Unique Care Facilities Offer Hope for Dementia Patients

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Story at-a-glance -

  • With costs for dementia care soaring, some families are now considering care alternatives far away from home, on the other side of the globe, to provide their ailing family member with better care for less cost
  • “Dementia: The Unspooling Mind” features three unique dementia care facilities in Thailand and the Netherlands
  • Dementia Village, just outside Amsterdam, is an entire village built to simulate the most normal life possible for dementia patients, in a sort of “manufactured reality” that keeps them both happy and safe
  • At the Thai Baan Kamlangchay center, which translates to “care from the heart,” there are no locks, gates or fences. Instead, each resident has a constant caretaker at their side for around-the-clock supervision and companionship
  • Care Resort Chiang Mai in Thailand sits on 11 acres of trees, gardens, swimming pool, fishponds and a lake. Each residence is equipped with a full nursing care station, and sightseeing excursions and a spa are part of their treatment

By Dr. Mercola

Like autism among children, Alzheimer's among seniors has reached epidemic proportions, with no slowdown in sight. On the contrary, evidence suggests the trend is worsening. At present, Alzheimer's affects about 5.4 million Americans and is the sixth leading cause of death in the U.S.1 The World Health Organization predicts that by 2050, 1 in 6 adults will be living with dementia, which means elderly dementia care facilities will soon be in critical demand.

More than 80 percent of current care home residents have significant memory problems or full dementia.2 More than 15 million Americans also provide unpaid care for family members with dementia, and 35 percent of caregivers say their personal health has declined as a result of the strain, compared to 19 percent of those who care for elderly without dementia.

With younger family members footing the bill, the cost of a good residential home is out of reach for many, causing some families to consider options outside of their own national borders. The 16x9 News Online documentary special, "Dementia: The Unspooling Mind," explores innovative models of dementia care in Thailand and the Netherlands — unique residential complexes designed to keep this vulnerable population safe, happy and well-cared for.

Netherland's Dementia Village

On the outskirts of Amsterdam in a small town called Weesp, is Hogeweyk, also known as Dementia Village.3 As this is typically a person's last residence, the goal at Hogeweyk is to provide the most normal life possible, reminiscent of each individual's formative years. It has the sort of manufactured reality depicted in the movie "The Truman Show," where Jim Carrey portrays a man who discovers his entire life is actually a reality TV show.

There is only one way into the village and one way out. All doors open automatically, except those to the outside world. This four-acre village was built with the specific needs of dementia patients in mind, designed around common and familiar social and cultural building blocks.

For example, residents with shared interests and backgrounds live together in "lifestyle groups," with the design and decoration of the 23 homes tailored to each type. Together, the residents manage their own households in most respects, with staff members helping out as needed.

The cost is nearly $8,000 per month, but the government provides subsidies so that each resident's rent will never exceed $3,600. The entire complex is geared toward giving residents a high quality of life; to provide them with a sense that their life is still worth living — they can have fun and have a purpose.

There are all sorts of amenities, including a cafe and parks with gardens and fountains along streets where the residents can freely roam.4 Village staff are everywhere, cleverly blending in as ordinary town folk. Caretakers staff the restaurant, the grocery store, the hair salon and the movie theatre. They also have the ability to surveil the resident's living quarters without being intrusive.

Care From the Heart  

Thailand, "the land of smiles," has two "dementia resorts," both of which are a stark contrast to your typical nursing home. At the Baan Kamlangchay center,5 which translates to "care from the heart," there are no locks, gates or fences at all. The center, which houses a dozen residents in a small village of eight homes, was established by Martin Woodtli, a Swiss psychologist who previously worked for Doctors Without Borders.

According to Woodtli, patients at his center generally don't require drugs to stay calm. Nor do they need locked doors to keep residents safe. Instead, they're never without an attendant, so they have the benefit of continuous human interaction and supervision, and have freedom to move about. He says his guests "feel part of a family, a community, and that's very important."6 Patients are accompanied to local markets, temples and restaurants, and receive personal around-the-clock care — all for $3,800 per month.

When considering whether or not to place a loved one in a care center far from home, the most challenging part is leaving their loved one behind, not knowing if he or she is aware of what's happening or feels abandoned. This is, of course, a very personal decision with multiple factors weighing differently in every situation, and each patient is different.

