It was Travis Sago, I believe, who invented the term “Bum Marketing.” The method itself is based on tried and tested principles and techniques which were already known and used for years – Article Marketing. However, Travis formulated a certain way of using these principles and techniques and called it his own.
Article marketing is at the root of this method that you use as the Ultimate Guide to Med Spa Marketing. That is, you write content (articles) that give value (or you should if you want to succeed), with the aim to lead the reader into making a purchase with you getting the commission. However, with Bum Marketing, you do this without spending a cent. The whole process should cost absolutely nothing! If it does, in my opinion it is no longer Bum Marketing, after all a “Bum” couldn’t do this method if it involves spending money.
With so many free resources on the Internet, this is not actually difficult to do. It is genuinely possible for someone off the streets to make a little money, so long as they can gain access to a computer and the net of course. Joining affiliate programs to have a product to sell is free. Article directories are free to submit your work to. The search engines will provide the traffic (if you have done your work correctly). For those article directories that do not allow you directly to promote affiliate programs in your articles, you will need to set up a separate page where you then recommend whatever you are selling. This is where some people might be tempted to spend a little money. And there is nothing wrong with doing so! BUT it would no longer be correct to call what you are doing as “Bum Marketing.” Thankfully, for those who wish to remain truthful, you can set up as many free landing pages as you wish.
I would also offer another signature feature of Bum Marketing, which many have forgotten. Although I guess it is fair to say that this is still my opinion, I am 95% sure of it.
What is it? It is that in addition to not spending a cent, you are also NOT looking to develop any kind of business from this, at least not initially (after earning you money, it is always wise to invest, but then you’re no longer a “Bum Marketer.”) which means you are looking to grab sales here and there, by grabbing those low hanging fruits that you find. This involves seeking out the low competition, reasonably searched long-tail keywords, and quickly writing your article to provide the juice on the subject, along with a way to make a sale. Then you move on to the next, and so on.
In conclusion, I see many people using the term “Bum Marketing” instead of article marketing, and also thinking those 2 are one and the same. Strictly, they are not the same at all. Article marketing simply means marketing by writing articles. Bum Marketing means marketing through writing articles without spending a cent, and without any plan to dominate any niche areas.
It can be very frustrating when you are a fitness fanatic and suffer an injury that prevents you from exercising. But with a little creative thinking and straying from your regular fitness routine, you can still get the exercise you need.
Exercising with a Broken Foot, Sprained Ankle or Broken Leg
If you suffer from a broken foot, sprained ankle, or broken leg there are still exercises that you can try. Providing that you have a waterproof cast for your broken leg or foot, you can try swimming. It is recommended to use a buoy to prevent further injury and strain. Pilates and yoga are also suggestions to try with a broken foot. Yoga is especially recommended for regaining flexibility and coordination. There are many yoga positions that you can try with a broken foot such as Wind Relieving Pose, the Cow-Head Pose, the Camel Pose and the Cobra Pose and many others.
If available at your local gym, rowing machines are great to try also with a sprained ankle. Another option to try is seated aerobics. This is also a great option for the disabled in wheelchairs. Lisa Ericson, a trained aerobics instructor designed and created her own seated aerobics program.
Exercising with a Broken Arm, Broken Wrist or Injured Shoulder
Any weight lifting would obviously have to be done with the uninjured arm or shoulder. But there are many cardio options to do with a broken arm. Walking, running, and using a stationary bike are great options for exercise. Creating your own walking routine with added challenges will help burn extra calories. Such challenges can be adding hills into your route or adding a minute or two of jogging into your schedule.
Exercising with Hip Injury
Hip injuries really limit how much cardio you can do, but low impact walking can still be an option. Swimming with a buoy is also an alternative exercise routine. Upper body weight lifting can also still be implemented. Contact a local yoga instructor as to what stretches to avoid and which ones might be able to help. Depending on what kind of hip injury or hip surgery you have had, the stretches vary.
Exercising with Knee Injury
Swimming and water aerobics are great options to try with knee injuries. Water aerobics using a noodle or other tools is a great way to lose weight and strengthen your knee. The elliptical machine and the rowing machines at your local gym are also suggested to try with sore knees. Walking is also an option, using a knee brace if needed. Biking is also an alternative exercise, either outside or a stationary bike inside. Most yoga positions are not recommended with knee injuries, so be sure to check with an instructor which positions to avoid to prevent further strain on your knees. Doing squats are also recommended for injured knees.
