Marianne Sciucco

[00:00:00]

John Salak: As we age, we all face challenges. There's simply no way around it. As a great Betty Davis said, old a Jane for sissies. However, in recent years, the mental health problems and challenges mature adults face have become more apparent, which is admittedly alarming for many, but also a good thing. Whether we are directly confronting those issues or caring for someone who is, it's critical that we all understand.

What we're facing and how best to deal with it, and that can mean anything from early identification [00:01:00] to prevention, treatment, and care. Two of the most common mental health issues facing those over 60 are depression and anxiety. The World Health Organization reports that perhaps 7% of mature adults suffer from depression while 4% face chronic anxiety.

There are a lot of factors driving these conditions, including isolation, loneliness, sleep deprivation, poor nutrition, and a lack of activity and social integration. Beyond this, however, is the dreaded fear of cognitive impairment and perhaps worst of all Alzheimer's disease. We hear about these diseases constantly and with good reason.

It's estimated that 6 million Americans currently suffer from Alzheimer, a number that is expected to double in the next 25 years. These are not pleasant topics or stats to deal with. They can turn stomachs and break hearts, but it is critical for those impacted along with their families and caregivers to clearly examine what's in front of them, how they can and [00:02:00] should deal with it medically and at what it means for them personally.

With this in mind, we're going to speak with an expert on Alzheimer and dementia shortly. A person who has both personal and professional insights on the challenges and approaches necessary for those directly affected and for their caregivers. It is also an opportunity for everyone to understand, even with the challenges, life goes on productively for many.

So we'd like to welcome everybody to this section of our podcast, and we are going to be interviewing a very special guest who's dealt both personally and professionally with some of the issues that mature audiences face in terms of mental health.

We are speaking with Marianne Sciucco, who among a number of other things is a nurse a caregiver, someone who's had personal experience Dealing with parents who have mental health issues, dementia. She is also I think it's fair to say one of the founders of Alt Saucers, which is a group of 350, at least individuals who deal [00:03:00] with the disease, deal with some of the issues surrounding it and who are involved in storytelling.

So we're gonna touch on today with Marianne a little bit about what are some of the challenges people face as they age? What's bringing this about and how caregivers and these individuals can deal with it?

So, Marianne, welcome to What the Health Podcast.

Marianne Sciucco: Thank you so much for inviting me, John. It's lovely to meet you.

John Salak: Now is that, was that a fair description on what you do, both your professional background and your personal background?

Marianne Sciucco: Yeah, it's pretty accurate. Alz Authors is the global community of authors who are writing about Alzheimer's and dementia from personal experience.

And our goal is to help other people who are currently caring for a loved one with one of those conditions.

John Salak: So, and your, your personal background, you describe yourself as a dementia daughter, I believe. Is that correct? Yes,

Marianne Sciucco: yes. I had a stepfather had dementia.

John Salak: So it, it hits you both on a personal and a professional level, obviously.

Yes. And of course your, group, you know, and it's a pretty [00:04:00] devastating situation to deal with, isn't it?

Marianne Sciucco: It sure is. Yes. It's very painful. Okay. And there's like a lot to learn.

John Salak: So let's see if we can hit some of the big issues. And not to say that we can address everything in this, this interview, but hopefully we can address some of the things, or at least help people learn where they can begin to go get some of the answers or What are some of the biggest challenges mature adults face as they age in terms of mental health? Certainly physical health can have an impact on mental health, and we've written about this and talked about this before, but what are some of the challenges that they face on a mental health level? And

Marianne Sciucco Mm-hmm. Sure does. In general speaking, anxiety and depression are obvious answers to that question where people , in the, the later years of life, you're going through a tremendous amount of changes. You may have retired, so you no longer have the structure of your day job anymore. You may have lost your spouse, you may have lost other family members and friends. So your world starts to shrink a bit. Some people have [00:05:00] relocated. So that presents a lot of new challenges. So it's important for people to stay connected and to be aware of the fact that things like anxiety and depression can come upon you and gradually, and you may not even realize it, and you may not realize the impact it's having on your life.