The majority of dementia patients placed far away from home are in the most advanced stages of the disease. Experts report that while many with early dementia would find it difficult to adjust to life in a foreign place, separated from their families, many in advanced stages adjust surprisingly well to a place with good care, because they "live in a world of earlier memories."

Chiang Mai Care Resort

A second Thai care center,7 a former four-star tourist resort located about 30 minutes from Chiang Mai, is owned by Peter Brown, a British entrepreneur who converted the resort into a care facility after his mother developed dementia and couldn't get adequate care in the U.K. The resort now houses about 70 patients who, according to Brown, "are having the time of their lives."

Brown's goal is to give each guest as much independence as their individual condition allows. Care Resort Chiang Mai sits on 11 acres of trees, gardens, swimming pool, fishponds and a lake. There are different designs ranging from studios to one- and two-bedroom villas, each equipped with a full nursing care station. Sightseeing excursions and a spa are a regular part of their treatment.

When you consider the average cost of full-time care for a family member with Alzheimer's in the U.S. is between $3,700 and $6,900, depending on your state of residence,8 it's easy to see why some families are considering what might be called radical options, such as care centers on the opposite side of the globe.

Continued efforts need to be made to improve the quality of life and quality of care for people living with dementia, and this requires the kind of "outside the box" thinking as demonstrated in the care centers featured in this video. In the final days and hours of life, whether the person at your loved one's bedside is you or a caregiver thousands of miles away, it's important that they're being cared for with dignity and respect.

Mitochondrial Dysfunction Is at the Heart of Alzheimer's

While there is no conventional cure for Alzheimer's, a number of lifestyle strategies show promise for preventing and slowing down its progression. Dr. Dale Bredesen, director of neurodegenerative disease research at the UCLA School of Medicine, discusses these alternatives in his book, "The End of Alzheimer's: The First Program to Prevent and Reverse Cognitive Decline." If you missed my interview with him, I highly recommend viewing it now (for the full interview, see the original article, linked above).

Bredesen has identified more than four dozen variables that can have a significant influence on Alzheimer's, but at the heart of it all is mitochondrial dysfunction. This makes logical sense when you consider that your mitochondria are instrumental in producing the energy currency in your body, and without energy, nothing will work properly. Your mitochondria are also where a majority of free radicals are generated, so when your lifestyle choices produce higher amounts of free radicals, dysfunctions in mitochondria are to be expected.

The accumulation of mutations in mitochondrial DNA are also a primary driver of age-related decline. Importantly, Bredesen's work sheds light on why amyloid is created in the first place. Amyloid production is actually a protective response to different types of insults, each of which is related to a specific subtype of Alzheimer's. Bredesen explains:

"If you've got inflammation going on, you are making amyloid because … it is a very effective endogenous antimicrobial. [I]n that case, it's not really a disease … [It's] a falling apart of the system. You're making amyloid because you're fighting microbes, because you're … inflamed, because you are decreased in your trophic support (insulin resistance, and so on) or because [you're toxic].

Guess what amyloid does beautifully? It binds toxins like metals, mercury and copper. It's very clear you're making [amyloid] to protect yourself. It's all well and good if you want to remove it, but make sure to remove the inducer of it before you remove it. Otherwise, you're putting yourself at risk."

The program Bredesen developed is a comprehensive approach that addresses the many variables of Alzheimer's at their roots. Interestingly, if you have the ApoE4 gene, which increases your risk for Alzheimer's, you would be wise to implement intermittent fasting or do longer fasts every now and then.

In fact, this gene appears to be a strong clinical indication that you need to fast on a regular basis to avoid Alzheimer's. The reason for this is because the ApoE4 gene helps your body survive famine. Unfortunately, it also promotes inflammation. Fasting appears to help cancel out this inflammatory proclivity.

Alzheimer's Screening Tests

Bredesen also recommends a number of screening tests to help tailor a personalized treatment protocol. For example, if you have insulin resistance, you want to improve your insulin sensitivity. If you have inflammation, then you'll work on removing the source of the proinflammatory effect. If your iron is elevated, you'll want to donate blood to lower it, and so on.

