Blogs We're Following

Dotty Still With Us, Hospice Comes Through with an Angel

Blog Title: 
Alzheimer's Reading Room



Did Hospice send us an Angel? An angel among us?

By Bob DeMarco
Alzheimer's Reading Room


Right after I wrote this morning, we entered into what can best be described as a period of chaos and stress.

Dotty's temperature started to climb steadily, all the way to 99.6 (Dotty's core temperature is 97.6). In addition, Dotty couldn't move her right arm. She was experiencing severe pain in the arm, particularly around her wrist. I discovered this when I was trying to move Dotty to change her briefs (also known as incontinence wear, and diapers). Dotty could not move that arm.

As a result, I could not get her new brief off, nor could I get her situated to administer a suppository for fever. I tried several times and I concluded I couldn't/wouldn't do it by myself. I did get the soiled brief off as it turned out.

My first attempt to get a Hospice nurse did not go well. We will skip over this part of the story and get to the important part.

Subscribe to the Alzheimer's Reading Room

Email:

Finally, after about 80 minutes a nurse came. 80 minutes might seem like a long time, but we were also in the midst of a monster rain, wind storm like you wouldn't believe.

As soon as the nurse came everything started to change. She approached Dotty in just the right way to talk to her and to reassure her.

Then we got to work.

Very quickly the nurse did get the suppository in. Dotty was howling. But as soon as the nurse stopped Dotty stopped.

Then the nurse to my surprise started stroking Dotty gently. She discovered the same thing I did. Dotty's right arm is in pain, mostly near her wrist. Of course Dotty freaked when she touched that area. Nothing happens but peace and love when you stroke Dotty's left arm, or head, or legs, etc.

This nurse has very nice touch. So nice, so effective, that it communicated to Dotty. The message was clear. I'm here for you, to help, to care.  Dotty seemed to relax.

Then the nurse sprung back into the action. She changed the sheet on Dotty's bed. The under sheet. We had another period of Dotty angst. I think when we roll Dotty on to her side she thinks she is falling into a black hole. I don't think it is pain. The nurse calmed Dotty nicely and immediately.

By the end, Dotty's bed was set, clean sheets, new absorbent pads. Dotty was resting.

By the way, the nurse did not need to do this. We have an aide coming today.

The nurse that came on-call is called a "runner".  She works from 1 AM to 9 AM. The period of greatest angst and stress. Oh my goodness.

She told me she likes her work,  and likes helping people. Wozo edwards, this is just the right kind of person and nurse they need for this time period. Chaos, confusion, stress, fear, angst, you name it. Why else would anyone call in the middle of the night?

I am going to grade this nurse, the runner, on understanding, coping, and communication.  Three skills that are necessary in order to deal effectively with the deeply forgetful. She gets straight A's.

Did Hospice send me an Angel? An angel among us?

I'll let you decide.

Frankly, I decided to skip some of the first parts of this story. We could call it a bit of a hubba bubba.

The hubba bubba resulted in a call that resulted in some very fast actions on the part of the lead nurse and aide.

Amen.

Dotty is resting comfortably at the moment. She is clearly in the process of leaving this world. Of completing her life and moving on to a better place.

Thanks for the support. Thanks for listening.

More Insight and Advice from the Alzheimer's Reading Room

Original content Bob DeMarco, the Alzheimer's Reading Room

Living with Bob and "Al"

Author: 
Sheri

Sometimes Sheri is surprised by Bob's lack of understanding. Yesterday Bob saw a good size pile of twigs and leaves in the yard, he went into the garage and got the snow shovel and started to dump it in the garbage can. Sheri caught him just in time and said "lets not put it in there lets put it out back in the woods" (brush is not allowed in with regular trash) Sheri looked away for a moment, and when she looked back "Al" was removing all of the regular plastic trash bags from the garbage can. Sheri said "that part is okay, it is garbage. Bob stood there his jaw clenched tight, thumb in his belt loop stretching out his back from the pain then in clear frustration, started placing the bags one by one back in the can.