And the same goes for cognitive impairment or cognitive decline, which would be actual brain changes that could be due to a host of factors and are something that really need to be investigated to find out is this something that's, temporary? Is it something that can be resolved or am I sliding into the path of maybe having Alzheimer's or some other kind of dementia in the next decade or so?

And those are important issues to confront and not to just. Assume it's just because you're getting older or an event triggered it or something like that, because it could really be some kind of organic [00:06:00] problem and there may be treatment for it.

John Salak: There's just a growing legion of articles, books, and a, a wider focus than ever on the problems with dementia, the challenges of dementia, challenges of Alzheimer's, which I is a good thing because it makes people more aware the challenges. I assume it probably terrifies a lot of people because it's a horrible disease.

Do we see Alzheimer's, dementia is it growing or are we just more aware of it today than ever before? Or combination of both, perhaps? Mm.

Marianne Sciucco: Yes. The answer to that is yes.

John Salak: What are some of the reasons that it is growing?

Marianne Sciucco: The number one reason is the number of people in the population that are affected is it, is the largest population that we had ever had up until, I guess, recently with the baby boomers. So now the baby boomers are starting to reach their old age 60, 80 nineties years of age.

And they are the ones who are more affected by cognitive challenges than say, younger people, although younger people can still have dementia [00:07:00] in early onset Alzheimer's as well. So that's kind of like a natural thing that we really, we can't fix that, you know, it's just a state of, of way that it is. And we also have greater awareness.

Now in diagnostics for people. So in the past if somebody were exhibiting signs of like Alzheimer's disease, people would just chalk it up to old age or they would be diagnosed with hardening of the arteries or senility. And there really isn't anything that you can do about that, which is true today.

There really isn't much that you can do about it, although we do have some options on the horizon. But Now you can actually pinpoint what it is that may be causing those symptoms. And in some cases it could be perhaps irreversible disease or condition that can be treated medically or with cognitive changes and other, and other things, lifestyle factors.

So that's why we would want people, if they were experiencing symptoms, to see their doctor and [00:08:00] to get a workup to make sure that it isn't something that can be corrected.

John Salak: So it would be fair to say that we're seeing more of this one because people are living longer or there's a greater percentage of the population now that's living longer.

So we're just confronting more people who are dealing with dementia. And we're more aware of, the issue because it's been diagnosed, it's been studied. Are there any other factors that drive it or is this just an awareness and natural progression? Is there something about the way we live our lives, our diet, anything like that?

Or just our social Isolation that may cause that

Marianne Sciucco: it's kind of a combination of all of that. One big factor is genetics. So if your parents, mm-hmm, your grandparents or siblings have had it, then you may also be predisposed. And there are tests that you can get to find out if you were that inclined.

You could find out if that might, maybe in your future, if you're at a higher risk or not. Stress then, and the way that we live our [00:09:00] lives has an impact on it. We are very a driven society. Everybody seems to think they have to work all the time, and that is not helpful for your brain health.

And another component of it is sleep. A lot of people feel that it's okay to skimp sleep, but what the studies now show is that sleep is a very important factor in brain health. So if you're cheating yourself outta sleep thinking you can get by four or five hours a night in the long run, you can't.

And so that's something that you want to work on, right away. And to try to build a better sleep habit so that your brain is getting the time that it needs at night to process it and to go through what it needs to go through so it can stay healthy.

John Salak: So some of these factors like sleep, like stress, they're actually having a physical impact on the brain.

It's actually changing your brain function. Or impairing your brain physically that's causing a disease. What are some of the signs that like, whoa, something may be happening that's a little bit different than [00:10:00] just forgetting where your car keys are?

Maybe that's a sign.

Marianne Sciucco: Yeah, a lot

of people get nervous, you know, when they can't find their keys, you know, where did I put my keys? And I think everybody does that like pretty regularly. Something that we, absent mindedly, put them down somewhere in our pocket, you know, and then you switch your code or you switch your purse.