For women, Curves is a great option to try as you can always modify your exercise routine as to what injury you have. That is what worked for me when I was pregnant and had hip pain and lower back pain. I could still do my cardio and upper body workouts, but just avoided some of the machines and still felt a difference when I was done!
Surely, there is no reason for you not to stay healthy even with injuries. For some inspiring stories about people who have overcome the challenge of being injured, read full story on this page. This story will surely motivate and inspire you.
The summer is a dry hot time for birds, and if you are an avid watcher, then you know that most are on the hunt for a cool comfortable place to bathe. If your budget is limited perhaps a birdbath that is made from a Frisbee would be just the necessary item to give your feathered friends a little refreshing break without breaking your budget. This simple concept can also double as a bird feeder in the winter months.
Finding a Frisbee should be the simple part. Almost everyone has a Frisbee around the house, in the lawn, or even on the garage roof. If you don’t, ask a neighbor or go to the local discount store to purchase one, they are relatively inexpensive. While you are there, get six feet of wire to hang the birdbath and the best value impact driver. If your budget is severely under the gun, use three thin metal wire coat hangers.
Punch three holes around the rim of the Frisbee. They should be large enough for the wire to go through. An ice pick is one tool that could come in handy. You could also drive a three-penny nail through with a hammer. No matter which one you choose, wear gloves and be very careful not to puncture yourself in the process.
Cut three 2′ long pieces of the wire using a pair of wire cutters. If you are substituting three coat hangers, cut off the curved area and straighten out the coat hanger with pliers. Once they are straight, measure each one and cut it at the 2′ mark.
You will need to now insert the wire that you have cut, into the hole in the Frisbee. You should insert it from the outside to the inside, pushing enough through to wrap and secure the wire to itself, without being too tight. You probably now understand why thin metal coat hangers were the terminology used. If the hanger metal is too heavy, it will be difficult to wrap.
Gather the three wires to form a pyramid, or teepee and twist together starting 6″ from the top, clear to the top. You now have a pyramid with twisted wires going straight up. Because of this one step, I highly recommend that you use wire. It twists together much better and easier than the coat hanger, but a lightweight hanger is doable. Be very careful when twisting the metal. The ends are usually quite sharp.
You will now need to bend the 6″ braided section to form a hook and hang the Frisbee birdbath from a tree. Fill this with water and continue to check it and refill throughout the summer. Once winter blows its icy breath at your door, remove the water, dry, and add seed.
If you are new to owning a domain I have some advice that even I didn’t know when I got my domain. This is written under the assumption that the person that bought a domain already knows how to create a basic web page through html.
Being clear in your mind is extremely important before trying out for your own domain website which is was not in the initial stages and therefore was not successful as it resembled more like a preventivo sito web roma where lovers swear to be together in all their lives.
When you register your domain, that information you enter is what is called “Whois.” When someone looks up your domain, they see all of that information. If you don’t want it to be public, you must pay a place like domainsbyproxy.com for example. Whois is public information for all, which can be seen at Geek Tools.
When you create new folders on your domain to store files, either pages, audio files, or images, you should always create a blank webpage titled ‘index.html’ or ‘index.htm’ The reason for this is, when a person is going through your web files, lets say they come to a folder where you stored your images, and you named it /images. Without an index.html file in that directory a person can see all your files in that directory. They can also download all the files stored there. It’s not safe, nor wise to do this. People can steal your files, and hard work and you won’t ever know, not to mention they can steal your bandwidth.
Keywords are vital to search engines. If you created a webpage and didn’t place keywords in your meta tags you may not reach the audience you intend to. Keywords are to be located between your tags. Keywords are common words repeated through out the page that rank high on search engines. This takes trial an error.
Once you have uploaded your files to your domain, and created all your folders, you need to create a robots.txt file. A robots.txt file tells ‘bots’ also known as ‘spiders’ what pages or files you want or don’t want indexed for search engines. A friend of mine forgot to create a robots.txt file and all his copyrighted images appeared in Google images search. Users were free to take his hard work and claim it as their own.