Dotty is Still With Us, Thursday, 7 AM

Blog Title: 
Alzheimer's Reading Room


Its a new day, and I continue to deal with the situation.
By Bob DeMarco
Alzheimer's Reading Room

Dotty is resting comfortably. So comfortable that she is not moving. It is getting very difficult to move her, as she won't cooperate, and she doesn't like it.

Her temperature is up a touch, so I am watching that closely.

She is not talking, although she occasionally says a few words.

She is not responding when I talk to her. Sometimes she opens her eyes, most times she doesn't.


Subscribe to the Alzheimer's Reading Room
Email:

Dotty is continuing to decline slowly, but surely.

When I rub her right arm she doesn't like it. When I rub her left arm she seems to like it. She is not responding negatively to touch. She seems to calm when I rub her.

I continue to get liquid into her by by putting my thumb on the end of a straw. Sometimes she sucks on her end of the straw. She cannot draw water by sucking on the straw herself.

I need some advice, equipment, and help from the Hospice right now, so I intend to call them when I finish here.

The best I can say by using my eyes is that Dotty is comfortable, but slowly fading. She is very weak.

As always, thanks for the support.

Its a new day, and I continue to deal with the situation. It seems like the end is really near this time. But, with Dotty who knows.

More Insight and Advice from the Alzheimer's Reading Room

Bob DeMarco is the Founder of the Alzheimer's Reading Room and an Alzheimer's caregiver. The blog contains more than 3,511 articles with more than 297,100 links on the Internet. Bob lives in Delray Beach, FL.
Original content Bob DeMarco, the Alzheimer's Reading Room

Obama administration pledges millions to fight Alzheimer’s; clinical trial tests Alzheimer’s drug

Blog Title: 
Minding Our Elders&reg

The Obama administration plan to end Alzheimer’s disease by the year 2025 was announced May 15, 2012 by Health and Human Services Secretary Kathleen Sebelius. The plan pledges millions of dollars for researchers as well as for those providing care and services for people with Alzheimer’s disease. 
Sebelius said in the announcement that, "What we know is that a lot more needs to be done and it needs to be done right now, because people with Alzheimer's disease and their loved ones and caregivers need help right now.”
Read on for more information on the Obama plan for Alzheimer's and the Columbian family clincial trial:
Purchase Minding Our Elders: Caregivers Share Their Personal Stories – paperback or e-book

Dotty is Still With Us, Wednesday, 4 PM

Blog Title: 
Alzheimer's Reading Room


I am now saying this with confidence.  Even though Dotty won't be able to say my name, or might ask me, who are you?, Dotty will know me.
By Bob DeMarco
Alzheimer's Reading Room

Dotty is resting comfortably right now, although her breathing is labored. It is very difficult for me to give you an assessment because at times I feel confused.

The biggest news so far is that out of the clear blue sky, Dotty ate a scrambled egg yesterday. For almost a week, I could not get her to eat anything even though I tried everything under the sun.

When she agreed to eat water melon, we turned the corner on the pattern. She went from refusing to eat, to eating.

Today so far she will eat water melon, you should see the look on her face. I'm tempted to make a video. She looks like she is really enjoying the melon. She is also drinking some Boost and some water.

I'll try egg or chicken broth with pastina shortly.


Subscribe to the Alzheimer's Reading Room
Email:

For certain Dotty is getting weaker. She is having trouble speaking, not garbled, just speaking.

Sadly, she didn't know me this morning, and I am not sure if she knows me right now. She did say my name during the day.

This is why I am confused about how I might describe to you how she is doing.

It appears that she won't know me for part of our journey.

Let me correct this so there won't be any confusion. It will appear to me, and to others that Dotty doesn't know me. But I know, beyond a shadow of a doubt that she will know me all the way to the end. Read that. Until the end.

I have absolutely no doubt that there is always more there. No doubt. Just because we can't see it much of the time, doesn't mean it isn't there.