But um, that's not really that much of an indicator. It's when you have the key in your hand and you don't know what to do with it. When you, that's when you need to start wondering. When you can't remember people's names, some of the authors in our community will tell stories of how, you know, they were at a, board meeting and they'd been on the board for 12 years, and then they introduced themselves to the people like they've never met before.

Stuff like that would happen if you're making mistakes at work, if you're not able to follow through, if you are leaving little notes for yourself to remind yourself of this very simple and routine thing. That's kind of an indicator that you're starting to forget if you don't know how to do basic household tasks anymore, like run your dishwasher or do the laundry, that's a sign that [00:11:00] there's some kind of cognitive impairment that you need to get a look at.

So there's a lot of different things that go on. It doesn't necessarily mean that you have Alzheimer's, but it could be something else. I know a lot of people get worried Over, over some little things that may turn out to be nothing, but it's when things start to impact the way that you function or other people are starting to notice.

You know, with my stepfather, his thing was he slept all the time. He slept about 20 hours a day. Mm-hmm. And that's not good. And he always had, strange behaviors. That was his personality. And when those were like exacerbating, that's how we kind of knew that there's something more here going on than what we, we initially thought.

So those are the kind of things that you need to watch out for.

John Salak: Are there other things people can do earlier in life that is going to lead to a stronger or better mental health, better protective health.

And then the second thing is once you see these issues coming up, what are your first steps take? And

Marianne Sciucco: [00:12:00] Yeah, so, basically whatever is going to keep your heart healthy, can keep your brain healthy. So if you're already following some kind of heart healthy habits you wanna keep that up.

So that would involve your diet. You wanna stay away from a lot of processed foods. You want to eat a lot of fresh fruits and vegetables, whole grains, lean meats, all of those things. Skip the fast food, try to skip the desserts and not too much sugar in your diet. Decrease alcohol. All of those are really good things to do for both your heart and your brain and overall health.

The other thing is exercise and movement. So, you know, that keeps your heart pumping and you know, that gets your blood going and that just helps all your processes really work better in including your brain. So it's a good idea to try to incorporate some kind of movement or exercise into your day.

Every day or most days, depending on your availability and, where you are, the climate, there's a lot of issues involved with people getting out and [00:13:00] moving. So if you're not moving now, you need to get up and start moving. And if you're not eating a healthy diet, you may need to change some habits you see in your loved one that they are having some kind of, difficulties.

With routine tasks or, or able to articulate for themselves, or they're not remembering things that they should, then the idea would be to go to your primary care healthcare provider and raise your concerns and then ask them to run some tests. So it would be like some simple blood work. They may do like, the mini mental health exam, which they can do in the office.

It takes just a few minutes. And they may order testing like MRIs to actually take a look at the brain itself. And if you don't get a good response or the type of response you'd like from your physician. And They may refer you to a neurologist and they may refer you to a [00:14:00] psychiatrist, which I know a lot of people, they don't.

Very don't want that he bucket the idea of seeing a psychiatrist. But those are the kind of people who are going to be able to make that diagnosis. So that's why you need, need to go to see them. So, if your doctor's not open to, to doing that and you still feel like you have concerns, you're not satisfied, then you need to pursue it even further and not be afraid to get a new doctor.

John Salak: You have personal experience and obviously you're involved in this. Are doctors more aware? Do you find doctors more aware of the problems, and how to refer people on, and they, were say 10 or 15, 20 years ago, as you mentioned, old age, just sort of ility, just sort of was a catchphrase that is natural now it seems maybe something else.

Marianne Sciucco: Right. Some are and some aren't. A lot of it depends on where you live. Mm-hmm. So if you live in like mm-hmm. Metropolitan area where some of the bigger hospitals are and you know, they're at the forefront of medicine, you might get a better response. There's a lot of stigma attached to [00:15:00] any mental health condition, especially to Alzheimer's and dementia.

