text:
Morningside Recovery, an addiction and mental health treatment center, was founded in 2001 to give clients the tools to achieve sobriety and healthfully function through our unique supervised, open treatment model. In other words, clients see and do everything in life that they would normally have exposure to, within the most supportive therapeutic environment possible.
This model was established based on the decades of case study and research, showing this open, real-world model to be the most successful mode of treatment for both achieving and maintaining recovery.
Contact Morningside Recovery now for a Confidential Assessment. Advisors are standing by 24/7 at 866-942-0095.
Our Addiction Treatment Model
In addition to core daily support, we assess clients as individuals in order to customize treatment through a broad range of programs. We also differ from other treatment centers via our thoroughly trained and educated clinical staff comprised of Masters and Doctorate level clinicians, rather than drug and alcohol counselors with only a few hours of required training in the very psychological issues that underlie most addictions.
A Staff Dedicated to Addiction Treatment
Our highly qualified clinicians offer successful rehabilitation by not only addressing an individual's current addictions and mental health state, but possible latent trauma that requires special attention. And within Morningside's real-world model treatment located in vibrant Newport Beach, CA, you can attend classes at a local college, work part-time, bike with your housemates to the beach, have your cellphone, and be visited by family whenever you'd like. In other words, you are as close to real life as you can get. Support in this real-world context allows for a smooth transition into self-sufficient, sustainable recovery. We firmly believe that we offer the best level of care and chance of recovery to anyone who needs help.
The Morningside Difference
You may have found yourself here because you or someone you love has once again spun through the revolving door of rehab. Or perhaps you're here because you've realized that you desperately need help for the first and—hopefully—only time. Finding treatment that actually works can be a confusing and seemingly hopeless process, which, on top of the stress you are already experiencing, is overwhelming.
We're here to help.
The majority of treatment centers follow the 12-step model, which, though well-known, is not as successful as treatment that fully integrates the latest therapeutic services and techniques. Most 12-step programs are the same: lockdown living for 28 days, following 12 "steps" that are largely based from AA principles. Addiction is seen as the only disease to be treated. What's missing is the treatment of psychological issues that often accompany addiction—grief, loss, trauma, low self-esteem, depression, and anxiety among them. In fact, 90% of addicts have suffered some form of trauma in their lifetime. Often, there are underlying mental health issues that drive addiction, which is referred to as dual-diagnosis or co-occurring disorders.
Traditional treatment centers are staffed by addiction counselors who were only required one course in their education on the psychological issues that coincide with addiction. Morningside Recovery is different, with a staff comprised of Master's and Doctorate level therapists who specialize in treating the underlying mental health issues and traumas that often go hand-in-hand with addiction. It's the excellence of our therapeutic team and our unique, open treatment model that make us unrivaled in dual-diagnosis treatment. According to Morningside Recovery executive director, Joel Edwards, "Morningside has one of the most comprehensive dual-diagnosis programs I've ever seen. We are also problem-focused rather than symptom-focused, which is unlike the majority of treatment models."
Our Successful Open Treatment Model
Morningside Recovery operates under a non-lockdown treatment model in Newport Beach and Costa Mesa, CA, which exposes and teaches clients the everyday life-skills necessary to live sober and healthfully function after treatment. With our constant therapeutic support and supervision, clients can attend classes at a local college, work part-time, bike with housemates to the beach, have their cellphone, and be visited by family whenever they'd like. In other words, you are as close to real life as you can get. Support in this real-world context allows for a smooth transition into self-sufficient, sustainable recovery.
Customized Treatment Just For You
Additionally, we custom tailor treatment for each client through a broad selection of treatments, ranging from traditional therapies such as Cognitive Behavioral Therapy (CBT) and the 12 Steps, to more advanced therapies like Dialectical Behavioral Therapy (DBT) and EMDR, in addition to an extensive array of experiential therapies and activities. We also have as many as twenty therapeutic groups each day, five running concurrently at any time, held at our clinical office throughout the day, which are delegated by topic and assigned according to each client's individual needs. Having this many options to choose from is a huge part of what makes us excel where other treatment centers fail. Rather than treat just the mental health and addiction issues, we strive to promote healing and recovery for the whole person.


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Collings standard oval hole A style mando with some nice touches: a gloss top, sheraton brown finish, nickel hardware, and ivoroid binding and buttons. Lotsa folks think of oval hole mandos as the choice for folk and Celtic styles (and they do excel at that), but these Collings examples have enough volume and chop to sail through even the rowdiest of bluegrass jams. Banjos...beware! Includes custom TKL hardcase. SN#A3055
List $3200 Our price $2880 On Hold

subset: commoncrawl


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About Us
Cup of Cheer™
Photo Album
Floral Design Workshops
Fall Design Class
Our next design class will be held Wednesday, October 15th at 9:30 a.m.
Class will be held at the Naperville Municipal Center. $35 non-members, $25 members. All supplies will be provided. Please bring your own floral clippers. Registration/money due by September 30th.
Is your club or community organization looking for a fun event? Why not schedule one of our workshops for your group? Learn floral design concepts using either fresh or permanent floral material. Let our in house designers show you how to update your home for everyday or seasonal interest. Contact us for ideas.
Site for classes is the Naperville Garden Club Workshop Space, 800 W. Fifth Ave. (conveniently located behind Naperville North High School at 800 Corporate Center,
Suite 100K.
Look for the double doors that read 100. Turn right and proceed up the corridor to Suite 100K
Unless otherwise noted: All classes are suitable for beginners. Class fees are non-refundable and must be paid before registration dates.
For more information, email us at email@example.com.
Directions: Take Ogden (east of Rte 59) – turn right (south) onto Royal St. George – this road will bend and become W. Fifth Ave. Turn right into 800 Corporate Center parking lot. Drive straight through the parking lot to the back of the building. Workshop is through the double doors marked #100.
Turn right and proceed up the corridor to Suite 100K.
Naperville Garden Club


text:
- Prison Planet.com - http://www.prisonplanet.com -
MSNBC Asserts Violent Rhetoric Exclusively From Right; Two Months Ago Featured Guest Calling for Violent Revolution From Left
Posted By admin On January 9, 2011 @ 8:38 am In World News | Comments Disabled
Jan 9, 2011
On January 8th MSNBC guests Eugene Robinson and Josh Marshall, along with host Keith Olbermann, soberly assured their viewers that violent, political rhetoric is exclusive to the American right. Two months earlier, on November 8th, MSNBC host Dylan Ratigan called for a new American revolution and featured guest Ted Rall who advocates a violent overthrow of the government.
Article printed from Prison Planet.com: http://www.prisonplanet.com
URL to article: http://www.prisonplanet.com/msnbc-asserts-violent-rhetoric-exclusively-from-right-two-months-ago-featured-guest-calling-for-violent-revolution-from-left.html
URLs in this post:
[1] Stock up with Fresh Food that lasts with eFoodsDirect: http://www.efoodsdirect.com/2010-holiday-special/?aid=14&adid=48
[2] Image: http://www.homegain.com/housead/homes_for_sale/index?entryid=11502
[3] Dem Congressman: If Violent Rhetoric Didn't Cause This Shooting, It Will Cause Next One: http://www.prisonplanet.com/dem-congressman-if-violent-rhetoric-didn%e2%80%99t-cause-this-shooting-it-will-cause-next-one.html
[4] Protester confronts Dylan Ratigan at Occupy Wall Street: http://www.prisonplanet.com/protester-confronts-dylan-ratigan-at-occupy-wall-street.html
[5] MSNBC Guest Who Attacked Infowars Exposed: http://www.prisonplanet.com/msnbc-guest-who-attacked-infowars-exposed.html
[6] Nigel Farage On "Wholesale, Violent Revolution" In Europe: http://www.prisonplanet.com/nigel-farage-on-wholesale-violent-revolution-in-europe.html
[7] Corporate Media Says Nevada Tea Party Candidate Calling for Revolution: http://www.prisonplanet.com/corporate-media-says-nevada-tea-party-candidate-calling-for-revolution.html
Click here to print.
Copyright © 2013 PrisonPlanet.com. All rights reserved.


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Touch pads, pointer, or mouse |
Touch pads, pointer, or mouse for your laptop...
Which pointing device which do you use?Which type of device is your favorite?Most laptops come with a built in pointing device (yes there are some that don't but that is not our concern they are fairly old) and most of them now are Touch pads (TP).Your computer may have two of the three, a TP, a pointer (some people call them erasers - they look like a pencil eraser!) or a mini-joy stick (which it really is). As for a mouse they are an external device that you attach to a port on the exterior of the computer. The port may be a true mouse/keyboard (PS/2) port (more on this later) or USB. The TP is a material that is conductive sensitive. By conductive sensitive I mean that your body is conductive, the pad is sensitive to the conduction your body creates. To be non-technical, when you touch the pad or move your finger across the pad the pointer on the screen moves. Magic. The pointer or mini-joy stick in the keyboard also moves the pointer on the screen in the direction you push it. More Magic. There is good news and bad news about these devices, good news is they seldom break or fail. Bad news is that if the mini-joy stick in the keyboard fails you have to replace the keyboard. If the TP fails sometimes it is only the TP that has to be replaced, but I have seen keyboards with the touchpad attached. So be prepared to buy a keyboard and if you only have to buy a TP you save some repair time and money. To replace the mini-joy stick or TP you would use the keyboard page for disassembly instructions.
Newer computers use USB for the mouse so you will have to buy a USB mouse to connect an external mouse to your laptop. . |
Wireless devices ARE NOT allowed on Airliners! But a wired mouse is!