I am now saying this with confidence. Even though Dotty won't be able to say my name, or might ask me, who are you?, Dotty will know me.

I am here for the first time. In this situation for the first time. It is now apparent to me that Ditty will know.

They will know you also. You have to go to the World, to recognize this. Go.

I learned how to feed Dotty water. At times she can no longer suck the water or Boost through the straw. How did I do it?

I dip the straw in the water, put my finger on the other end of the straw, and they I let the liquid drop into her mouth. I don't drop it straight in, I put it in on an angle. I don't want Dotty to feel like she is drowning. Although the amount of liquid that I am putting in her mouth at a time is only several drops.

Why didn't somebody tell me to do it this way. All you need is a straw and a finger. No syringe, no turkey baster.

Bunkhouse Logic at its best.

I will try to be more specific late tonight or tomorrow morning.

As always, thanks for your support. Dotty and I needed you more than I could have imagined before we arrived at this place in space and time.

I'm prepared for any and every eventuality right now. Please don't feel sorry for me.

Instead, pray for Dotty to pass over into the light peacefully.

More Insight and Advice from the Alzheimer's Reading Room

Bob DeMarco is the Founder of the Alzheimer's Reading Room and an Alzheimer's caregiver. The blog contains more than 3,511 articles with more than 297,100 links on the Internet. Bob lives in Delray Beach, FL.
Original content Bob DeMarco, the Alzheimer's Reading Room

Alzheimer's and Dementia News 139

Blog Title: 
Alzheimer's Reading Room


Critics Call Government's Alzheimer's Plan Unrealistic and More
By Bob DeMarco
Alzheimer's Reading Room

Critics Call Government's Alzheimer's Plan Unrealistic -- ABC News
"It's great to have the attention drawn to the disease and have a temporary blip in funding," Dr. Samuel Gandy, a professor of Alzheimer's disease research at Mount Sinai School of Medicine, told ABC News. "But this is at least an order of magnitude off the figure that is likely to have meaningful impact."
Read More

New Drug Trial Seeks to Stop Alzheimer’s Before It Starts -- the New York Times
In a clinical trial that could lead to treatments that prevent Alzheimer’s, people who are genetically guaranteed to develop the disease — but who do not yet have any symptoms — will for the first time be given a drug intended to stop it, federal officials announced Tuesday.
Read More


Subscribe to the Alzheimer's Reading Room
Email:

What Geneticists Think You Should Know -- the Wall Street Journal
Given the rapid drop in price of whole genome sequencing — a technology that allows doctors to get information on your entire DNA — one day relatively soon you may get a chance to find out about your risks for different diseases.
Read More

Glenn Campbell, out front with Alzheimer's diagnosis and activism --the Washignton Post
Along the way, he’s become an ambassador for the disease: On Tuesday, Campbell turned up at the Rayburn House Office Building for a press conference calling for more government action.
Read More

Study to test antibody crenezumab for preventing Alzheimer's -- USA Today
The government will launch a first-ever collaborative, multimillion-dollar drug trial to try to prevent a form of Alzheimer's disease, officials said during a two-day research summit at the National Institutes of Health here.
Read More

Individuals With Dementia More Likely to Die at Home Than in Nursing Homes -- Indiana University
A new study from the Regenstrief Institute and Indiana University has found that, at time of death, individuals with dementia are more likely to be living at home than in a nursing home. This contradicts the commonly held view that most individuals with dementia in the United States eventually move to nursing homes and die there.
Read More

More Insight and Advice from the Alzheimer's Reading Room

Original content Bob DeMarco, the Alzheimer's Reading Room

Living with Bob and "Al"

Author: 
Sheri

Sheri never really knows what she is going to find with "Al" around, and she knows better than to even ask...   :)