So what we see, Through the books that come in through our collection and the authors that we meet is a lot of doctors may be reluctant to attach that label to a person because it has profound effects. So they may not want to be the one to make that call. They may bounce you off to somebody else. They may wanna look for something else.

A lot of people, especially when they're diagnosed with the early onset Alzheimer's, which is typically diagnosed before age 65, you know, that can have a profound effect on a person because many cases they're gonna end up having to leave their employment when they're still of working age and not eligible for their social security, or retirement benefit.

So it has this massive financial issue for them. So, Those are kind of some of the things that would be in the way [00:16:00] of maybe obtaining a diagnosis.

John Salak: Would a standard, annual physical pick up signs of possible dementia or early stage Alzheimer's, or would it need to be testing, treatment?

Marianne Sciucco: It should be a part of a basic, physical exam, especially for an older person. It may not be. I mean, there's a simple questionnaire that you would put somebody through and to see how they answered those questions. So now people who have cognitive impairment are very skillful at answering the questions properly so that they skate through.

The test my stepfather did that. And that's like a very common thing. Somebody will be brought in and they exhibit all kinds of symptoms at home, but as soon as they get into the doctor's office, they're totally lucid and answer all the questions. Right. So, it might require more digging. And so then you may be referred on to other people, you know, with more skill, like a neurologist to try to get mm-hmm.

To the bottom of what the [00:17:00] problem is. They like to look at brain scans, you know, that'll give you some clue as to, what's the size of the brain, how does it look, how does it compare to a normal brain? Things like that. And then a lot of the other stuff is just behavioral.

The family member is gonna be the one that's gonna be able to articulate the behavioral changes probably better than the person themselves, because A, they may not be aware of it. Or be there in denial. They don't wanna discuss it, which was in my situation where my stepfather believed he was perfectly alright, and then it was, you know, my mother and I were the ones to say, no, we have this, this, this, this is all going on.

It can be very time consuming to go through the workup. It takes months or maybe even years for people to get an accurate diagnosis.

John Salak: So there are no simple tests effectively to determine whether you have Alzheimer, early stage, , Alzheimer, dementia.

Marianne Sciucco: No, it's not easy.

When I brought my stepfather in for the first, I had to get a new doctor because the doctor didn't really want to, go in that direction. So I brought them to a gerontologist, a [00:18:00] specialist in complex.

Geriatrics. And, she met with him and we gave her our concerns and she examined him and went through some questions and things and said right there that he has dementia. So, then we had to go through the steps of like medically proving it, which we did. And that took, a few months.

John Salak: When people, are diagnosed with dementia, Alzheimer, and I know the degrees differ and some of the other, cognitive impairments differ.

Is it a matter at that point of just, dealing with a disease or lessening the impact? Or what are the treatment prospects? Are they growing, are they the same or is it just a matter of handling it?

Marianne Sciucco: Mm-hmm. So there are some drugs that are available, whether or not they help is up for debate.

There are new drugs in the pipeline coming out, which seem promising. The only way that we have to address it is through pharmaceuticals. There's no surgery or anything like that that you can have. And [00:19:00] a lot of it is just watching and monitoring symptoms and. Changes usually in behavior and learning how to adapt and how to make the most of your life inspire the fact that you have this diagnosis.

So for many people to hear that they have dementia is like a, death sentence, or it means life is now over, meaning now on that day, my life just ended. But in reality, you are the same person that you were before. You had that diagnosis and you can continue to your life and live your life for years, if not decades, without having any real profound change.

So it's not necessarily that your life is over, it's just different. A different awareness. It's different knowing You know, some of your abilities might change. It doesn't mean that you have to give up everything. I mean, a lot of times people have to give up employment because [00:20:00] that's, you know, they can't do the work anymore, but that doesn't mean that they can't live a good life.

And you can still be a productive family member and a friend and travel. And we've got authors who have written more than one book since they got diagnosed. And Travel. I have no authors who travel all over the country doing advocacy work for Alzheimer's and dementia. So that's huge. Being able to do something like that.