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Neighbors Leyland Cypress
I'm in Knoxville tn and an avid gardener . Several years ago Our neighbor planted a row of Leyland Cypress trees 1 foot from the property line and about 2-3 ft apart. They are now at least 5-7 ft across our property. Not only is mowing impossible but to make matters worse I've now lost 2 rows of gardening space from the branches. Also Last year several of the trees had bag worms and I actually found some bag worms growing on my red peppers plants that were closest to it.
My husband tried calmly talking to the neighbor who immediately got upset - raised his voice and wouldn't talk about it. Any suggestions?
In most locations, the law allows you to prune off any parts of a neighbor's tree which cross the property line! So find out where you stand legally. The trimmed hedge would look pretty ugly from your side, but you'd have your space back.
How wide is your yard? What percentage have you lost the use of? How much wider will the lost area be in another 3 or 4 years?
Note that the Leylands will continue to grow at the same yearly rate they've been growing thus far. Also, their roots extend over the property line about as far as their branches, and so steal moisture from the plants in your yard.
Your lawyer might have some advice.
[My neighbor planted Leylands along the northern edge of his property, which is my southern boundary. After 15 or 20 years, they're ... well, tall enough to shade the southern 60' of my property all winter. There isn't often enough snow to matter, but when there is, it lasts for 2 months in the shade of the hedge, and the earth beneath that snow remains frozen. That's the southern 30-50% of my property (the width varies).
The neighbor in question has a golf course. The alternative to shade would be even more golf balls than I have now. But I fantasize that he'll go out of business and I can buy the 25' adjacent to my property and put up a mixed hedge of flowering shrubs.]
Wasn't there a thread very recently in the trees forum about this exact scenario? (I think they were even Leyland Cypress, too!).
Yes--linked below!
Here is a link that might be useful: Neighbor Tree Thread
Leylands can be a problem in many places, but they can be especially problematic around here because of pests and disease. The 1' spacing from the property line is ridiculous. It sounds like the neighbor is either very naive about the issues or is just a jerk and doesn't care...bad either way.
Unless you live in an area with an HOA, I don't know what a good solution would be in this situation. Unless the trees are damaging something on your property (which they probably aren't, yet), I don't think there is much you could do legally to get the trees removed. And, like Missingtheobvious said, pruning back hard to the property line is going to result in a serious aesthetic problem for your side.
The bagworms might be your best legal bet. I don't know if there is a way to encourage them or not (and I know that sounds horrid), but they may be on your side in the dispute. Unfortunately, as you noted, they are not going to be good for your plants.
There are a variety of less legal solutions, but they could possibly get you in trouble if the neighbor found out that you were trying to kill the trees.
I think I know how you feel, but I'm afraid there may not be a great solution. All I know to do is wish you luck!
Spray the tree and enjoy the privacy. Unless you have a very tiny lot to me it isn't a big deal. If your lot is really small what do you expect?. You will have neighbor problems on a small lot.
Or cut the tree back to the trunk to get your space back. Trees on or near lot lines are too common to involve lawyers and such.
Did you talk to the neighbor about it? He may be tired of the tree. Offer to pay to have it removed.
I know this thread is a couple months old but I just ran across it looking for info on Leyland Cypress.
There is much variation across the county in the laws regulating this problem so you should carefully determine the law in your jurisdiction, BUT:
Almost all areas have a law that limits the height of a fence/wall on the property line.......AND a hedge of any plant is a fence/wall in many jurisdictions.
If my neighbor did this, I could call Code Enforcement and they would make him cut it back to the property line and top it at 6'6". This might seem extreme but it does force a misbehaving property owner into coming to agreement with his neighbors. This seem mostly like a good thing, as they would only enforce this when the affected neighbor complains.
For example, one neighbor of mine has Hollywood Junipers on his side of our shared wall along 125'. He has his gardener trim them after we agree on the height. He always tells me the day they will be trimmed in case I want to be there for anything special. I like "my" side to have that twisted/tortured Hollywood Juniper look and he likes his side to be a a solid rectangle. Isn't this the way it is supposed to work?


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(4 star hotel)
including 8 days parking
from the airport
customer rating
Holiday Inn, its in the name...
A warm welcome can be expected at the Holiday Inn M1 J9. Whats that I hear you say: you want an airport hotel not a country one? Well, lucky you, here you get both. Youll enjoy views of the countryside as well as the knowledge that youre just 15 minutes drive from the airport.
The perfect setting.
Theres something idyllic about staying in the country hotel. You feel a million miles away from the hustle and bustle of the airport. The hotel feels warm and cosy, the rooms equally so. Each has everything you need and a little more for that matter.
A spa escape.
The hotel even has its own health spa, Club Moativation. Get it? Moativation? No, us either. Despite the dodgy spelling, the leisure club is very nice. The staff are friendly, there are two gyms and the swimming pool is a good size. Its definitely worth a visit. You feel like youre on a spa retreat in the country rather at a busy airport hotel.
We recommend the Holiday Inn South M1 J9 for:
A great escape -Run away to the country and enjoy the pool, the bar and the glorious restaurant before you get away.
Convenient parking -the Holiday Inn is the closest Luton hotel to Airparks.
Tasty food - the food is really good, at a great price and the restaurant staff are brilliant.
Check in
Check in is from 2pm Check out is before 11am
Holiday Inn South M1 J9London Road,
AL3 8HH. Top


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This beautiful black matte laser-cut case is specifically designed to house a Raspberry Pi with an optional Pi Power Supply. It also accommodates our right-angle stereo cable as well as the Nwazet Pi IR Receiver. The vents ensure that the electronics within the case will have sufficient air flow to stay cool.
The case ships with the fasteners required to secure the Raspberry Pi and the optional power supply, a clear light pipe and rubber feet. Assembly time is about 15 minutes. The back of the case has four standard VESA 75 screw holes that make it possible to mount your device on the back of a monitor. Last but not least, it has been scientifically proven to pass the 'Living Room Aesthetics Test' 99.99% of the time (a.k.a 'The Spouse
Login Here to rate and review this product.
28-17918 - Raspberry Pi Project Power Supply
This power supply is designed to provide the Raspberry Pi with a clean and stable power source from a 9V wall-wart such as 9V 1A Power Supply. As you may know, the Raspberry Pi can become unstable when used with power-hungry USB devices and this power supply will ...
83-15642 - USB A - Micro B Black
This compact adapter bridges standard USB A and Micro USB female plugs, from a USB power supply to a microcontroller, Raspberry Pi or phone. Its two male plugs are the shortest path between power and your device, for those cases where a cable just won't do.
MCM Cat 57, Page 662


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Product Number: | RM22414 |
Item Price: | $35.99 |
Availability: | Currently Out of Stock, click the alert icon to be notified when product is available. |
Shipping Weight: | 1.65 lbs. |
For hunters and competitive shooters who want the best reloading cases sold, Remington Unprimed Brass Rifle Cartridge Cases - 100/box should be a top consideration. The Remington name is synonymous with excellence, which is evident in these cases. Made in the United States, the cases are ideal for building custom loads.
Because of the drawn brass, shooters are provided with outstanding durability as well as consistency, capable of withstanding multiple reloading sessions. These cases are sold for a variety of different gauges according to need and are specially designed to bolster accuracy and performance.
Customers who bought this item also purchased
Similar items: Brass
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Product Title | In Stock | Pricing | |||
Remington 8mm Mauser Unprimed Brass 50/bag | Out | $34.99 | |||
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Remington 9mm Luger Unprimed Brass 100/bag | In Stock | $27.99 | |||
Remington 45-70 Gov't Unprimed Brass 50/Bag | Out | $52.99 | |||


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The new shop filter looks absolutely amazing and effective. I love how we're going to be able to just search for the item we need instead of having to sift through everything. Also, could the shop be made so that it can be made into a small window that can fit into one f the areas in-between the abilities, minmap, and champion information? I think that woud make it a lot more accessible to some of the summoners with larger screens or even those who don't feel like re-opening the window.
Best Pony Rarity
Junior Member
dota 2?
Oh no, DoTA has taken over LoL. Wonderful.
24k Diamond Boob
how long it needs !i wanna play
There's an app for custom reccomended items.
Senior Member
Wow I got on LOL to redeem a 1 day IP boost and get off for 10 minutes. I Attempt to get back on but it keep's saying the server is busy. This has been happening for about 3 hours so far so far...
Are the numbers for the items really that important? We all know there are six item slots, and with the numbers for potions/wards etc, it just seems unnecessary and confusing. Its not very pleasing to the eye, just my opinion. Otherwise, I like the shop filters, the search bar and the ability to save builds. Colors are awkward, though. Maybe improvements will be made in the future, but its coming along.
420 thumbs up could not deny it. personally i liked the classic set up better... This could work though
the unknown8
kinda good , but dont like the item set up , but overall is good .
Trinity R