Alzheimer's Screening Tests

Test Recommended range

Ferritin

40 to 60 ng/mL

GGT

Less than 16 U/L for men and less than 9 U/L for women

25-hydroxy vitamin D

40 to 60 ng/mL

You can get the test here

High-sensitivity CRP

Less than 0.9 mg/L (the lower the better)

Fasting insulin

Less than 4.5 mg/dL (the lower the better)

Omega-3 index and omega 6:3 ratio

Omega-3 index should be above 8 percent and your omega 6-to-3 ratio between 0.5 and 3.0 

You can get the omega-3 index test here

TNF alpha

Less than 6.0

TSH

Less than 2.0 microunits/mL

Free T3

3.2 to 4.2 pg/mL

Reverse T3

Less than 20 ng/mL

Free T4

1.3 to 1.8 ng/mL

Serum copper and zinc ratio

0.8 to 1.2

Serum selenium

110 to 150 ng/mL

Glutathione

5.0 to 5.5 μm

Vitamin E (alpha-tocopherol)

12 to 20 mcg/mL

Body mass index (which you can calculate yourself)

18 to 25

ApoE4 (DNA test)

See how many alleles you have: 0, 1 or 2

Vitamin B12

500 to 1,500

Hemoglobin A1c

Less than 5.5 (the lower the better)

Homocysteine

4.4 to 10.8 mcmol/L

Strategies to Help Prevent Dementia and Alzheimer's Disease

It's important to realize that dementia, including Alzheimer's, is largely a preventable disease, predicated on lifestyle choices that enhance mitochondrial function. Following are a summary of suggestions that can boost your mitochondrial health and help protect your brain health well into old age:

Eat real food, ideally organic

Avoid processed foods of all kinds as they contain a number of ingredients harmful to your brain, including refined sugar, processed fructose, grains (particularly gluten), vegetable oils, genetically engineered ingredients and pesticides like glyphosate. Ideally, keep your added sugar levels to a minimum and your total fructose below 25 grams per day, or as low as 15 grams per day if you already have insulin/leptin resistance or any related disorders.

Opting for organic produce will help you avoid synthetic pesticides and herbicides. Most will benefit from a gluten-free diet, as gluten makes your gut more permeable, which allows proteins to get into your bloodstream where they sensitize your immune system and promote inflammation and autoimmunity, both of which play a role in the development of Alzheimer's.

Replace refined carbohydrates with healthy fats

Healthy fats such as saturated animal fats and animal-based omega-3 are very important for optimal brain function. Healthy fats to add to your diet include avocados, butter, organic pastured egg yolks, coconuts and coconut oil, grass fed meats and raw nuts such as pecans and macadamia.

Avoid all trans fats or hydrogenated fats that have been modified in such a way to extend their longevity on the grocery store shelf. This includes margarine, vegetable oils and various butter-like spreads. Contrary to popular belief, the ideal fuel for your brain is not glucose, but ketones, which are produced when your body converts fat into energy.

The medium-chain triglycerides (MCT) found in coconut oil and MCT oil are a great source of ketone bodies. Also make sure you're getting enough animal-based omega-3 fats. High intake of the omega-3 fats EPA and DHA help prevent cell damage caused by Alzheimer's disease, thereby slowing down its progression and lowering your risk of developing the disorder.

Optimize your gut flora

To do this, avoid processed foods, antibiotics and antibacterial products, fluoridated and chlorinated water, and be sure to eat traditionally fermented and cultured foods, along with a high-quality probiotic if needed. Dr. Steven Gundry does an excellent job of expanding on this in his new book "The Plant Paradox."

Intermittently fast

Intermittent fasting is a powerful tool to jump-start your body into remembering how to burn fat and repair the insulin/leptin resistance that is a primary contributing factor for Alzheimer's.

Move regularly and consistently throughout the day

It's been suggested that exercise can trigger a change in the way the amyloid precursor protein is metabolized,9 thus, slowing down the onset and progression of Alzheimer's. Exercise also increases levels of the protein PGC-1 alpha. Research has shown that people with Alzheimer's have less PGC-1 alpha in their brains and cells that contain more of the protein produce less of the toxic amyloid protein associated with Alzheimer's.

Excess sitting is associated with an increased risk of many diseases, including type 2 diabetes, cardiovascular disease and neurological illnesses. Stand up and walk as often as possible, with a goal of walking about 10,000 steps a day.

Optimize your magnesium levels

Preliminary research strongly suggests a decrease in Alzheimer symptoms with increased levels of magnesium in the brain. Unfortunately, most magnesium supplements do not pass the blood brain levels, but a new one, magnesium threonate, appears to and holds some promise for the future for treating this condition and may be superior to other forms.