Search engine submission is important. This is a good site for that, as it’s free and easy to use. Not all the engines work but its enough to get started. It will take a while for the pages to get indexed.
Any type of site needs some sort of contact link, that way if anyone has a question they can get a hold of you. Even if you aren’t selling anything it’s still a good idea to have a contact page or post your contact information somewhere on the site.
After you have set up the following, the next step is link exchanges. The more link exchanges you have the better, as your connections just like in real life, will get you known. You can do banner exchanges or just text exchanges. The more exchanges the better, as the sites you may have set up link exchanges with may have a higher ranking as well as update often. If that’s the case, it helps your search ranking as well.
If you are going to make your email address public, it’s a good idea to leave it in the following form so spiders, spam harvesters, and spam bots don’t index your email address. Name (@) domain.com or better yet, just create an image of your email address, but don’t name it email, nor name it email in the ‘ATL’.
So let’s recap, image for email address, contact page, whois information, link exchanges, robots.txt, index.html, keywords, and search engine submission. With these covered you are on your way to prospering. So my friend, thank you for reading and live long and prosper.
We have both good news and bad news about the CBD industry. The good news is that Marijuana has become widely available these days. On the contrary, looking for decent CBD suppliers can be a bit challenging. That’s the bad news. After all, in order to decide whether a certain CBD is good or not, you need to have personal experience. Since not everyone is well-equipped when it comes to this aspect, we can only hope that this article serves its purpose in providing CBD information to all of you.
What Is Healthy Habits PUREfect Hemp?
We are not here to give you some random or trivial information about CBD. On the contrary, we want to introduce you to one of the world’s most renown CBD suppliers: Healthy Habits PUREfect Hemp.
This is a line that offers people CBD isolate products as well as a full spectrum of Marijuana products. Their products go through strict quality control protocols to make sure they sell CBD items of utmost quality. This is a company that only works with the best Marijuana growers. These Marijuana plants were grown in the best environments for CBD plants. Up until the packaging, you can see that Healthy Habits PUREfect Hemp has indeed prioritized the quality of the items.
The company claims that their products are:
- THC free
- Therapist recommended
- Have been clinically proven
- Legal in all 50 states
In terms of their diverse offerings, people can usually choose between CBD capsules, oils, pain relief roll-on, gummies, CBD healing rub, CMU, rejuvenating and anti-aging creams, as well as sleeping aid oral sprays. All of these products are GMO-free and made organically in the United States.
What Are The Benefits Of Using Healthy Habits PUREfect Hemp Products?
There was once a time when Marijuana is a type of substance that you’d really have to hide. But after a long while, society has finally seen how it can be good for people.
With that, it shouldn’t be too surprising that CBD is now used for a wide selection of products as well (and not just for recreational and medicinal purposes). CBD can also help you cure a whole lot of mild illnesses. Let us enumerate them below:
- Chronic pain
- High blood sugar
Does Healthy Habits PUREfect Hemp Have Harmful Chemicals?
One thing you need to know about this CBD oil is that it is made organically. With that, you can rest assured that this product won’t contain any herbicides, pesticides, and other dangerous chemicals. This is the first thing that you need to look into when you are searching for a new tincture. It is not just about which one has the best effect on your in a recreational level.
Organic farming has become really popular not only because it is good for the environment but also since it is good for the people using the plants.
How To Use Healthy Habits PUREfect Hemp Oil
We don’t know why some people that CBD oil is very difficult to use in everyday life. It is actually quite the contrary. We are more than happy to explain to you how to use it.
Each Ananda hemp oil bottle comes with an eyedropper. You can use this to portion out how much oil you want to apply to your tongue or some of your food or drinks. If this is your first-time taking CBD oil, you may want to just use this as a mixture to your meals since this oil can be quite bitter. If you want to experience the full effects, you need to use this CBD oil for thirty days straight.
Healthy Habits PUREfect Hemp Side Effects
It can be quite a rare circumstance to hear reports about someone experiencing negative side effects after taking CBD oil. But you know this does not mean that experiencing adverse effects is impossible. It can still happen.
If it does happen, know that the side effects can vary per case basis. With that, we won’t be taking the time to enumerate what these side effects are. But we will tell you that if you notice something strange about your body functions after taking this oil, make sure to stop using it immediately and don’t let three days pass without having to consult your doctor.
A lot of people use CBD oil for a whole bunch of reasons. Most of the time, it is for recreational purposes but that is not always the case. If you have read this far, we are pretty sure that you came here because you are worried about your health. And if that is the case then it is most important to look for a product that was made right. Healthy Habits PUREfect Hemp is a pretty good choice in this sense. If you know someone who is in need of CBD, make sure to show them this article as well.
Let me begin by saying that I hate going to the dentist. I’ve been fortunate to have some excellent, understanding dentists in my life, and I’ve liked some of them very much, but I hate going to see them. I have post-traumatic stress disorder and getting dental work done causes significant anxiety for me.
Knowing that, you can imagine how much pain I was in on a recent Saturday morning when I bit into a protein bar and fractured the root on the one tooth in my mouth that was capped by a crown. Of course, I did not know at the time that I’d fractured the root. I just knew the tooth was suddenly very loose and very painful. So painful, in fact, that I immediately grabbed the phone book and started phoning dentists, which includes one of those General dentistry Batavia IL clinics that I found in the directory. pleading with someone to please, please, please see me that very day. Do you know how hard it is to find a dentist to see you the same day, especially on a Saturday?
I live in a rural area and there are not that many dentists around. I had no luck getting an appointment that day.
When I phoned Dr. Schmelzer, though, I was surprised that the dentist himself answered the phone. He said he was actually out of town, otherwise he would have seen me that day. He told me to call his office first thing Monday morning and they would get me in that day. He also advised me on how to care for the damaged tooth until then.
Well, I made it through the weekend and I did call first thing Monday morning and got an appointment that afternoon. I found the staff to be friendly and efficient and Dr. Schmelzer himself to be extremely personable. The first thing he asked me was, “How are you?” I said, “Fine,” and he said, “You don’t look fine,” recognizing at once how very anxious I was. He did his best to put me at ease, talking me through everything he was doing and encouraging me to focus on the pictures of a tropical beach on the ceiling above the dental chair. I won’t say I relaxed completely because, well, I was still at the dentist, but he and his staff did everything they could to minimize the stress of the experience.
It turned out the root of my tooth was fractured, requiring extensive dental services, including putting in a bridge. This, of course, is terrible news for someone that hates visiting the dentist. Since it was a necessity, however, I’m glad I was able to find a dentist I like, with convenient office hours and reasonable fees (a bridge is going to be expensive anywhere you go, unfortunately), that can see me quickly in an emergency and that is sensitive to the anxiety I experience when visiting the dentist.
Many people are preoccupied with their weight. More people seem concerned with being too heavy than those who might be concerned about being too thin. The media is full of stories, studies and editorials discussing, documenting, and warning about the increasing incidence of obesity in the US.
Everyone knows that weight – or, more accurately, too much of it – can jeopardize the overall health and well being of the person. So, like with any identified human need – especially in a capitalistic, entrepreneurially driven culture like ours, programs to ‘help’ spring up like weeds. Weight loss programs, books, pills such as idealica gocce, and more diets than you can shake a stick at.
Some of them work for some of the people some of the time – but the one thing that seems to work most reliably for most of the people most of the time – and is actually free – is simply aging. The older most people get past 50 or so, the smaller their appetites tend to become. Consequently, if you wait long enough, you may be able to lose the weight you have been wanting to unload for years with little or no deliberate effort – just get older.
So, if you can wait to lose the weight – you can save a great deal of money (on programs, tapes, books, clothing, classes, and specially processed frozen meals) and angst by telling yourself that this, too, shall pass – probably. I refer to this as the “Sure Fire Weight Loss For Most People – Eventually Program” and I invite you to try it out. It’s easy. Don’t do anything at all. Just wait. Before you know it, your clothing will feel too big and your stomach will seem to have shrunk. You will be the lighter person you always wanted to be.
I realize that this ‘solution’ will not do much for a 20-year-old who wants to drop 50 pounds. But for those in less of a hurry (as most middle-aged people tend to become), time will heal. There are lots of reasons for this phenomenon – some understood better than others. As we age and our cells are no longer growing and reproducing at the rate they were when we were ‘growing up,’ we need less nourishment. Also, many people tend to become somewhat less active as they age, requiring, again, fewer calories and carbohydrates. Eventually, these lessened need to translate into lesser desires and drives.
So the long-term, almost sure-fire diet begins, nearly effortlessly in midlife and continues until you don’t need to eat anything at all anymore. Radical – perhaps. But unarguably inevitable.
There’s a great Toyota Venza commercial that I believe truly captures the essence of how social media is affecting our daily interactions. It starts with a young woman sitting at home in front of the computer; she starts talking about an article that she read online about older people becoming increasingly anti-social. After reading the article, she began to aggressively encourage her parents to become active on Facebook. While she’s talking, the commercial flashes between shots of her sitting behind a computer screen and shots of her parents laughing together and mountain biking with friends. She proceeds to describe herself as “living” because she has 687 Facebook friends, while her parents are “so sad” for having only 19. The commercial concludes with two shots, one of the parents reloading their Toyota with their bikes after a seemingly great day of fun and one of the daughter reverting back to browsing the Internet alone.
You can see the commercial here.
The Socialization Chasm
The juxtaposition of this young woman sitting at home behind a computer screen and describing herself as “living,” while in the same sentence describing her middle-aged parents – who are engaged in an outdoor activity with friends – as “so sad,” depicts the growing socialization chasm between the younger and older generations. The former seem content, even happy in many cases, to replace human interaction with online socialization; older generations appear to place a greater emphasis on traditional forms of socialization, such as spending time with friends and family.
The idea that we can describe interacting online as “social” is somewhat at odds with the isolating effect that it appears to be having on the younger generations. In one of my articles, ” A Brief Introduction to the ‘Social’ in Social Media ,” I explain that the “social” qualifier refers to the interactive communication that takes place over the Internet. But what happens when online socialization becomes the primary form of socialization?
Are We Really Connected?
The advent of social networks and all forms of social media have us more tightly networked than ever before. Yet, I get the sense that we are becoming less and less connected to one another both physically and emotionally. I actually believe that we’re getting lonelier.
In 2005, researchers at the Stanford Institute for the Quantitative Study of Society (SIQSS) found that of those who use the internet spend 70 minutes less interacting with family, 25 minutes less sleeping, and 30 minutes less watching television on a daily basis. If my Internet habits are at all indicative of most peoples’, these numbers have certainly gone up over the past several years.
Even the concept of gift giving has drastically changed. From the traditional way of actually buying gifts from physical store to just buying it online from takethecoupon.com and have it delivered to the doorstep of your loved ones, it is fair to say that gift giving is also being affected by the technology.
Remember what it was like to walk up to someone and strike up a conversation? Or call a love interest and ask him/her out on a date? It’s very possible that you don’t remember; an alarmingly high number of people have come to use electronic communication – and mobile devices in general – as a crutch for avoiding conversation. How many times have you frantically pulled out your phone while silently chanting, “Please don’t talk to me. Please don’t talk me,” in the hopes of avoiding someone? I certainly have.
The overwhelming majority of single people that I know are dating online. When I was younger, my girlfriends would call to ask my advice on what to wear on a date. Now when they call (or email), it’s to ask my advice on what to include in their dating profiles. For the record, I believe that online dating can be a great tool and resource for meeting people. I only use this example to highlight the paradigm shift that has taken place over the past decade. That is, the unfortunate belief that typing is just as effective, and thus a suitable replacement, for conversation. There’s no electronic stand-in for the nuances of tone of voice and body language; there’s no comparison between the conversation depth of an in-person meeting and a text.
Online socialization is not a replacement for offline human interaction. Yes, the Internet is an extremely valuable tool and resource that can, arguably, enhance our offline communication. But in no way, shape, or form is typing, texting, sexting, blogging, vlogging, IMing, or any other electronic communication, a suitable substitute for good ol’-fashioned conversation.