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You are here: PSPad forum > English discussion forum > Cygwin as C++ Compiler
Posted by: DilanShah | Date: 02/21/2011 18:02 | IP: IP Logged
I am using Cygwin on Windows 7 with PSPad and am trying to set up the compiler in highlighter settings to compile an executable of C++ code.
I have followed an example way of doing this, but I cannot get it to compile, even though I have set up the paths correctly.
When I use
/C "set PATH=%PATH%;C:\cygwin\bin\; & make"
I get the message:
make: *** No targets specified and no makefile found. Stop.
Process completed, Exit Code 2.
Execution time: 00:00.136
I then changed the parameters to
/C "set PATH=%PATH%;C:\cygwin\bin\; & g++"
and then I just get the message:
Access is denied.
Process completed, Exit Code 1.
Execution time: 00:00.036
Can anyone help me with this?
Editor PSPad - freeware editor, © 2001 - 2015 Jan Fiala
Hosted by Webhosting TOJEONO.CZ, design by WebDesign PAY & SOFT, code Petr Dvořák


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U17 Tackle Team
The U17 Provincial Team will participate/compete at the 2014 Wilson Challenge, Montreal, Quebec July 4-13, 2014. The team will leave for Montreal on Friday, July 4th. They will play their first game on Sunday, July 6th and will return after their final game on Sunday, July 13th. Arriving back home on Monday July 14th.
The selection process to make the final team this year has changed. Please read the following over so you know the new selection process.
The Selection Criteria for the U17 Provincial Team policy outlines in a clear and transparent fashion the criteria and process involved in athlete selection to TEAM NOVA SCOTIA. The process will consist of three (3) phases; Provincial Identification Combine & Training Camps, Provincial Team training and development and finally the selection of the Travel Team.
The U17 Provincial Identification Combine & Training Camps, will consist of four (4) sessions.
February 8 – 2014 Prodigy Sport Maritime High School Combine (CIS Coaches will be scouting)
11:00 am - Registration
12:00 pm - Testing Begins
2:00 pm - Positional Drills
2:40 pm - 1 v 1s
4:00 pm - Awards and Closing Remarks
May 21, 2014 – Training Camp Begins– 6:00 pm to 9:00 pm (NEW TIME) at EHS
July 2, 2014 – Training Camp Ends– 6:00 pm to 9:00 pm at EHS
For Full Schedule of Practices and Events please click the following link:
U17 Provincial Tackle Schedule
Location: All events will be held at the East Hants Sportsplex, 1076 Hwy #2, Lantz, NS.
The cost for the Provincial Identification Combine & Training Camp is $125.
Registration Process: Registration is now open on line for both the 2014 Prodigy Sports Maritime High School Combine and Provincial Training Camps. You must register under both links for the 2014 TEAM NS program.
1. To register for the combine please use the following link - 2014 Maritime Combine
2. To register for the provincial training camps please use the following link - 2014 Provincial Selection Camps
Please feel free to contact me if you have any questions or concerns about the Provincial Team program. I can be reach at (t) 883-1842, (c) 818-5345 or (e) email@example.com


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Welcome to the Vincent Domínguez Cycles website.
Vincent Domínguez Cycles is a one-person operation founded and run by me, Vincent Domínguez. I have been designing and building custom, high-quality steel bicycle framesets since 2002. Located in Saint Paul, Minnesota, Vincent Domínguez Cycles is dedicated to creating soundly-engineered, hand-made, human-powered works of art, in the form of bicycles, for people everywhere.
Each custom frameset and custom-made accessory is hand-made by me with care, precision, and an attention to detail that meets my exacting quality, operational, and aesthetic standards. My "Rabbit-Proof Guaranty" is my assurance of the highest quality: a limited lifetime warranty proudly covers every custom bicycle frameset and cycling accessory I make.
Vincent Domínguez Cycles builds unique bicycles that fit their owners: each frameset is designed and built to fit you and to accommodate your fitness levels and goals; each frameset is designed and built to match your riding style and is suited to its intended purpose; each frameset is designed around the componentry selected for your bicycle in order to optimize its functioning, handling and ride characteristics; each frameset is always built with meticulous care and attention to detail; and, of course, each frameset is designed and built to provide a lifetime of utility and enjoyment.
Vincent Domínguez Cycles offers: custom, hand-made framesets and bicycles; custom racks and touring accessories; custom utility and touring trailers; framebuilding findings; frame repair services (steel frames only); design and fabrication services.
Vincent Domínguez Cycles specializes in fully integrated bicycles for long-distance events, such as brevets and grand randonnées; racing bicycles for off-road, on-road, and track; and fully integrated commuting bicycles.
To get me started designing your favorite bicycle, please
contact me
at 651.214.9903.
Please follow the links on this page to discover more about the hand-crafted bicycle framesets and cycling accessories available from Vincent Domínguez Cycles or go directly to the
pages to see examples of some of my work.
Thanks for visiting.
– Vincent.
NAHBS 2011 (Austin, Texas)
[2011 March 7]
Vincent Domínguez Cycles was awarded "Best Fillet-Brazed" at the 2011 North American Handmade Bicycle Show held in Austin, Texas.
What a surprise that was! The award was given for the
first frameset
I ever built:
Photo courtesy of
Thanks to all the nice people who made their ways to Austin and stopped by my booth for a chat. You're the reason I came to NAHBS. It was sure nice talking with all of you – I hope you all had a great time!
And, a big "Thanks!" to Lesley Schommer and Don Walker for organizing and hosting the show and making us all feel welcome and part of a big family. Of course, thanks to Erik, Matt, Dave, Chris, and Randall for working together to spread the "nice" in Minnesota at the show.
And, finally, congratulations to
Dave Anderson
for being awarded "President's Choice" for his 953, brushed-finish, touring bicycle!
Web Site Updates
[2013 February 5]
It's been a while since the last site update and much has taken place: frames were made, bikes were built and ridden, feedback was given, and improvements are continually made. Please take a look at the
pages for more examples of my work and feedback from owners. Because I'm busy building and riding, changes to the web site will continue to be few and far between. Nevertheless, please check back periodically because I endeavor to post photos and descriptions of works completed and in progress.


text:
Alzheimer's Disease
Topic Overview
Is this topic for you?
Alzheimer's disease is the most common cause of mental decline, or dementia. But dementia also has many other causes. For more information, see the topic Dementia.
What is Alzheimer's disease?
Alzheimer's disease damages the brain. It causes a steady loss of memory and of how well you can speak, think, and carry on daily activities.
Alzheimer's disease always gets worse over time, but how quickly this happens varies. Some people lose the ability to do daily activities early on. Others may still do fairly well until much later in the disease.
Mild memory loss is common in people older than 60. It may not mean that you have Alzheimer's disease. But if your memory is getting worse, see your doctor. If it is Alzheimer's, treatment may help.
What causes Alzheimer's disease?
Alzheimer's disease happens because of changes in the brain. These include lower levels of chemical messengers (neurotransmitters) that help brain cells work properly. What causes these changes is not clear.
The risk of getting Alzheimer's disease increases as you get older. But this does not mean that everyone will get it. By age 85, about 35 out of 100 people have some form of dementia.1 That means that 65 out of 100 don't have it. Dementia is rare before age 60.
Having a relative with Alzheimer's raises your risk of getting it, but most people with Alzheimer's disease do not have a family history of it.
What are the symptoms?
For most people, the first symptom of Alzheimer's disease is memory loss. Often the person who has a memory problem does not notice it, but family and friends do. But the person with the disease may also know that something is wrong.
As the disease gets worse, the person may:
- Have trouble making decisions.
- Be confused about what time and day it is.
- Get lost in places he or she knows well.
- Have trouble learning and remembering new information.
- Have trouble finding the right words to say what he or she wants to say.
- Have more trouble doing daily tasks like cooking a meal or paying bills.
The symptoms of Alzheimer's get worse slowly over time. A person who gets these symptoms over a few hours or days or whose symptoms suddenly get worse needs to see a doctor right away, because there may be another problem.
As people with Alzheimer's get worse, they may get restless and wander, especially in late afternoon and at night. This is called sundowning. Over time, they may also start to act very different. They may withdraw from family and friends. They may see or hear things that are not really there. They may falsely believe that others are lying, cheating, using them, or trying to harm them. They may strike out at others.
Later, they may not be able to take care of themselves. They may not know their loved ones when they see them. They may forget how to eat, dress, bathe, use the toilet, or get up from a bed or a chair and walk.
How is Alzheimer's disease diagnosed?
To check for the disease, your doctor will ask about your past health and do a physical exam. He or she may ask you to do some simple things that test your memory and other mental skills. Your doctor may also check how well you can do daily tasks.
The exam usually includes blood tests to look for another cause of your problems. You may have tests such as CT and MRI scans, which look at your brain. By themselves, these tests can't show for sure whether you have Alzheimer's.
How is it treated?
There is no cure for Alzheimer's disease, but there are medicines that may slow it down for a while and make it easier to live with. Drugs that may be prescribed include:
- Medicines to help with memory and thinking problems, such as donepezil (Aricept).
- Medicines to help with help with moderate to severe confusion and memory loss, such as memantine (Namenda).
These medicines may not work for everyone or have a big effect, but most experts think they are worth a try.
As the disease gets worse, the person may get depressed or angry and upset. The doctor may also prescribe medicines to help with these problems.
How can you help your loved one with Alzheimer's disease?
If you are or will be taking care of a loved one with Alzheimer's, start learning what you can expect. This can help you make the most of the person's abilities as they change, and it can help you deal with new problems as they arise.
Work with your loved one to make decisions about the future before the disease gets worse. It is important to write a living will and a durable power of attorney. A living will states the types of medical care your loved one wants. A durable power of attorney lets your loved one pick someone to be his or her health care agent. This person makes care decisions when your loved one cannot.
Your loved one will need more and more care as the disease gets worse. In time, he or she may need help to eat, get dressed, or use the bathroom. You may be able to give this care at home, or you may want to think about using a nursing home. A nursing home can give this kind of care 24 hours a day. The time may come when a nursing home is the best choice.
Because people are living longer than they used to, Alzheimer's disease is becoming a more common problem. Ask your doctor about local resources such as support groups or other groups that can help as you care for your loved one. You can also search the Internet for online support groups. Help is available.
Frequently Asked Questions
Learning about Alzheimer's disease: |
Being diagnosed: |
Getting treatment: |
Living with Alzheimer's disease: |
End-of-life decisions: |
Health Tools
Health Tools help you make wise health decisions or take action to improve your health.
Decision Points focus on key medical care decisions that are important to many health problems. | |
Alzheimer's disease: Should I take medicines? | |
Alzheimer's or other dementia: Should I move my relative into long-term care? |
The cause of Alzheimer's disease is not clear, and it is likely there are several causes of this condition. Alzheimer's disease causes changes or deterioration in certain areas of the brain that control thinking, communication, and behavior. Some of the deterioration may be related to a loss of chemical messengers in the brain (neurotransmitters)—acetylcholine, in particular—that allow nerve cells in the brain to communicate properly.
It is not clear why these changes in the brain occur, but they are a major focus of Alzheimer's research. Although most people who have Alzheimer's disease do not have a family history of the condition, you are at increased risk for the condition if a member of your family has it.
Some theories have suggested that metals, such as zinc or aluminum, play a role in Alzheimer's disease. But research has not found much evidence to support these theories. Experts agree that there is no reason to leave zinc out of your diet or to avoid items that contain aluminum, such as cooking utensils or soda pop cans.
Memory loss is usually the first sign of Alzheimer's disease. Many older people may worry about Alzheimer's disease if they start to have memory problems. Having some short-term memory loss in your 60s and 70s is common, and some people with mild memory problems will go on to develop Alzheimer's disease. If you start having memory problems, share your concerns with your family and your doctor.
Examples of normal forgetfulness include forgetting:
- Parts of an experience.
- Where the car is parked.
- Events from the distant past.
- A person's name, remembering it later.
- Where you left an object, such as your car keys.
Examples of memory loss caused by Alzheimer's disease include forgetting:
- An entire experience.
- How to drive a car or read a clock.
- Recent events, such as forgetting you left the stove on.
- Ever having known a particular person.
Alzheimer's disease also causes changes in thinking, behavior, and personality. Early in the disease, the person may still behave appropriately in social situations, leading others to believe that the person is not ill. Close family members and friends may first notice the symptoms of Alzheimer's disease, although the person may also realize that something is wrong. Learn the warning signs of dementia—such as having difficulty thinking or remembering, or having trouble balancing a checkbook—and talk to a doctor if a friend or family member has developed any of the signs. Symptoms vary as the disease progresses.
The Alzheimer's Association has identified 10 warning signs for Alzheimer's disease. These signs are:2
- Memory loss, such as forgetting recently learned information like names and phone numbers.
- Difficulty performing familiar tasks, such as cooking a meal.
- Problems with language, such as forgetting simple words or substituting unusual words.
- Disorientation as to time and place, such as forgetting where you live on your street.
- Poor or decreased judgment, such as dressing improperly for the weather or giving away large sums of money to strangers.
- Problems with abstract thinking, such as not being able to balance a checkbook or understand what numbers represent.
- Misplacing things, like putting an iron in the freezer or a wristwatch in the sugar bowl.
- Changes in mood or behavior, such as rapid mood swings—from calm to tears to anger—for no apparent reason.
- Changes in personality, such as becoming extremely confused, suspicious, fearful, or dependent on a family member.
- Loss of initiative, such as sleeping all the time, watching television all day, or not wanting to do any usual activities.
Symptoms that may be but are not always present include:
- Firmly held false beliefs (delusions), such as that someone is stealing from the person.
- Seeing or hearing things that aren't really there (hallucinations).
- Lack of interest in surroundings or activities, or withdrawal from family and friends.
- Purposeless activity, such as opening and closing a purse, packing and unpacking clothing, pacing, or repeating demands or questions.
- Verbal and physical aggression.
- Inability to control impulses, which may lead to unusual or inappropriate actions. Men are somewhat more likely than women to exhibit behavior problems such as wandering, abusiveness, and social impropriety.
Early in the disease, Alzheimer's usually does not affect a person's fine motor skills (such as the ability to button or unbutton clothes or use utensils) or sense of touch. A person who develops motor symptoms (such as weakness or shaking hands) or sensory symptoms (such as numbness) probably has a condition other than Alzheimer's disease. Conditions such as Parkinson's disease, for instance, may cause motor symptoms along with dementia.
Other conditions with symptoms similar to those of Alzheimer's disease may include:
- Other types of dementia, such as multi-infarct dementia, which is dementia resulting from a series of small strokes.
- Dementia plus not getting proper nutrition, such as being malnourished.
- Thyroid problems, such as hyperthyroidism or hypothyroidism.
- Depression .
- Other problems such as kidney and liver disease and some infections such as HIV (human immunodeficiency virus).
What Happens
Researchers have discovered changes that take place in the brains of people who have Alzheimer's disease. These include:
- Lower levels of acetylcholine in certain areas of the brain. Acetylcholine is a chemical messenger in the brain (neurotransmitter) needed for some nerve cells to work properly. Other neurotransmitters also are affected.
- Senile plaques, which are clumps of abnormal nerve cells surrounding abnormal protein (amyloid) deposits, and neurofibrillary tangles, which are clumps of material that disrupt the normal structure of nerve cells. Senile plaques and neurofibrillary tangles can be seen during an examination of the brain after the person has died.
These brain changes may cause the memory loss and decline in other mental abilities that occur with Alzheimer's disease. It is not fully understood why these brain changes occur in some people but not in others.
Alzheimer's disease always gets worse over time, but the course of the disease varies from person to person. Some people may still be able to function relatively well until late in the course of the disease. Others may lose the ability to do everyday activities very early on.
- The disease tends to get worse gradually. It usually starts with mild memory loss and progresses to severe mental and functional problems and eventual death.
- Symptoms sometimes are described as occurring in early, middle, and late phases. It is difficult to predict how long each phase will last.
- The average amount of time a person lives after developing symptoms of Alzheimer's disease is 8 to 10 years.
Mild dementia
Usually, a person with mild dementia:
- Becomes confused about where he or she is and gets lost easily.
- Loses the ability to start tasks on his or her own without prompting.
- Avoids new and unfamiliar situations.
- Has delayed reactions and slowed learning ability.
- Begins speaking more slowly than in the past.
- Develops difficulty handling money and paying bills.
- Starts using poor judgment and making inappropriate decisions.
- May have mood swings and become depressed, irritable, or restless.
These symptoms often are more obvious when the person is in a new and unfamiliar place or situation.
Moderate dementia
With moderate dementia, a person typically:
- Has problems recognizing close friends and family.
- Becomes restless and wanders, especially in late afternoon and at night. This is called sundowning.
- Has problems reading, writing, and dealing with numbers.
- Has problems organizing thoughts and thinking logically.
- Can't find the right words to say or makes up stories to fill in the blanks.
- Has trouble dressing.
- Gets upset easily and can be hostile or unwilling to cooperate.
- Has firmly held false beliefs (delusions), suspicion of others (paranoia), and agitation.
- Needs full-time supervision.
- Loses recognition of time.
Severe dementia
With severe dementia, a person usually:
- Can no longer remember how to bathe, eat, dress, or go to the bathroom independently. The person may become bedridden or confined to a wheelchair because he or she has forgotten how to move.
- Loses the ability to chew and swallow.
- Has trouble with balance or walking and may fall frequently.
- Becomes more confused in the evening (sundowning) and has trouble sleeping.
- Cannot communicate using words.
- Loses bowel or bladder control (incontinence).
A person with severe dementia becomes more vulnerable to other illnesses. Death often results from complications of being confined to bed, such as pneumonia.
What Increases Your Risk
The main factor that raises your risk for Alzheimer's disease is getting older. About 6 out of 100 people over 65 years and 35 out of 100 people over 85 years have some form of dementia.1 People rarely have dementia before age 60. Other factors that increase your risk of developing Alzheimer's disease include:
- A family history of Alzheimer's disease, especially if one or more of your parents or siblings has the disease.
- The presence of the apolipoprotein E-4 gene, which increases the chances you will develop Alzheimer's disease.
- Having Down syndrome, which is a genetic disorder that results in mental retardation.
- Having diabetes, which is a condition that causes high blood sugar.
- Taking hormone replacement therapy. Research shows that if you are a woman age 65 or older, your risk for developing dementia (including Alzheimer's disease) increases if you take estrogen or estrogen plus progestin therapy.3, 4
When To Call a Doctor
Alzheimer's disease tends to develop slowly over time. If confusion and other changes in mental abilities come on suddenly, within hours or days, the problem may be delirium, a condition that needs immediate treatment.
Seek care immediately if:
- Symptoms such as a shortened attention span, memory problems, or seeing or hearing things that aren't really there (hallucinations) develop suddenly over hours to days.
- A person who has Alzheimer's disease has a sudden, significant change in normal behavior or if symptoms suddenly become worse.
Call your doctor to schedule an appointment if:
- Symptoms such as a shortened attention span, memory problems, or false beliefs (delusions) develop gradually over a few weeks or months.
- Memory loss and other symptoms begin to interfere with the person's work or social life or could result in injury or harm to the person.
- You need help caring for a person with Alzheimer's disease.
Watchful Waiting
If memory loss is not rapidly becoming worse or interfering with your work, social life, or ability to function, it may be normal age-related memory loss. Talk to your doctor if you are concerned about new memory loss or memory loss that is getting worse or other signs of dementia, such as having trouble finding your way around familiar places.
Who To See
The following health professionals can evaluate symptoms of memory loss or confusion:
- Nurse practitioner
- Physician assistant
- Family medicine physician
- Internist
- Geriatrician
- Neurologist
- Psychiatrist
A family member or friend will need to go with the person who needs to be evaluated.
To prepare for your appointment, see the topic Making the Most of Your Appointment.
Exams and Tests
Alzheimer's disease is diagnosed after other conditions are ruled out. If you are suffering from a decline in mental abilities (dementia), your doctor will attempt to find out if another treatable condition may be causing those symptoms.
- It is very important to rule out delirium as a possible cause of symptoms, especially if the symptoms came on suddenly rather than gradually. Delirium may require emergency medical attention.
- Symptoms of confusion and memory loss can sometimes be caused by depression. Depression is very common among older adults, but it is sometimes difficult to recognize. It may be successfully managed with medicine and counseling.
Alzheimer's disease is diagnosed with a medical history and a physical exam. A physical exam is used to help find out if a physical problem may be causing a person's dementia symptoms. It may be possible to correct some of these problems. For example, sometimes a simple hearing or vision problem can cause confusion, social withdrawal, or a change in behavior, such as hostility or unresponsiveness. The person may have an undiagnosed illness or infection that is causing the symptoms.
In addition, the doctor will do a mental and functional status exam and a mental health assessment. During these exams, the person will be asked to perform simple tasks that check orientation. It usually is helpful to have a family member or someone in close contact with the person present at the appointment. A family member may be able to provide the best information about how a person's day-to-day functioning, memory, and personality have changed.
Brain imaging tests such as CT scans and magnetic resonance imaging (MRI) may also be done to make sure another problem is not causing the symptoms. Positron emission tomography (PET) or single photon emission tomography (SPECT), two other imaging tests, are not routinely done but may be useful in individual cases.
Lab tests
A small number of people with dementia have a condition that proper treatment can reverse (unlike Alzheimer's disease). Lab tests may be done to rule out other possible causes of a person's symptoms, such as levels of certain minerals or chemicals in the blood that are too high or too low, liver disease, abnormal thyroid levels, or nutritional problems, such as folate or vitamin B12 deficiencies. Treatment for these conditions may slow or reverse mental decline.
Blood tests often done to check for these conditions include:
- Complete blood count (CBC), which shows the kinds and number of cells in your blood to help your doctor evaluate your symptoms.
- Liver function tests (AST, ALT, alkaline phosphatase, bilirubin), which detect liver damage or disease.
- Folate (folic acid) test, which detects the level of the B vitamin folic acid either in plasma (the liquid part of blood) or in the red blood cells. Folic acid is needed for the production of both red and white blood cells.
- Vitamin B12 concentration, which detects the level of vitamin B12 in your blood. Vitamin B12 is needed to produce red blood cells and to maintain a healthy nervous system.
- Electrolyte and blood glucose levels (sodium, potassium, creatinine, glucose, calcium), which are needed to keep the body's balance of fluids at the proper level and to maintain normal functions, such as heart rhythm, muscle contraction, and brain function.
- Thyroid function tests. Abnormal thyroid hormone levels are a common cause of forgetfulness, confusion, lethargy, and other symptoms of dementia in older people. Medicine can easily improve symptoms if a thyroid problem is present.
- Human immunodeficiency virus (HIV) infection test, if the person has risk factors for HIV or the medical history suggests it. Untreated HIV can cause symptoms such as personality changes or problems concentrating.
Other tests
- Brain imaging tests such as a CT head scan or an MRI of the head may be done to rule out other causes of symptoms when the diagnosis is unclear.
- A test that measures electrical activity in the brain called an electroencephalogram, or EEG, may be done if the medical history suggests a seizure disorder.
In some cases, examining the brain after death (autopsy) is done to look for changes in the brain that may show Alzheimer's disease. An autopsy is the only definite way to diagnose Alzheimer's disease, but the illness may not be clearly identified if the autopsy is performed when someone dies during the early stages of the illness. An autopsy is rarely necessary, but may be done if the family wants to confirm that the person had Alzheimer's disease.
Early Detection
At this time, there is no routine screening for Alzheimer's disease. It is difficult to diagnose Alzheimer's disease in its early stages. This does not mean that you should ignore symptoms of mental decline (dementia) or assume that they are a normal part of aging. Talk to your doctor if you are concerned about memory loss or other symptoms of dementia, such as having difficulty finding your way around familiar places.
Treatment Overview
While there is not yet a cure for Alzheimer's disease, there is much that can be done to maintain quality of life and help the person stay active.
Initial treatment
Medicines called cholinesterase inhibitors may be started as soon as Alzheimer's disease is diagnosed. These medicines—which include donepezil hydrochloride (Aricept), galantamine (Razadyne), and rivastigmine (Exelon)—may temporarily help with memory and thinking problems caused by the disease. The effect of these medicines usually is not dramatic, and they may not work for everyone who has the disease. Even though cholinesterase inhibitors may slow the progression of symptoms, they do not prevent the disease from getting worse. But most experts agree that cholinesterase inhibitors are worth trying for most people who have Alzheimer's disease.
Another medicine, called memantine (Namenda), may be used alone or with cholinesterase inhibitors to treat moderate to severe symptoms of confusion and memory loss caused by Alzheimer's disease.
For more information on when or whether to take medicines, see:
Another important aspect of initial treatment is detecting and treating any other medical problems the person may have. For instance, depression occurs in nearly half of people with Alzheimer's disease, especially those in the early stage of the disease who are aware of what the future holds for them. Detecting and treating problems such as depression can minimize disability and maximize the person's remaining abilities.
Newly diagnosed individuals and their families face important questions during initial treatment:
- What kind of care does the person need right now?
- Who will take care of the person in the future?
- What can the family expect as the disease progresses?
- What kind of planning needs to be done?
Education of the family and other caregivers is critical to successful care for a person with Alzheimer's. If you are or will be the caregiver, start learning what you can expect and what you can do to manage problems as they arise.
Ongoing treatment
If treatment with a cholinesterase inhibitor medicine seems to be helping the person with Alzheimer's disease, it can be continued until it is no longer helpful. The medicine may remain effective longer in some people than in others. Treatment may be stopped at any time if the person is unable to tolerate side effects from the medicine.
Regular assessment by a doctor helps evaluate the person's response to medicine, detect new problems, monitor changing symptoms, and provide continuing education to the family. Decisions about treatment for behavior problems or other issues often need to be revisited as the disease progresses. A general guideline is that a person with Alzheimer's should see the doctor every 6 months, or sooner if a problem arises.
It is important to continue watching for and treating other conditions. Hearing and vision loss, arthritis, thyroid problems, kidney problems, and other conditions are common in older adults and may aggravate symptoms of Alzheimer's. Arthritis may make it harder to move around without help. A hearing or vision problem may make the person more agitated, anxious, or unresponsive. Treating these problems can improve quality of life and ease the burden on the caregiver.
Most people with Alzheimer's disease can be cared for at home by family or friends, at least until the disease becomes severe. Ongoing treatment focuses on making the most of the person's abilities as they change and dealing with new problems as they arise. Caregiving tasks range from keeping the environment safe and helping the person get dressed every day to finding ways to manage or minimize disruptive behaviors such as wandering and sleep problems. No single strategy works for everyone. Successful care also depends on making sure the caregiver is involved in making decisions about treatment. These decisions will affect both the person with the disease and the caregivers.
If you are a caregiver for someone with Alzheimer's, finding help and support is crucial to the person with Alzheimer's and your own well-being. Take advantage of respite services, home care nurses or aides, or adult day care. Seek help from family and friends. And take care of yourself. All of this is key to providing ongoing care. Seek support as soon as you need it. Contact the Alzheimer's Association at 1-800-272-3900 or visit its Web site (www.alz.org) for help and advice on being a caregiver for someone with Alzheimer's disease.
Treatment when the condition gets worse
As Alzheimer's disease progresses, providing care at home usually becomes more and more challenging. Being a caregiver for someone with Alzheimer's is not easy, no matter how much you know about the disease and how committed you are to taking care of the person. The decision to place a family member in a nursing home or other facility can be a very difficult one, but sometimes nursing home placement is the best choice. For more information, see:
What To Think About
Palliative care
As Alzheimer's disease gets worse, you may want to think about palliative care. Palliative care is a kind of care for people who have illnesses that do not go away and often get worse over time. It is different from care to cure a disease, which is called curative treatment. Palliative care focuses on improving quality of life—not only in the body but also in the mind and spirit. Some people combine palliative care with curative care.
Palliative care may help with symptoms or side effects from treatment. It may also help your family make future plans for medical care. It could even help the person living with the disease or his or her caregivers understand Alzheimer's disease or better cope with feelings about living with the disease.
If you are interested in palliative care, talk to your doctor. He or she may be able to manage your care or refer you to a doctor who specializes in this type of care.
For more information, see the topic Palliative Care.
End-of-life care
Because Alzheimer's disease gets worse over time, people may want to think about discussing health care and other legal issues that may arise near the end of life. Many people find it helpful and comforting to state their health care choices in writing (with an advance directive or living will) while they are still able to make and communicate these decisions. Some people want every possible medical treatment to sustain life, while others prefer measures to maintain their comfort without prolonging life. It may be helpful to think about what kind of medical treatment you want. For more information, see the topic Care at the End of Life.
At this time, there is no known way to prevent Alzheimer's disease.
Research has been done to link physical activity and the risk of Alzheimer's disease and other dementias. Adults who are physically active may be less likely to get Alzheimer's disease or dementia than adults who are not physically active.5 Moderate activity is safe for most people, but it's always a good idea to talk to your doctor before starting an exercise program.
There is also good evidence that older adults who stay mentally active may be at lower risk for developing Alzheimer's disease.6, 7 Regularly reading newspapers, books, and magazines, playing cards and other games, working crossword puzzles, going to museums, and doing other social activities, and even actively watching television or listening to the radio may help you avoid symptoms of Alzheimer's disease. Although this "use it or lose it" approach has not been proved, no harm can come from regularly putting your brain to work.
Research has also shown that people who eat more fruits and vegetables, high-fiber foods, fish, and omega-3 rich oils (sometimes known as the Mediterranean diet) and who eat less red meat and dairy may have some protection against dementia. But the reason for this is still being studied.8, 9
As we learn more about the causes of Alzheimer's disease, we also may learn more about how to prevent the disease. Drugs now in development to prevent the formation of neurofibrillary "tangles" or amyloid plaques that damage the nerve cells in the brain may someday be used in people who are at risk for Alzheimer's.
Research into a vaccine for Alzheimer's disease is ongoing.
Home Treatment
If you have just been diagnosed with early Alzheimer's disease, you may feel angry, frightened, depressed, anxious, and worried about the future. Although the disease does get worse over time, some people are able to continue their usual activities for many years, even if at a reduced level or in different ways.
Common issues faced by people in the early stages of Alzheimer's disease and by their families include:
- Whether to continue driving. People in the very early stages of Alzheimer's disease can have their driving performance checked regularly to make sure they can drive safely. Family members can help find out about changes in the person's ability to drive by riding along when the person is driving. Talk to your loved one's doctor if you are concerned about his or her ability to drive safely.
- What kind of legal and financial planning to do. Soon after the diagnosis of Alzheimer's disease, consider writing a living will and assigning a durable power of attorney for health care. These documents will ensure that your wishes for medical care are documented.
The following tips may be helpful in the early stages of dementia:
- Tailor tasks to abilities. A task may take longer than it used to, but if you want to continue doing it, you should try. Make changes as needed. For example, if you no longer feel comfortable cooking, consider other tasks you are comfortable with, such as helping with shopping and meal planning or setting the table. Try making recipes that are easier.
- Make your home safe. Tack down rugs, put nonslip tape in the tub or use handrails, and put safety switches on stoves and appliances if you have trouble remembering to turn them off. Think about the risk of injury as well as the benefits of independence from continuing to cook.
- Make sure you eat a balanced diet. It's important to get plenty of whole grains, fruits, and vegetables every day. If you aren't hungry at mealtimes, plan snacks for midmorning and afternoon. Consider supplement drinks such as Boost, Ensure, or Sustacal if you are having trouble gaining weight.
- Some people with dementia have trouble sleeping. If you do, avoid napping during the day, get regular exercise (but not within several hours of bedtime), and try drinking a glass of warm milk or caffeine-free herbal tea before going to bed.
- Deal with depression. Many people with dementia have a problem with depression too. Talk with your family or friends about how you feel. And ask your doctor what you can do to help with depression. You may feel better if you spend more time with other people (for example, going to events at a senior center or volunteering). Or you may need to talk to a counselor or try medicines.
- Schedule activities and tasks for times of day when you are best able to handle them. It may be helpful to develop a routine that doesn't vary much from day to day. You may feel less frustrated or confused with a clear, simple daily schedule.
- Be creative in dealing with memory problems. Use labels, lists, sticky notes, and other helpful devices as reminders. Write daily activities on a calendar or daily planner, and keep it where you can refer to it often. Keep calendars and clocks in clear view.
- Before you go out alone, write down the destination, how to get there, and how to get back home, even if you have gone there many times before. Take someone along with you when possible.
- Remain active. Staying active and involved may slow the deterioration of mental abilities.
- Plan for the future. You should review legal and financial documents while your judgment is clear and you can make decisions.
Information for caregivers
Most people who have Alzheimer's disease are cared for at home by family members and friends. Taking care of someone with Alzheimer's disease can be physically and emotionally draining, but there are ways to make it easier. One of the keys to successful home care is educating yourself. You can do a lot to make the most of the person's remaining abilities, manage the problems that develop, and improve the quality of his or her life as well as your own. Also remember that caregiving can be a positive experience for you and the person you are caring for.
If you are taking care of someone with Alzheimer's, one of the goals is to keep the person as healthy and safe as possible. A safe environment, good nutrition, regular sleep habits, good hygiene, and prompt care of other medical problems are important to the person's overall well-being.
- Make your home safe by keeping rooms free from clutter, using locks on doors and cupboards, and installing handrails on the bathtub.
- Maintain good nutrition by making meal time a positive experience. You may need to serve finger foods that are easily held by the person with Alzheimer's. Set aside enough time for the person to eat, and limit choices. Too many choices may be confusing to the person.
- Manage sleep problems by discouraging napping during the day and offering warm milk before bedtime.
- Manage bladder and bowel control problems (incontinence) by encouraging the person to regularly use the bathroom and restricting liquids before bedtime.
Dealing with behavior problems and failing mental abilities often is the biggest challenge for caregivers. Strategies for dealing with these problems may not eliminate all the problems, but may make the problems easier to deal with.
- Make the most of remaining abilities. Let the person make decisions as long as he or she is able to.
- Help the person be at ease in his or her surroundings. Put labels on items and surround the person with familiar objects such as photographs.
- Understand behavior changes. Wandering or disruptive behaviors may occur. Try to remember the person's background and consider that the behaviors may be the person's way of trying to continue past activities or habits.
- Manage agitation. Keep distractions to a minimum and keep your voice quiet.
- Manage "sundowning." Sundowning is when symptoms of agitation and wandering become worse during the early evening hours. Try turning on lights as evening nears and give the person a single task to focus on.
- Manage wandering. Get the person an ID bracelet in case he or she does wander away. Lock outside doors to make it more difficult for the person to get out of the house without your knowing it.
- Consider the way you communicate. For example, don't argue with the person. Offer reassurance and try to focus the person's attention on something else. Use short, simple, familiar words and sentences.
It also is critical that you take good care of yourself. Finding and relying on sources of caregiver support can be extremely helpful. Try to find a support group in your area and an adult day care for some respite care. Remember to take care of your own health and not to shoulder all the responsibility of caring for your loved one who has Alzheimer's disease. Groups such as the Alzheimer's Association and the Dementia Advocacy and Support Network can provide not only educational materials but also information on support groups and services.
Nursing home placement
Taking care of a person with Alzheimer's disease at home is not always possible. Even when it is possible, it often becomes more difficult with time as the person develops new behaviors or medical problems that are hard to manage. The caregiver may develop medical problems of his or her own. Or the stress of caring for the person at home may become too overwhelming. There are many assisted living arrangements that you may consider, though many people with Alzheimer's will need full-time care at some point. Making the decision about nursing home placement is often very difficult because there are no guidelines that fit every situation. Every family has different needs, preferences, and situations to think about. For more information, see:
At this time, there are no medicines that can prevent or cure Alzheimer's disease or that will restore normal mental abilities. Medicine may help some people function better by temporarily reducing memory loss and thinking problems. Other medicines may be needed to treat associated conditions, such as depression.
Improving memory and daily functioning
Medicines include donepezil (Aricept), galantamine (Razadyne), and rivastigmine (Exelon). These medicines, called cholinesterase inhibitors, have been approved specifically for treatment of Alzheimer's disease. Research suggested that people with moderate to severe Alzheimer's disease who took cholinesterase inhibitors experienced improvement in thinking and daily functioning when they added memantine (Namenda) to their treatment.10
All these medicines may temporarily help improve memory and daily functioning in some people who have Alzheimer's disease. The improvement varies from person to person. These medicines do not prevent the disease from getting worse, although they may slow down mental decline.
The main decision about using medicines to treat failing mental function usually is not whether to try a medicine but when to begin and, later, when to stop treatment. Medicine treatment can be started as soon as Alzheimer's disease is diagnosed. But the person may or may not significantly improve when taking medicines because they do not work for everyone. If the medicines are effective, they are continued until the side effects outweigh the benefits or until the person no longer responds to the medicines. For more information, see:
Treating behavior problems
Sometimes, medicine may be used to manage behaviors or symptoms that are causing strain for the person with Alzheimer's disease and his or her caregivers. Medicines generally are used only when other treatments have failed. For example, if the person still has trouble sleeping after trying regular exercise and avoiding naps, a medicine may be needed.
When it comes to disruptive behaviors, caregivers are encouraged to try to understand the reasons for the behaviors and to develop other ways to manage them whenever possible. Distracting the person, avoiding situations that seem to cause the behavior, and using good communication often can help limit these behaviors.
Although other approaches to managing behaviors should always be tried first, medicines such as tranquilizers may be needed if:
- A behavior is severely disruptive or harmful to the person or to others.
- Efforts to manage or reduce disruptive behavior by making changes in the person's environment or routines have failed.
- The behavior is making the situation intolerable for the caregiver.
- The person has trouble telling the difference between what is and is not real (psychosis) in addition to dementia. Psychosis causes the person to have false beliefs (delusions) and to hear or see things that are not there (hallucinations).
Treating depression
Depression occurs in close to half of people who have Alzheimer's disease. It is especially common during the early stages of the disease when a person may be aware of losing his or her ability to think and function independently. Antidepressants can relieve symptoms of depression and may improve quality of life, although they will not slow down the progression of Alzheimer's disease.
For more information , see the topic Depression.
Treating other causes of dementia
Conditions such as high blood pressure (which can lead to multi-infarct dementia), thyroid problems, or Parkinson's disease, also can contribute to dementia in an older person with Alzheimer's disease. Some of these conditions may respond well to treatment with medicines.
Medication Choices
Medicines used to treat symptoms of mental decline in people who have moderate Alzheimer's disease include cholinesterase inhibitors such as donepezil (Aricept), galantamine (Razadyne), and rivastigmine (Exelon).
Memantine (Namenda) is a medicine for treating severe symptoms of confusion and memory loss from Alzheimer's disease. It works differently than cholinesterase inhibitors. But, like cholinesterase inhibitors, it does not prevent Alzheimer's disease from progressing. This medicine may cause dizziness, confusion, headache, and/or constipation in some people.
Other medicines may be tried to treat anxiety, agitated or hostile behavior, sleep problems, frightening or disruptive false beliefs (delusions), suspicion of others (paranoia), or hallucinations (seeing or hearing things that aren't there).
What To Think About
Close monitoring and regular reevaluation of the person with Alzheimer's disease are very important during treatment with medicine. As the disease progresses and symptoms change, the person's medicine needs often change. If you are a caregiver for someone with Alzheimer's disease, be alert for adverse drug reactions or side effects that further impair the person's ability to function.
Before deciding to manage behavior problems with a medicine, try to figure out what is causing the behavior. Understanding why a person is behaving in a certain way can point to better ways of dealing with that behavior. If you are able to find other ways of dealing with behavior problems, you may be able to avoid treatment with medicine and the side effects and costs that come with it.
Doctors don't know for sure that cholinesterase inhibitors help with behavior problems in people who have Alzheimer's disease.11 Some studies show that these medicines do help, which can mean less burden on caregivers.12 If that burden is reduced, people who have Alzheimer's may be able to live at home longer.
Other studies show that cholinesterase inhibitors do not help with behavior.13, 14 But these medicines may still help some people with memory and daily functioning.
Rivastigmine (Exelon) can now be given through a skin patch. Skin patches release medicine into the blood at a steady level and may reduce side effects. And when the person uses a skin patch, it's easier for caregivers to make sure a person is taking the medicine properly.
Some behaviors, such as agitation, wandering, and becoming restless and agitated in the early evening (called sundowning), do not always respond well to treatment with medicine. Figuring out what is causing the behavior and taking steps to manage or change it can sometimes be helpful. It may be worth trying this approach before resorting to medicine.
Development of new drugs
As research on the causes and progression of Alzheimer's disease continues, the search for effective medicines continues.
Researchers are studying many medicines, including those used for other conditions, as possible treatments for Alzheimer's disease. Some of the medicines may be available only to people who are enrolled in clinical trials. It may be some time before researchers know whether these medicines are effective in treating Alzheimer's disease. For more information on clinical trials, contact the Alzheimer's Disease Education and Referral Center (ADEAR) by calling 1-800-438-4380 or by going online at www.alzheimers.org.
Research into a vaccine for Alzheimer's disease is ongoing.
There is no surgical treatment for Alzheimer's disease at this time.
Other Treatment
Treatment with the herbal supplement ginkgo biloba to improve mental functioning is considered experimental.
Other therapies, such as light therapy, aromatherapy, and exercise, may help reduce behaviors such as agitation but should only be done with supervision.
Other Treatment Choices
- Ginkgo biloba. Many people take ginkgo biloba to improve or preserve memory. But studies have not shown that ginkgo biloba helps improve memory or prevent dementia.15 Ginkgo biloba is widely used in Europe to treat age-related dementia, including Alzheimer's disease.
- Aromatherapy. One small study indicates that this therapy, when used as a lotion containing essential balm oil, may be safe and effective for reducing significant agitation in people with severe dementia.16 But more research is needed to prove its effectiveness.
- Light therapy. This treatment is often used to relieve depression. It may help reduce depression, agitation, and sleeplessness associated with Alzheimer's disease. The person is exposed to either natural light or artificial light for several hours every morning or at night to reduce depression.
- Exercise. Gentle exercise, such as walking or swimming, can also relieve symptoms of depression associated with Alzheimer's disease. Exercise is most effective when it is combined with teaching caregivers how to work through behavioral problems with the person who has Alzheimer's disease.
Another way a caregiver can try to reduce agitation is to play soothing music for the person who has Alzheimer's disease, during meals and when the caregiver is helping with bathing.
What To Think About
As with other new drugs in development, other treatments for Alzheimer's disease such as ginkgo biloba need further study. Their effectiveness and possible side effects are not yet fully known. Talk to your doctor before you decide to try any herbal therapies, supplements, or nonprescription treatments.
Other Places To Get Help
Alzheimer's Association | |
225 North Michigan Avenue, Floor 17 | |
Chicago, IL 60601-7633 | |
Phone: | 1-800-272-3900 |
Fax: | 1-866-699-1246 toll-free |
TDD: | 1-866-403-3073 toll-free |
E-mail: | email@example.com |
Web Address: | www.alz.org |
The Alzheimer's Association is a national organization that provides educational materials, support groups, and community services for people dealing with Alzheimer's disease. It has more than 200 local chapters throughout the United States. The organization publishes a newsletter as well as a wide range of brochures and videos. The Web site includes a lot of useful information for people with Alzheimer's and other dementias, as well as for their caregivers. |
Alzheimer's Disease Education and Referral (ADEAR) Center | |
P.O. Box 8250 | |
Silver Spring, MD 20907 | |
Phone: | 1-800-438-4380 |
Fax: | (301) 495-3334 |
Web Address: | www.nia.nih.gov/alzheimers |
Part of the National Institute on Aging, ADEAR is a government-funded agency that prepares computer searches on educational and library resources as well as information on clinical drug trials. |
Alzinfo.org | |
Fisher Center for Alzheimer's Research Foundation | |
One Intrepid Square, West 46th Street & 12th Avenue | |
New York, NY 10036 | |
Phone: | 1-800-ALZ-INFO (1-800-259-4636) |
E-mail: | firstname.lastname@example.com |
Web Address: | www.alzinfo.org |
Alzinfo.org was created by the Fisher Center for Alzheimer's Research Foundation to educate people about Alzheimer's disease. The mission of the Web site is to build an online community with 24-hours-a-day/7-days-a-week access to information and support via online chats, message boards, and resource databases. |
Family Caregiver Alliance | |
180 Montgomery Street | |
Suite 1100 | |
San Francisco, CA 94104 | |
Phone: | 1-800-445-8106 (415) 434-3388 |
E-mail: | firstname.lastname@example.com |
Web Address: | www.caregiver.org |
This organization supports and assists people who are providing long-term care at home. It also provides education, research, services, and advocacy. |
National Institutes of Health Senior Health | |
9000 Rockville Pike | |
Bethesda, MD 20892 | |
Phone: | (301) 496-4000 |
E-mail: | email@example.com |
Web Address: | www.NIHSeniorHealth.gov |
This Web site for older adults offers aging-related health information. The Web site's senior-friendly features include large print, simple navigation, and short, easy-to-read segments of information. A visitor to this Web site can click special buttons to hear the text aloud, make the text larger, or turn on higher contrast for easier viewing. The site was developed by the National Institute on Aging (NIA) and the National Library of Medicine (NLM), both part of the National Institutes of Health (NIH). NIHSeniorHealth features up-to-date health information from NIH. Also, the American Geriatrics Society provides independent review of some of the material found on this Web site. |
Related Information
- Beers MH, et al., eds. (2004). Merck Manual of Health and Aging. Whitehouse Station, NJ: Merck Research Laboratories.
- Alzheimer's Association (2007). Symptoms of Alzheimer's. Available online: http://www.alz.org/alzheimers_disease_symptoms_of_alzheimers.asp.
- Espeland MA, et al. (2004). Conjugated equine estrogens and global cognitive function in postmenopausal women: Women's Health Initiative memory study. JAMA, 291(24): 2959–2968.
- Shumaker SA, et al. (2004). Conjugated equine estrogens and incidence of probable dementia and mild cognitive impairment in postmenopausal women: Women's Health Initiative memory study. JAMA, 291(24): 2947–2958.
- Wang L, et al. (2006). Performance-based physical function and future dementia in older people. Archives of Internal Medicine, 166(10): 1115–1120.
- Wilson RS, et al. (2002). Participation in cognitively stimulating activities and risk of incident Alzheimer disease. JAMA, 287(6): 742–748.
- Wilson RS, et al. (2007). Relation of cognitive activity to risk of developing Alzheimer disease. Neurology, 69(20): 1911–1920.
- Barberger-Gateau P, et al. (2007). Dietary patterns and risk of dementia: The three-city cohort study. Neurology, 69(20): 1921–1930.
- Sofi F, et al. (2008). Adherence to Mediterranean diet and health status: Meta-analysis. BMJ. Published online September 11, 2008 (doi:10.1136/bmj.a1344).
- Tariot PN, et al. (2004). Memantine treatment in patients with moderate to severe Alzheimer's disease already receiving donepezil. JAMA, 291(3): 317–324.
- Sink KM, et al. (2005). Pharmacological treatment of neuropsychiatric symptoms of dementia: A review of the evidence. JAMA, 293(5): 596–608.
- Trinh NH, et al. (2003). Efficacy of cholinesterase inhibitors in the treatment of neuropsychiatric symptoms and functional impairment in Alzheimer disease: A meta-analysis. JAMA, 289(2): 210–216.
- Raina P, et al. (2008). Effectiveness of cholinesterase inhibitors and memantine for treating dementia: Evidence review for a clinical practice guideline. Annals of Internal Medicine, 148(5): 379–397.
- Howard RJ, et al. (2007). Donepezil for the treatment of agitation in Alzheimer's disease. New England Journal of Medicine, 357(14): 1382–1392.
- Birks J, Grimley Evans J (2009). Ginkgo biloba for cognitive impairment and dementia. Cochrane Database of Systematic Reviews (2).
- Ballard CG, et al. (2002). Aromatherapy as a safe and effective treatment for the management of agitation in severe dementia: The results of a double-blind placebo-controlled trial with Melissa. Journal of Clinical Psychiatry, 63(7): 553–558.
Other Works Consulted
- California Workgroup on Guidelines for Alzheimer's Disease Management (2008). Guideline for Alzheimer's disease management. Chicago: Alzheimer's Association. Available online: http://www.alz.org/californiasouthland/documents/professional_GuidelineFullReport.pdf.
- Desai AK, Grossberg GT (2005). Diagnosis and treatment of Alzheimer's disease. Neurology, 64(Suppl 3): S34–S39.
- National Center for Health Statistics (2008). Alzheimer's Disease. Available online: http://www.cdc.gov/nchs/fastats/alzheimr.htm.
- Petersen RC, et al. (2001, reaffirmed 2003). Practice parameter: Early detection of dementia: Mild cognitive impairment (an evidence-based review): Report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology, 56(9): 1133–1142.
- Small SA, Mayeux R (2005). Alzheimer disease and related dementias. In LP Rowland, ed., Merritt's Neurology, 11th ed., pp. 771–780. Philadelphia: Lippincott Williams and Wilkins.
Author | Monica Rhodes |
Editor | Kathleen M. Ariss, MS |
Associate Editor | Pat Truman, MATC |
Primary Medical Reviewer | Anne C. Poinier, MD - Internal Medicine |
Specialist Medical Reviewer | Peter J. Whitehouse, MD - Neurology |
Last Updated | November 10, 2008 |
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Last Updated: November 10, 2008
Author: Monica Rhodes
Medical Review: Anne C. Poinier, MD - Internal Medicine & Peter J. Whitehouse, MD - Neurology


