extensively on the benefits of red light therapy. There’s also extensive published literature out of Russia, and more and more people are adopting this red light therapy. It is very safe and seems to be effective.
The benefits are more obvious with more severely affected residents. The lower the MOCA scores, the quicker we see benefits, sometimes in just 20 minutes. With our residents who are less progressed we don’t notice differences we can say are just the redlight therapy day-to-day, but over the course of time, we’re seeing dramatic benefits. And so we certainly think based on the literature that the red light therapies including the VieLight and the Joovv Light we have at Marama are contributing to that improvement in combination with the environment, social engagement, an organic ketogenic diet, great sleep, and love.
Another red light therapy that is applied to the entire body. This helps with collagen production, wound healing, reduces stress and anxiety, promotes improved sleep, and decreases inflammation.
And we also have a sauna, which is infrared light as well, inside the sauna. But that is really great for detoxification. So we really want to get them to sweat out all the toxins, and then take a cool shower after. This of course, is if it’s recommended by your doctor. This isn’t safe for everyone. Not all of these devices are safe for everybody. Even exercise. For our most recent resident, he went through a bit of a cardiac workup, and his doctor asked that he not exercise for the first couple weeks while we were waiting on some data to come back. We first make sure everything is approved by your doctor. We are obviously very committed to safety here.
These devices are available at Marama and our caregivers are very well versed in helping people to get the maximum benefit out of it in a very safe way.
It is a warm mat that helps with reducing anxiety and releasing tense muscles. And for example…we have one resident who has scoliosis and is often in pain. When we get her to lay on the BioMat for 30 min, we’ve noticed that immediately after, she’s a bit straighter and in less pain. It is very calming and soothing for residents to relax on the BioMat. When this resident with scoliosis first moved in she was very unsteady on her feet using the walls to balance as she walked around the house. She had suffered from a fall at the previous assisted living facility she was living in. Working with our activities specialists and a physical therapist,she now can walk without a cane, easily get up and down the stairs and no longer balances on the walls. She is straighter and more confident than she has been in years.
Several of our activities specialists have personal training and physical therapy backgrounds. At Marama we incorporate strength and resistance training. There are free weights and resistance bands that are simple, easy, effective and enjoyable for residents to use during their afternoon exercise routine.
We all know that movement is so important for circulation for cognitive function. Basically, if you could bottle exercise, we would have no more chronic diseases on the planet. One of the unfortunate things about the typical senior living facility is that they discourage exercise, because people are labeled a fall risk. Many communities feel the risk is greater than the reward. We feel the opposite. For our brains and bodies to work we must keep moving.
Read all 4 Pillars: