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Anthea Rowan

This is the 70th instalment in a series on dementia, including the research into its causes and treatment, advice for carers, and stories of hope.
Caring for a loved one with dementia is about providing the best care you can. This is a core theme in Irish psychologist Dr Sabina Brennan’s new book, Still Me: A neuroscientist’s guide to caring for someone with dementia.
It opens with a poem that explains the title and speaks to the individuality of both the dementia sufferer and their carer.
I have dementia and I am still me
I care for you and I am still me
Both people can get lost in this disease, their personalities eroded by either pathology or the part they play in caring.
Brennan, whose mother had dementia, cared for her part-time. During the week, her mother was looked after in a nursing home. At weekends, Brennan looked after her.
From a professional perspective, as a neuroscientist and psychologist, she understood the trajectory of the disease and “the challenging nature of the behavioural and psychiatric symptoms and also – something that is not spoken about enough – the end stages”.
“I’m not a natural caregiver,” she says. “I knew I could never do 24/7 care – I was good at visits and mum coming at the weekends, but it wouldn’t have been good for her or for me to care for her full-time.”

Her own strengths, she believes, are being good at solving problems, getting the right treatment and making demands of healthcare providers.
These are crucial. Care is not just about the day-to-day tending to physical and emotional needs. It is also about understanding the disease and healthcare systems, and advocating for the sufferer.
As one who cared for her mother in depression and later dementia, I am heartened to know that even with considerable knowledge of the disease, Brennan struggled with caring, too. It endorses this as a really hard job.
Brennan’s mother was in her eighties when she succumbed to dementia. She had become depressed and dependent after Brennan’s father died.
Those factors – and her age – would have put her at risk. Though she was not overweight, did not drink or smoke, or have high blood pressure, she did struggle with hearing loss, was almost blind from macular degeneration, had a low level of education, and rarely exercised.
What is more, Brennan says, “she never engaged in mentally stimulating activities – she never read books, never really did any of the things that promote neuroplasticity in the brain”.












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Dementia takes a huge toll on a carer, Brennan confirms. From a scientific perspective, “the research indicates that dementia care is more stressful and has more negative impact on the carers’ health than other types of care”.
A significant portion of dementia carers die before the person they are caring for does. Studies indicate that around 18 to 40 per cent of dementia carers, particularly spousal carers, may die before their partners.
This higher mortality rate is often attributed to the physical, emotional and mental burden of caregiving.
It is not just the chronic stress associated with caring for somebody with dementia, Brennan says, but the constant downhill trajectory with little reprieve of symptoms and no hope of them getting better.
“The carer may also be grieving the loss of an imagined future, the loss of their loved one while they are still living,” she says.
A loss of recognition – if the person with dementia no longer knows your name or your face or who you are – can also have a considerable impact, she adds.
I would attest to this: my mother forgot who I was, a problem that was compounded because it made me an unreliable witness as far as she was concerned.
When I referenced my sister or brother – who she remembered for much longer – that elevated her confusion and feelings of mistrust: how could they be my siblings if I was not her daughter?

Brennan is adamant that to look after somebody with dementia well, first you need to look after yourself well. She employs the analogy of an oxygen mask on an aeroplane.
“People often think that being a good carer means putting themselves last. But just like on a plane, you have to put on your oxygen mask first. Otherwise, you can’t help anyone else.”
Many carers do not put themselves first. They feel guilty if they have a night out or even a good laugh, and beat themselves up when they feel frustrated in their caring role.
But allowing yourself the time to do what makes you feel better can be the difference between coping and suffering burnout.
Brennan’s book is full of small, doable shifts – “micro-moments of care” – to sustain energy and protect health.
It is also full of vignettes from the lives of other people who live with dementia, either in themselves or as carers, which offer valuable insights into how the disease affects everybody.
You might feel alone in your dementia-care journey, but read their stories and you will understand you are not.
When Wei Wei admits to her ignorance of Alzheimer’s at the beginning of her mother’s illness, I recognise my own at the start of my mum’s.
When Susan describes the imperatives of keeping a record of her mother’s dementia, I am reminded of the notes I kept to track mum’s symptoms and medication.

When Kay recounts her distress at her daughter taking her wedding rings away to keep them safe, I remember how my mother worried when her wedding band grew too large for a finger that was getting skinnier.
That wedding ring reminded her she was – had been – married, even if she had no memory of whom she had been married to.
“A person with dementia may forget your name, but they will never forget how you make them feel,” a geriatrician once told me.
That is because the hippocampus – our memory vault for facts and faces – goes first in dementia. The amygdala, on the other hand – the bit of our brain that processes emotion – goes later. In the absence of remembering, a sufferer still feels.
Brennan says that when we see only the disease, “we stop making eye contact, we stop asking questions, we stop laughing”.
Dementia may change a life, but it does not cancel it, she says.
“When we remember there’s still someone in there, everything changes.”
Brennan’s top tips for dementia carers

It is not about doing everything – it is about doing what matters, sustainably.


Providing good quality care does not mean you have to do it all yourself.


There is no one right way to care – just your way, with support.


You do not have to be perfect. You just have to be present.


Understanding the symptoms – what they mean, why they are happening – helps you respond with empathy, not impatience. It helps you connect more, and resent less.

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How to provide the best care for a dementia sufferer: you need to put yourself first

Irish psychologist Dr Sabina Brennan (left) is pictured with her mother, who was in her 80s when she succumbed to dementia. Brennan is adamant that to look after somebody with dementia well, you first need to look after yourself well. Photo: Sabina Brennan

Brennan looked after her mother at weekends, while a nursing home cared for her during the week. Photo: Sabina Brennan

Understanding more about dementia and its symptoms can help make a carer more patient and less resentful.  Photo: Shutterstock

The cover of Dr Sabina Brennan’s book, Still Me. Photo: Amazon

How copper could improve brain health, fight Alzheimer’s, and aid memory and concentration

Copper is a key player in brain function, building connective tissues and supporting blood health. Our bodies cannot produce it, so we must get it from our diet, sometimes from supplements. Photo: Shutterstock 

Beth Wright refers to copper as one of the “Goldilocks” nutrients. Photo: Beth Wright

Dr Puja Agarwal has conducted several studies examining the role of copper in brain health. Photo: Alyce Henson/Rush University Medical Centre

An illustration of neurons in a brain with Alzheimer’s disease and amyloid plaques. Elevated brain copper levels are linked to fewer amyloid plaques and tau tangles. Photo: Shutterstock

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Shiitake mushrooms are a good source of copper. Photo: Shutterstock

Unmarried people have lower risk of dementia, including Alzheimer’s disease, study finds

There are many health benefits to being in a happy marriage, but a new study from Florida State University found that unmarried people are less likely to develop dementia, including Alzheimer’s disease and Lewy body dementia. Photo: Shutterstock

Previous studies have found that married men and married women live longer than singletons. Photo: Shutterstock 

Writer Anthea Rowan with her husband on their wedding day, 36 years ago. Photo: Anthea Rowan

While being married can sometimes mean a better social life, there is also a risk that older married individuals have a smaller social network. Photo: Shutterstock

Florida State University postdoctoral researcher Selin Karakose says divorce can lead to greater happiness and life satisfaction if the marriage has been unhappy, and that widowed individuals may experience an increase in friends after losing a spouse. Photo: Shutterstock

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Imagine having dementia. ‘Virtual’ tour simulates clumsy hands, painful feet, filmy vision

An employee of Second Wind Dreams in the US struggles with a simple folding task while wearing gloves, which interfere with dexterity - as arthritis might - on a virtual dementia tour that simulates the challenges of the condition. Photo: Second Wind Dreams

A participant in a virtual dementia tour experiences the sensations and challenges someone with dementia might have. Photo: Second Wind Dreams

PK Beville, a certified end-of-life care provider and founder of Second Wind Dreams, designed the virtual dementia tours. Photo: Second Wind Dreams

A VDT participant in the UK attempts to sort socks while wearing accessories and equipment designed to help simulate the challenges of having dementia. Photo: danieljonesphotography.co.uk

Melanie Bishop joined a virtual dementia tour to experience what it might have felt like to have the condition that had afflicted her mother. Photo: Melanie Bishop

Does caring for someone with dementia stress you out? 10 top tips for how best to cope

Carers of people with dementia can learn ahead of time everything they can expect to encounter, but for some that is too much information. The writer, who was a dementia carer, offers advice on how to cope and solicits tips from a professor of Alzheimer’s. Photo: Shutterstock

Anthea Rowan with her late mother, who suffered from Alzheimer’s disease. Big changes in her mother, she says, came abruptly and without warning. Photo: courtesy of Anthea Rowan

The cover of Rabins’ book. Dementia caregivers have higher rates of stress than carers of patients with other conditions. Photo: Johns Hopkins

Peter Rabins is a professor of Alzheimer’s and related dementias at Johns Hopkins School of Medicine. Photo: Johns Hopkins

The cover of the book about dementia care that Peter Rabins co-authored. The title comes from a husband who cared for his wife. Photo: Amazon

Among the greatest challenges for a carer is dealing with a patient who cannot remember who the carer is. Photo: Shutterstock

Lifestyle

Health & Wellness

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Author Anthea Rowan (right) with her mother.

Author Anthea Rowan (right) with her mother, who has Alzheimer’s disease, the most common type of dementia. Photo: Anthea Rowan

Anthea with her mother. Photo: Anthea Rowan

Studies suggest that regular exercise lowers the risk of cognitive decline by 35 per cent. Photo: Getty Images

Staying active can help prevent or delay the onset of dementia, studies suggest. Photo: Shutterstock

Why should you have a brain scan to test for dementia when there’s no cure? Knowing can help you delay its onset, neurologist says

It can be daunting to get a brain scan to test for signs of dementia, but a neurologist behind new research reveals the advantages of knowing early. Photo: Shutterstock

New research has found that dementia can be detected as early as nine years before symptoms manifest, and this could have significant implications for treatment. Photo: Shutterstock

Timothy Rittman, the neurologist who led the dementia research at Cambridge University. Photo: Cambridge University

A brain scan showing signs of dementia. Photo: Getty Images

Lizzie Perry, founder of This is Dementia, with her father, who was diagnosed with the disease at 58. Photo: This is Dementia

The approval in the US of a new drug that slows the onset of Alzheimer’s makes Rittman hopeful about the future of dementia treatment. Photo: Cambridge University

Why women are more likely to have dementia than men as they age, and how exercise and engagement can help lower your risk

Women may be at a greater risk of developing Alzheimer’s than men for a number of reasons: biological, societal or cultural. Experts suggest exercise and social engagement can help offset the risk. Photo: Getty Images

The spread of tau – the protein that clumps into the telltale tangles of dementia – may contribute to Alzheimer’s disease. Photo: Shutterstock

Female twins with a male co-twin were less likely to be diagnosed with dementia than female twins with a female co-twin. Photo: Shutterstock

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Taking regular exercise is key for women – and men – to reduce the risk of dementia. Photo: Shutterstock

How high or low blood pressure increases the risk of dementia, and why it’s never too late, or early, to adopt a healthy lifestyle to manage it

Having blood pressure that is too high or too low has been linked to a higher risk of dementia, but it’s never too late to start living a healthy lifestyle that will help maintain optimal blood pressure. Photo: Shutterstock


An optimal blood pressure reading, easily measured with a home device, is around 120/80. Photo: Shutterstock

Dr Ruth Peters was lead author of a study looking at the links between blood pressure and dementia. Photo: Dr Ruth Peters

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Problems with reasoning, planning, judgment, memory and other thought processes may result from damage caused by impaired blood flow to the brain – which may be brought on by high blood pressure. Photo: Shutterstock

6 dementia fighting tips from Dr Sanjay Gupta and Marc Milstein, experts on brain health – walk, talk, read, learn, relax, and eat and drink properly

We can protect ourselves against the risk of dementia with some simple lifestyle practices. Exercising (above), eating a good diet, drinking less alcohol, socialising, reading more and trying new things all help keep the brain sharp, say brain experts including Dr Sanjay Gupta. Photo: Shutterstock 

The cover of one of Dr Sanjay Gupta’s book. Photo: Simon & Schuster

The cover of Marc Milstein’s book. Photo: Marc Milstein

Drink alcohol mindfully and ask yourself why you are having that drink. Photo: Shutterstock

Learning new things creates new brain cell connections and helps keep your mind sharp. Photo: Shutterstock

Reading is good for brain health. Try to read a wide range of book styles, and join a book club to discuss with others what you are reading. Photo: Shutterstock

During sleep, our brains are restored and repaired, so relaxing is important if we’re going to get those seven hours of quality sleep. Photo: Shutterstock

Relationships keep us engaged, interested and interesting, and may help prevent dementia. Photo: Shutterstock

‘Like a light switch’: how sundowning syndrome affects dementia sufferers – and their carers; what it is and tips for how to cope

A person with dementia may experience “sundowning” syndrome - towards the end of the day they become more agitated, confused, panicked, resistant to instruction and restless. This affects their carers, too. Photo: Shutterstock

A person in bed, unable to sleep. Conservative estimates suggest about 20 per cent of dementia patients experience sundowning at some point.

Trey Todd is a neuroscientist at the University of Wyoming. Photo: Trey Todd

Sundowning was coined in 1987 by Lois Evans of Penn Nursing at Pennsylvania University. Photo: University of Pennsylvania

The pineal gland in our brain produces melatonin, which is what helps prompt us to sleep and awaken. In a broken system it is disrupted. Melatonin supplements might help fight sundowning. Photo: Shutterstock

Taking a patient with sundowning syndrome for a walk at a consistent time each day, morning or evening, may alleviate symptoms. Photo: Shutterstock

Getting out into the daylight early in the day is good for our sleep patterns, whether we have dementia or not. Photo: Shutterstock

Healthy marriage, healthy mind? Dementia risk lower for people married a long time, studies show; expert suggests why

Research suggests that people who have stayed married for a long time have a lower risk for dementia because they feel less lonely, are more likely to eat well and exercise more, and are more cognitively engaged. Photo: Shutterstock

Vegard Skirbekk is a researcher at the Norwegian Institute of Public Health. Photo: Norwegian Institute of Public Health

Anthea Rowan’s parents on their wedding day. Photo: courtesy of Anthea Rowan

A long-time married partner represents a security that provides a buffer against stressors. Photo: Shutterstock

Anthea Rowan and her husband on their wedding day. Photo: courtesy of Anthea Rowan

If you live with a partner long term, you are more likely to develop healthy daily patterns, to eat well and exercise more. Photo: Shutterstock

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Residents are free to live their lives as they like at the world’s first “dementia village”, The Hogeweyk in The Netherlands. Photo: The Hogeweyk

The Hogeweyk, a “dementia villlage” in the Netherlands, provides care and a familiar and safe environment in which people with dementia live while retaining their own identity and autonomy as much as possible. Photo: The Hogeweyk

Jannette Spiering is the senior managing adviser and co-founder at The Hogeweyk in the Netherlands, which offers “humanising care for people with dementia”. Photo: The Hogeweyk

Residents relax around the fountain in the theatre square at The Hogeweyk. Photo: The Hogeweyk 

Residents of The Hogeweyk respond positively to their increased autonomy. Photo: The Hogeweyk

Residents at the healthcare facility take part in a painting class. Photo: The Hogeweyk

Hearing loss dramatically raises the risk of dementia, so why are so many people in midlife doing nothing to prevent it? A test is easy to arrange

Hearing loss has been linked to a higher risk of dementia and cognitive decline,  say experts, who recommend testing for preventable hearing problems (above).  Photo: Getty Images

Alison Huang, a senior research associate at the Cochlear Centre at Johns Hopkins, in the US, says hearing loss makes the brain work harder to process sounds. Photo: Johns Hopkins

Jiang Fan from the School of Public Health at China’s Shandong University. Photo: Shandong University

Checking your hearing in midlife is crucial, and can help you stave off cognitive deterioration. Photo: Shutterstock

Can HRT reduce dementia risk? New hormone replacement therapy studies say yes, upending 2002 reports

HRT use has been linked to better cognition, blood flow and brain size and a reduction in all neurodegenerative disease in recent studies. Photo: Shutterstock

HRT (hormone replacement therapy) use has been linked to better cognition, blood flow and brain size and a reduction in dementia and other neurodegenerative disease in recent studies. Photo: Shutterstock

If HRT is started after the age of 65, brain cells will have already been deprived of oestrogen for many years. This could mean there is a decline in neuronal connections – the brain’s messaging system. Photo: Shutterstock

HRT was found to be most effective when introduced early in menopause, says Anne Marie Minihane, director of the UK’s Norwich Institute of Healthy Ageing at the University of East Anglia. Photo: University of East Anglia

Dr Andrea Kwakowsky from at the University of Galway in Ireland believes the “critical period” for starting HRT is within five years of menopause. Photo: University of Galway

How can you prevent dementia? Free brain health online tool teaches the risks and gives essential tips on avoiding it

The new free “Think Brain Health Check-in” online tool from Alzheimer’s Research UK doesn’t test your memory but checks how well you’re looking after your brain and gives tips to help prevent dementia. Photo: Shutterstock

Dr Susan Mitchell is head of policy at Alzheimer’s Research UK. Photo: Dr Susan Mitchell

The Think Brain Health Check-in asks how often you challenge your brain - and then highlights why challenging your brain is key to staving off dementia. Photo: Shutterstock

Getting a good night’s sleep every night is one way to lower the risk of developing dementia. Photo: Shutterstock

Up to 40 per cent of dementia cases could be prevented if people were mindful of the risk factors for the illness and made lifestyle changes to prevent them. Photo: Shutterstock

Can lack of sleep raise dementia risk? Yes, studies say – but with one exception

Having only five hours of sleep a night can increase dementia risk by 30 per cent for adults over 50, one study says. Photo: Shutterstock

One tip to overcome insomnia is to avoid clock-watching. Photo: Shutterstock

Taking a warm shower or bath in the hour or so before bed may help you fall asleep – and stay asleep. Photo: Shutterstock

Professor Roger Wong of the department of public health and preventive medicine at the State University of New York’s Upstate Medical University. Photo: Roger Wong

Sleep aids can heighten dementia risk, Wong says. Photo: Shutterstock

Can’t sleep? Try getting up and engaging in cognitively stimulating activities, like reading or making jam. Photo: Shutterstock

Dementia and ACB scores: how common prescription and over-the-counter drugs raise the risk of memory loss and cognitive decline

Certain common drugs, including antihistamines, antacids, antidepressants and anti-anxiety medicines, can disrupt the neurotransmitter acetylcholine, dubbed the “memory molecule” increasing the risk of dementia. Photo: Shutterstock

The writer, Anthea Rowan, with her mother. Photo: Anthea Rowan

Taking medications that block the action of acetylcholine can lead to memory loss, problems with spatial awareness, and cognitive decline. Photo: Shutterstock

Studies have found that anticholinergic drugs carried “significant’ dementia risk” for the over-65s. Photo: Shutterstock

Doctors need to be mindful of the risks posed by anticholinergic drugs, especially to an already at-risk population: the over 65s. Photo: Shutterstock

How to safeguard your ageing brain: build ‘cognitive reserve’ with mental and physical exercise, and stay active and socially engaged

The phrase ‘use it or lose it’ is not just a hypothesis, it’s a basic biological fact that holds as true for our brains as our muscles or bones. Photo:
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Our brains, like our muscles need regular use to stay healthy and flexible, say experts, and keeping our brains active builds our ‘cognitive reserve’, helping us to stave off dementia. Photo: Shutterstock

Geriatric psychiatrist Dr David Merrill recommends the active pursuit of activities that keep the brain sharp to stave off dementia. Photo: Dr David Merrill

Dorina Cadar says cultural and social engagement, reading, doing crossword puzzles, visiting art galleries, clubs and cinemas, and volunteering all increase our cognitive reserve. Photo: Dorina Cadar

Visiting an art gallery or doing something new and different are good ways to build up cognitive reserve. Photo: Shutterstock 

How yoga benefits dementia patients: new study uncovers brain-health boosts, supporting earlier research

Yoga has health benefits including better brain neuroplasticity, improved sleep quality, and more robust cardiorespiratory fitness, all of which help people experiencing cognitive decline or dementia. Photo: Shutterstock

Dr Diana Karamacoska is a research support programme fellow in healthy ageing and dementia at the NICM Health Research Institute at Western Sydney University. Photo: Courtesy of Diana Karamacoska

How to provide the best care for a dementia sufferer: you need to put yourself first

With many dementia carers dying before the person they are caring for does, Irish psychologist Dr Sabina Brennan talks about prioritisation