text:
I also give guitar lessons. I teach guitar full time I've been teaching over 12 years now. I teach all levels all styles so if you want to learn the guitar give me a call I can help.
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The curriculum is designed to provide a broad working knowledge of the theory and practice of marketing management. Among the courses offered are Principles of Marketing, Sales Management, Advertising, Market Research, and Retail Management.
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Information for Future:


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Curriculum and Instruction: Teacher Licensure
This program is designed for the student seeking initial teacher licensure or completing provisional licensure requirements while concurrently completing the MEd in Curriculum and Instruction.
In addition to professional studies/licensure requirements, students must meet the content course requirements for their particular endorsement prior to completion of the MEd The 36 hours of the program is exclusive of the internship in Education and content course requirements.
Licensure courses below are marked with an asterisk (*). Reading requirements are based on the desired grade level to be taught. For elementary education endorsement students, RDNG 625 should be taken before RDNG 640.
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Total Hours: 36
Required Courses: 24 hours
EDCI 600* Classroom Management And Instructional Methodology (3)
EDCI 606* Effective Instructional Strategies (3)
EDCI 617* Foundations and Curriculum of American Education (3)
EDHD 602* Human Development (3)
EDLS 609 Research Methods and Applications (3)
EDLS 603 Legal and Ethical Issues (3)
EDLS 646 Improving the School Structure and Climate (3)
SPED 600 Survey of Special Education (3)
3-6 hours from (selected based on licensure goals/requirements):
RDNG 625* Survey of Effective Reading Methods (3) (elementary and middle)
RDNG 640* Strategies for Teaching Phonics, Spelling and Vocabulary (3) (elementary)
RDNG 672* Reading and Study Skills in the Content Area (3) (middle and high)
EDCI 699* Internship in Education (6) (optional) (If a non-teacher secures a teaching position prior to completion, one year of successful teaching can be substituted for this internship.) Prerequisites for this course include passing scores on Praxis I, Praxis II, VCLA, and RVE (formerly the Virginia Reading Assessment, VRA) for elementary and special education.
Coursework Electives
0-9 credit hours as needed for degree requirements
Information on Student Teacher Testing Requirements