And you know, they still married, they still have their families and you just don't give up.

John Salak: Somebody who's diagnosed with these problems. I assume that with this still things like reducing stress, sleeping properly, eating properly, getting exercise socialization are also keys.

If not for reversing the disease, then maybe lessening its impact or lessening the speed at which it comes on.

Marianne Sciucco: Yeah, exactly. That's what you would want to do is to have like a routine and to participate in [00:21:00] activities and things as you normally would. You know, you don't have to become a hermit. You can still go to church, you can still go shopping, go to the movies, visit with people, take a walk, travel.

You know, people, they go on cruises, they fly, they have new experiences. And sometimes they don't remember, they have no short term memory. They can't remember, but they still are able to enjoy in the moment and they can be funny. Okay. And this, you know, they can be creative. Mm-hmm. They can do art.

We have some beautiful artists, people who've never picked up a paint brush in their life. Suddenly doing very good works that can be hung in public and. People are selling, actually selling paintings. So that's an amazing thing. Writing poetry is huge. A lot of people writing poems, writing their memoir, writing stories.

That all keeps you very engaged. It keeps your mind active. You need to have a purpose. Yes. And you also need a lot of socialization. And the first [00:22:00] instinct is to hide from the world. And that's like the worst thing that you can do. You need to be out and you need to continue socializing for as long as you can.

And so does the caregiver. A lot of caregivers become isolated and, fixated on, their loved one and being present every minute of the day, and that's not good for their mental health either. So there is, in some communities you can find, Things called memory cafes where people with dementia can get together with other people and have, a social hour and the caregivers can go off and have their own social hour as well, a support group or something like that, or even just a drop off where you can go for two hours and, and take care of something you need to do, and knowing that your loved one is, in good hands and is also having a good time.

John Salak: It's probably one of most overlooked a facets of, dementia, Alzheimer's, medical impairment as people get older is the impact on caregivers. Beyond this, what does a caregiver need to know so they maintain their own wellbeing because they can't give decent care to [00:23:00] someone if they get sick.

And you mentioned some of those aspects, but what about on a wider scale or there other things they need to think about to maintain their own health and to help others?

Marianne Sciucco: Yeah. When a, when a doctor diagnoses a person with dementia, now they have two patients, cuz it's usually that person's spouse.

Or whoever the caregiver is, say their daughter or whatever. But now you have two people dealing with this condition. It's, shared. I always say the caregiver needs to know everything they need to know on day one, and they usually don't know anything. So now there's this steep learning curve of trying to find out what it is that you need to know, like you wanna know about this disease process, how does it manifest?

What should I expect? What do I do if this happens? Then you also wanna know like, how do I get help in my community. Every community offers different resources in the United States, so you know, you may live in a community, very rich in resources, or there may be nothing. So you need to [00:24:00] find that out.

What's available to me, and reach out, and use the resources and not to be shy and not to be afraid to discuss this situation with others. Other people in your social circle because a lot of them are probably dealing with the same thing and nobody's talking about it. So you could be a source of support for each other.

And the caregiver also needs to be aware of their own health and continue their own good health practices, managing their weight, what they eat, getting exercise, getting enough sleep. It's usually the caregiver is the one that collapses first.

John Salak: Interesting. And it's as I suspect, it's not something that's well known or it's not something that's thought of first.

Marianne Sciucco: No. I don't think people think about it until they're in a situation.

John Salak: Yeah. All right. So we're, this obviously is, a devastating situation and it's growing. But something you said earlier, it doesn't necessarily have to be a [00:25:00] death null for people or the end of their lives, or they can still lead productive, enjoyable lives.

I just want you to reinforce that notion to people because it is such a frightening disease. Mm-hmm.

Marianne Sciucco: So, A person can live with dementia for 20 years or even more. Sometimes people only live a couple of years like my stepfather. But you can have any range of life ahead of you from the day that you're diagnosed.