Eye, ear and dental checkups can be a nightmare when people have dementia

Blog Title: 
Minding Our Elders&reg

...Teeth were another huge issue. Dad had worn dentures for many decades. He had little bone left to support the dentures, but I kept "gluing them in" with a tooth bonding cream. However, he managed to lose his lower plate. This is common in nursing homes, since elders will often take out an uncomfortable plate when they eat. Then, if the denture is not noticed, it will go in the garbage with the leftover food. In Dad's case, I believe he may have gotten annoyed with his denture and thrown it in his own garbage can. Whatever the reason, it could not be found, so off to the dentist we went.
Read more about eye, ear and dental checkups when people have dementia:
Purchase Minding Our Elders: Caregivers Share Their Personal Stories – paperback or e-book
 

MetLife Foundation Recognizes Alzheimer's Researchers with Awards

Blog Title: 
Alzheimer's Reading Room


Alzheimer's Reading Room


MetLife Foundation today announced the recipients of its 2012 Awards for Medical Research in Alzheimer’s Disease: Clifford R. Jack Jr., M.D., professor of Radiology and The Alexander Family Professor of Alzheimer’s Disease Research at Mayo Clinic (Rochester, MN), and Christine Van Broeckhoven, Ph.D. D.Sc., professor and department director of the VIB Department of Molecular Genetics at the University of Antwerp (Belgium).

In addition, Randall J. Bateman, M.D., associate professor of Neurology at the Washington University School of Medicine in St. Louis, is recipient of MetLife Foundation’s Promising Investigator Award.

Dr. Jack, an innovator in clinical studies of brain structure in disease, developed and applied imaging methodologies to determine and track the stages of Alzheimer’s disease. Dr. Van Broeckhoven, a basic scientist and expert in molecular genetics, has made groundbreaking discoveries establishing the genetic basis of inherited Alzheimer’s disease and related disorders. Dr. Bateman, a neurologist and biochemist, has pioneered the use of measurements of beta-amyloid protein in the brain to better understand the biochemical basis of this illness.

The winners were recognized at a scientific briefing and awards ceremony today in New York.

“MetLife Foundation is proud to present these awards that recognize outstanding achievements in medical research,” said Dennis White, president and chief executive officer, MetLife Foundation. “Doctors Jack, Van Broeckhoven and Bateman have made significant contributions to our understanding of Alzheimer’s disease and their dedication helps bring us closer to finding a cure for Alzheimer’s disease.”
About the Awards

Now in their 26th year, the awards provide outstanding researchers with an opportunity to freely pursue new ideas. At the heart of the program is a belief in research as the road to understanding and ultimately treating this devastating disease. Each major award recipient receives a $200,000 research grant for his or her institution to further their work, and a personal prize of $50,000. The recipient of the Promising Investigator Award receives a $100,000 grant to his institution to further his work in Alzheimer’s disease. MetLife Foundation established the awards in 1986 to recognize and reward scientists demonstrating significant contributions to the understanding of Alzheimer’s disease.

The MetLife Awards for Medical Research in Alzheimer’s Disease are managed by the American Federation for Aging Research (AFAR). Founded in 1981, AFAR has championed the cause and supported the funding of science in healthier aging and age-related medicine.

“We have selected these individuals because of their novel and significant approaches to Alzheimer’s disease, which are paving the way for additional discoveries that are important for diagnosis and treatments for this disease,” said Donald L. Price, M.D., chair of the MetLife Awards for Research in Alzheimer’s Disease Advisory Committee, which selected the winners. Dr. Price, professor of Pathology, Neurology and Neuroscience, Johns Hopkins School of Medicine, is a previous recipient of the MetLife Award.

According to recent estimates by the Alzheimer’s Association, the number of Americans aged 65 and older with Alzheimer’s disease will reach 16 million by 2050. Alzheimer’s costs related to health care and long-term care services are expected to total $200 billion this year.

Significant Discoveries That Have Shaped the Field
Drs. Jack, Van Broeckhoven and Bateman have made significant discoveries that have clarified our understanding, shaped new approaches to the disorder, and changed our view of Alzheimer’s disease.