text:
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text:
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If you like a vent, press this to move it higher up the list.
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Remember folks, according to the Democrats, everything you earn really belongs to the government. Anything they let you keep is a loophole or a subsidy. That's just how it works.
To the prrson who thinks Southerners mispronounce words...I wonder what the British think of YOUR pronunciation.
If you want to understand what it means to have a really small dating pool try being a conservative lesbian.
Jesus wouldn't have been too happy to "render" 60% or more unto Caesar...
So this is all George Washington's fault????? Where did you get that idea?
I'll believe legislators' ridiculous claims that every place is safer with gun-toting people when they take the metal detectors out of the Capitol.
chuckle, chuckle, chuckle...candidates...can and will deliver...chuckle, chuckle, chuckle...
Bless their Heart is not an insult it simply means. They can help it, I understand your pain. It's called empathy. Signed 5th generation Southerner.
Paranoia must be bliss since so many so willingly embrace it.
So, a raving anti-gay marriage, anti-gay Republican Senator now changes his views after his son come out as gay...amazing! It takes direct personal impact to change narrow-minded attitudes just like Dick Cheney had.
You would give up Emory Healthcare because Chick-fil-A closed? Why don't you also cut off your nose to spite your face?
This President has ended two wars and a recession. Give his plans some credit. Get over your past President losing the wars and losing the economy.


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text: FYI, nALFS build successful on SuSE 7.3 for LFS 3.1. I have not booted it yet, but it was quite successful, not a single error. Operator Error not included however ;) I fergot to download the packages and initscripts and put them in /usr/src/packages/LFS/packages-3.1/. Other than that, successfull build in nearly four hours on Duron 800 with 1/2 gig of ram. Arthur H. Johnson II arthur at linuxbox.nu The Linux Box http://www.linuxbox.nu -- Unsubscribe: send email to listar at linuxfromscratch.org and put 'unsubscribe alfs-discuss' in the subject header of the message