Get sensible sun exposure

Research shows people living in northern latitudes have higher rates of death from dementia and Alzheimer's than those living in sunnier areas, suggesting vitamin D and/or sun exposure are important factors.10

Sufficient vitamin D is imperative for proper functioning of your immune system to combat inflammation associated with Alzheimer's. If you are unable to get sufficient amounts of sun exposure, make sure to take daily supplemental vitamin D3 to make your blood level at least 60 to 80 nanograms per milliliter.

Sun exposure is also important for reasons unrelated to vitamin D. Your brain responds to the near-infrared light in sunlight in a process called photobiomodulation. Research shows near-infrared stimulation of the brain boosts cognition and reduces symptoms of Alzheimer's, including more advanced stages of the disease.

Delivering near-infrared light to the compromised mitochondria synthesizes gene transcription factors that trigger cellular repair, and your brain is one of the most mitochondrial-dense organs in your body.

Avoid and eliminate mercury from your body

Dental amalgam fillings are one of the major sources of heavy metal toxicity; however, you should be healthy prior to having them removed. Once you have adjusted to following the diet described in my optimized nutrition plan, you can follow the mercury detox protocol and then find a biological dentist to have your amalgams removed.

Avoid and eliminate aluminum from your body

Common sources of aluminum include antiperspirants, nonstick cookware and vaccine adjuvants. For tips on how to detox aluminum, please see my article, "First Case Study to Show Direct Link between Alzheimer's and Aluminum Toxicity."

Avoid flu vaccinations

Most flu vaccines contain both mercury and aluminum.

Avoid statins and anticholinergic drugs

Drugs that block acetylcholine, a nervous system neurotransmitter, have been shown to increase your risk of dementia. These drugs include certain nighttime pain relievers, antihistamines, sleep aids, certain antidepressants, medications to control incontinence and certain narcotic pain relievers.

Adults who use benzodiazepines such as Valium, Xanax and Ativan for anxiety or insomnia are about 50 percent more likely to develop dementia, especially if used chronically.

Statin drugs are particularly problematic because they suppress the synthesis of cholesterol, deplete your brain of coenzyme Q10, vitamin K2 and neurotransmitter precursors, and prevent adequate delivery of essential fatty acids and fat-soluble antioxidants to your brain by inhibiting the production of the indispensable carrier biomolecule known as low-density lipoprotein.

Limit your exposure to non-native electromagnetic fields (EMF from cellphones and other wireless technology)

The primary pathology behind EMF damage is caused by the reactive nitrogen species peroxynitrites,11 which damage your mitochondria, and your brain is the most mitochondrial-dense organ in your body. Peroxynitrite is an unstable structural ion produced in your body after nitric oxide is exposed to superoxide, and this complex chemical process begins with exposure to low-frequency microwave radiation from your cellphone, Wi-Fi and cellphone towers.12,13

Increased peroxynitrite generation has also been associated with autonomic hormonal dysfunction and increased levels of systemic inflammation by triggering cytokine storms. Martin Pall, Ph.D., has published a review14 in the Journal of Neuroanatomy showing how microwave radiation from cell phones, Wi-Fi routers, computers and tablets (when not in airplane mode) is clearly associated with many neuropsychiatric disorders, including Alzheimer's.

To reduce your risk, limit your exposure to wireless technology. Simple measures include turning your Wi-Fi off at night, not carrying your cellphone on your body and not keeping portable phones, cellphones and other electric devices in your bedroom.

I also strongly recommend turning off the electricity to your bedroom at the circuit breaker every night. This will radically lower electric and magnetic fields while you sleep. This will help you get better, more sound sleep, allowing your brain to detoxify and cleanse itself out each night.

Get plenty of restorative sleep

Studies indicate that poor sleeping habits cause brain damage and may accelerate the onset of Alzheimer's by impeding your brain's ability to clear out toxins and waste.

Manage your stress

Researchers have found that nearly three out of four Alzheimer's patients experienced severe emotional stress during the two years preceding their diagnosis. One of my favorite stress-busting tools is EFT (Emotional Freedom Techniques).

Challenge your mind daily

Mental stimulation, especially learning something new, such as learning to play an instrument or a new language, is associated with a decreased risk of dementia and Alzheimer's. Researchers suspect that mental challenge helps to build up your brain, making it less susceptible to the lesions associated with Alzheimer's disease.