There are several types of optical filters that you can choose from. But all of these filters have only one main function – to transmit light of a certain wavelength or color range and at the same time, prevents the color spectrum from getting through. Basically, there are 2 categories of optical filters. They are the dichroic and absorptive filters. Dichroic filters are responsible in the reflection of the selected wavelengths instead of absorbing them. Consequently, tis filter will transmit the remaining wavelengths. On the other hand, absorptive filters are considered to be made from glass with chosen inorganic or organic compounds added. Such compounds will absorb wavelengths while transmitting other wavelengths. These two categories of filters have several functions. However, dichroic filters get the most of their wavelength ranges can either be reflected or transmitted. In addition to dichroic and absorptive filters, there are also other types of filters. These include the following:
One of the most popular optical filters is the ultraviolet filter. This kind of filter has the ability to effectively block the ultraviolet range of the light spectrum. This filter transmits visible light like an infrared filter. It is usually used in cameras because film is quite sensitive to ultraviolet light. Hence, for an image to be captured on film where human eyes can perceive it, using ultraviolet filter is really necessary.
Just like ultraviolet filters, infrared filters are used to absorb lights so that an image can be captured and eyes can perceive it. This filter transmits light and blocks mid-infrared light spectrum.
Another type of optical filter is the longpass filter. This type of filter is made of colored glass. It transmits longer wavelengths of the color spectrum like visible light, ultraviolet and infrared. This type of filter has also the ability to block shorter wavelengths and frequently serve as emission filters in fluorescence microscopy.
Opposite of the longpass filter is the shortpass filter,. This type of filter transmits short wavelengths instead of long wavelengths. Short pass filters are made of color glass filters and its function is applied to the mentioned wavelength with different effects and results from longpass filter.
If we are going to combine short pass and long pass fil;ters, we will come up with a bandpass filter. These filters do transmit less light compared to both longpass and shortpass filters.
Last but not the least is the polarization filter. This type of filter blocks or transmits light depending on the polarization of the filter. Usually, polarized filters are used in certain camera lenses and sunglasses because it can block some of the spectrum that causes the reflection. As a result, this creates clearer visibility. Moreover, polarization filters have also the ability to darken the bright components in color photography which provide a new approach and appeal to the perceivers.
For more information about custom optical filters, you can visit this page: https://www.evaporatedcoatings.com/custom-optical-filters/
Patient Dementia and Wandering: Dementia is a serious disorder facing elderly patients. After age 60, the prevalence of the disorder doubles every five years until it affects from 30-50 % of those over eighty. Dementia is also the leading cause of institutionalization in this country, with 60-80% of nursing home patients showing signs of the disorder (1).
A lot has been written about the management of the disorder in this magazine and in other sources, but little has been written about the matching of assessment and appropriate intervention, including new treatment options. The reason that is true is that medical professionals tell us patient dementia is irreversible and can only be managed. They say the only steps one can take are to reduce the risk of falls and other harm to the patient and reduce the risk of lawsuits and governmental censures to the nursing homes where patients with dementia live.
In the past year, research has shown that a disease previously thought irreversible may be reversible after all. As a result, it is important to carefully assess the patient or resident to determine to what extent he is cognitively impaired, what pattern of wandering he exhibits, and what pre-morbid lifestyle he enjoyed.
The National Guideline Clearinghouse has a protocol for wandering (2).
In it, the proper steps to assessment are described:
– Use the Mini-Mental State Examination (MMSE) to assess cognitive decline
– Use the Algase Wandering Scale (AWS) to assess neurocognitive deficits and wandering patterns
– Use the Short Geriatric Depression Scale for signs of depression
– Use the Cohen-Mansfield Agitation Inventory: Long Form with Expanded Descriptions of Behaviors to assess for agitation and anxiety, being careful to evaluate for any underlying general medical, psychiatric, or psychosocial conditions that could partially cause the disturbance.
– Use the Memory and Behavior Problems Checklist-1990R (MBPC) to assess the frequency of the memory and behavior problems, including patient wandering and the degree to which the behavior upsets the caregiver.
– Assess factors associated with patient wandering, including a decline in activity, cognitive impairment, and increased difficulty in performing the activities of daily living (ADLs).
– Assess the environmental strategies currently used by formal and informal caregivers.
Once the initial assessments are made, information from the assessments can be used to investigate the patterns of the patient more closely.