So you need to make the most of that time. that's one of the gifts of dementia, is it teaches people how to live in the moment because there is no past and we don't know about the future, which is true for everybody.

People with dementia, that's the only thing they have, is that moment. And a lot of people and authors in our organization have written that was the gift that they got, was learning how to be in the moment and to appreciate what is happening at that time. it is a terminal. Disease. Alzheimer's disease is terminal illness.

Most so is most dementia, [00:26:00] so it does have that attached to it as well. But it doesn't mean that you're gonna die today or tomorrow. You may have many years ahead. People who have gotten married after a dementia diagnosis. I know a woman, she got two honorary doctorates from two different universities where she lived for her advocacy work.

She wrote three books. People play music. I mean, there's still a lot going on. I went on a cruise and it was for people with dementia and there were, I don't know, at least six or eight couples there, and they traveled and they had a wonderful time. We visited all these islands and, you know, that was going on.

And other people would say, think that they couldn't even leave the house, but it's like, no, there's still a lot of living left to do. So start living.

John Salak: All right. That's probably a great way to to underscore that importance. I would like you Marianne to let us know how people can get in touch with you or your group, so that at least they can reach out and, connect and, and some help if they need it.

So, if you could please give us your contact information or where it's best for people to reach out and connect to you.

Marianne Sciucco: Okay, the [00:27:00] best place to go is to our website, which is a l z authors, a u t h o r s alzauthors.com. And when you go there, you'll see our blog posts. Every other week we have a new author with a new book or a new storytelling product.

Could be a film, it could be a podcast, it could be a blog. Most likely it's a book. We do a podcast. And you can find that on our podcast page. We have a bookstore. So all of our books are categorized to make it easy for you to find what you want. So if you're just looking for a book on caring for your mother, you can find all the books in one section that are about that.

And then you'll also find us on Facebook, Twitter, Instagram, and LinkedIn. And there's a contact page on the website, so you can write into us there and, and we'll get your email.

John Salak: Give us that website one more time.

Marianne Sciucco: It's alzauthors.com, A L Z A U T H O R S.com.

John Salak: That sounds great. Thank you very, very much for your time and your insights and, really your, your [00:28:00] hopeful message, of how to deal with Alzheimer's, effectively. Thanks so much, Marianne.

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I wish we could provide health hacks for treatments for every form of cognitive impairment, dementia, or Alzheimer's. Unfortunately, there aren't totally proven ways to treat and reverse many of these diseases, including dreaded Alzheimer's, [00:29:00] but there are ways to help individuals and caregivers identify, help prevent and more effectively live with the consequences of these diseases.

First off, don't avoid or ignore signs that your a loved one may be dealing with cognitive issues. If you suspect something, get to your general practitioner right away and demand a cognitive assessment be conducted Early identification is critical. To lessening or delaying the impact of cognitive impairment, and if you discover that the issues involve may instead be tied to depression, anxiety, or something else, well, you're now ahead of the game in terms of treatment.

Two, learn the signs of possible cognitive problems, which include issues with learning, remembering, paying attention, or reasoning. Three. Don't freak out if you forget the small things. Something slips your mind. If you misplace your [00:30:00] keys or you can't remember where you put your glasses. It doesn't necessarily mean that you're dealing with cognitive impairment.

Four, no matter what you're facing, physical activity, mental stimulation, and social integration will have a positive impact on your physical health. And your mental wellbeing. Get and stay moving and engaged. Five. Diet and rest are other factors that can promote or harm mental health, depending on what you're eating and if you're getting enough rest.

This is especially true for mature adults. Six caregivers need to find time for themselves if they are going to help others through these challenging times. Seven, A diagnosis for cognitive impairment or Alzheimer's is never going to be a positive thing, but it also doesn't mean your life has to stop or become unproductive.

It does mean however, that you should take the opportunity to [00:31:00] live every single day to its fullest possible extent. Thanks for joining us on this edition of What The Health. We'd like to thank our guest Marianne Sciucco as well. Hope you enjoyed the effort and please listen again. Thanks.