The patient wandering patterns assessed by using the AWS and through observation can, at this point, be described by type. This allows the clinician to discover the severity of the cognitive decline. Patterns are described as direct travel, random travel, pacing, and lapping. Additionally, patient wandering behavior can be observed to determine if: 1) the patient appears to be overtly searching for something which is often unobtainable by repeatedly calling out and/or approaching others to obtain the goal; 2) the patient has a seemingly inexhaustible drive to remain busy, and 3) the patient is aimlessly drawn from one stimulus to another.
According to the government protocol, the type of wandering pattern demonstrates the cognitive decline, because a direct route is more efficient and shows a less cognitive decline. Also, the most severely impaired patients will travel inefficiently all day, while the less severely impaired will travel less efficiently near the end of the day. That may occur because the patient is fatigued.
Once all of the above steps have been taken, the clinician should examine the lifestyle of the patient prior to impairment:
– Did he have an active interest physically and mentally in music?
– Was he warm and outgoing, and positive emotionally?
– Did he demonstrate social-seeking behavior?
– Did he have good self-esteem?
– Was he physically active?
– Had he experienced a lot of stressful events throughout his life?
– Did he respond to stress with physical activity or with an emotional reaction?
– Did he respond to stress with physical activity more in his earlier years?
Once the assessment is complete, the clinician and caregiver can decide what environmental modifications, technological and safety measures, and/or other interventions are necessary to protect the patient at his current level of impairment. This article will not discuss these measures in detail, as many past articles have done a thorough job of doing just that. Instead, we will explore how to determine what treatments may be appropriate for the patient in light of his assessment findings.
There are prescription medications that are used for the treatment of dementia. Those most frequently prescribed include donepezil (Aricept), rivastigmine (Exelon), and galantamine (Reminyl) (3). These medications will not cure dementia. However, with proper dosing, they can help restore cognitive functioning for the minimal to the moderately impaired patient to a level he had nine months previously. In a patient who has just started exhibiting dementia, that could mean as six months to a year of more independent living.
In some cases, the medications can restore the patient’s memory enough for him to recognize close friends and family. So isn’t it worth the use of medication for the patient to have as good of a quality of life as possible for as long as he can?
A new medication has just been approved by the Food and Drug Administration (FDA) that has demonstrated that it can help the moderately to severe Alzheimer’s patient, something no other drug has proved. It is memantine HCL (Namenda TM) an NMDA receptor antagonist, which is a new class of drugs for the treatment of the disorder (4).
Besides medication, there are alternative treatments. Diversional activities may be used, especially if the patient’s assessment showed a tendency toward or like for music or other outlets. Examples of these activities would include music therapy, pet therapy (which is being used more and more in nursing homes and assisted living facilities), volunteer reading, using raised toilet seat with lid, and therapeutic touch.
Other alternative treatments that are showing great promise are herbal therapy, aromatherapy, and light therapy:
According to the Alzheimer’s Association, two herbs that appear to positively affect the disorder are Ginko Biloba and Huperzine A. (5).
Ginkgo Biloba is a plant extract that has been used in Chinese medicine for centuries and is currently being used in Europe for the treatment of neurological disorders.
It has antioxidant and anti-inflammatory properties and appears to protect cell membranes and regulate the neurotransmitter function. Studies have been published that demonstrate improved cognitive function and better performance with ADLs after a patient is treated with the extract. However, it does reduce the ability of the blot to clot, and it cannot be used by patients on aspirin and/or warfarin (a blood-thinning medication).
Huperzine A, a moss extract, is also a Chinese medication and has similar properties to FDA-approved Alzheimer’s medications. However, since it is classified as a dietary supplement, it is unregulated and could have serious side effects.
Last August, British researchers released a study of the use of aromatherapy and light therapy for the treatment of dementia (6). In the four-week study, one-third of the patients suffered fewer bouts of agitation when they were rubbed with lemon balm compared to only ten percent of patients when rubbed with odorless sunflower oil.
Additionally, the researchers found that those who sat in front of a bright lightbox for two hours each morning for two weeks slept longer and more soundly than those in dim light for a similar period of time.
All of these treatment options are available to today’s wandering dementia patient. The clinician must simply tailor the treatment to the assessed dementia patient. Still, modern science is proving that the wandering patient can get better.