Dr. Jack is a pioneer in developing medical imaging methods that identify biomarkers for Alzheimer’s disease. Identification and validation of biomarkers – characteristics that measure a biological state, such as a stage of disease – is a major objective in understanding and developing treatments for this disease. Starting in the early 1990s, Dr. Jack introduced imaging methods to help delineate manifestations of the disease in the brain, assess its severity, measure disease progression, and make predictions regarding its future course. These concepts have been widely adopted. Dr. Jack’s initial studies focused on a type of brain imaging known as anatomic MRI, but he has also contributed pioneering work in other areas including MR spectroscopy, diffusion imaging, functional MRI, high field microimaging, and amyloid PET analyses of amyloid burden.

He has integrated information from measures of biomarkers for the disease, derived from studies of central nervous system imaging and levels of markers in cerebrospinal fluid, into a comprehensive model of brain abnormalities in parallel with clinical features. The staging of presymptomatic (preclinical) Alzheimer’s disease in recently published National Institute on Aging-Alzheimer’s Association criteria was based largely on his model.

Dr. Van Broeckhoven is a leader in the molecular genetics of Alzheimer’s disease and other complex neurological and psychiatric disorders. Her research has established critical features of the genetic basis of different types of dementia. Nearly 30 year ago, she identified the gene encoding APP (amyloid precursor protein), the first gene linked to familial Alzheimer’s disease. She and her colleagues demonstrated the involvement of the brain’s blood vessels in the neurodegenerative process. She helped identify the presenilin-1 gene on chromosome 14 as an additional gene involved in inherited cases of Alzheimer’s disease and contributed important information on the role of apolipoprotein E4, a protein that binds blood lipids, as a risk factor for both late-onset and early-onset Alzheimer’s disease.

Dr. Van Broeckhoven’s most recent work has focused on the genetics of other neurodegenerative diseases. She and her colleagues identified the gene that encodes the protein progranulin, an observation that provided the first evidence that growth factors play a major role in neurodegeneration in certain types of dementia.

Dr. Bateman has pioneered the use of Stable Isotope Labeling Kinetics (SILK) measurements of these disease markers in cerebrospinal fluid. Using this method, he has shown that people with Alzheimer’s do not properly eliminate amyloid-beta – the protein that builds into plaques in the brains of those with Alzheimer’s – from the brain as well as those without the disease. With a primary focus on the ways in which the disease changes the brain’s functional properties – in order to develop better diagnostic and treatment strategies – his lab has begun to study additional Alzheimer’s related proteins and their potential roles in the disease process.

In addition to conducting clinical trials, Dr. Bateman is director of the Therapeutic Trials Unit of the Dominantly Inherited Alzheimer’s Network, the largest international study of autosomal dominant Alzheimer’s disease. He has led efforts to make effective experimental treatments available to people with this hereditary form of the illness, with the goal of preventing clinical dementia before cognitive impairments are evident.

For additional background on the award recipients, visit: http://www.afar.org/research/MLF-awards

About MetLife Foundation

MetLife Foundation was established in 1976 by MetLife to carry on its long tradition of corporate contributions and community involvement. For over 25 years, MetLife and MetLife Foundation have invested more than $20 million for Alzheimer's research and public information programs, including over $13 million through the Awards for Medical Research in Alzheimer’s Disease program. The Foundation has also supported a number of major initiatives, including the PBS documentary The Forgetting: A Portrait of Alzheimer’s; short pocket films on Alzheimer's narrated by David Hyde-Pierce; an educational initiative with the National Institute on Aging’s Alzheimer’s Disease Centers; the film Alzheimer’s Disease: Facing the Facts; and initiatives that include caregiving videos, Alzheimer's toolkits and resources for the Hispanic community.

More Insight and Advice from the Alzheimer's Reading Room

Obama Administration Presents National Plan to Fight Alzheimer’s Disease

Blog Title: 
Alzheimer's Reading Room



“This is a national plan—not a federal one, because reducing the burden of Alzheimer’s will require the active engagement of both the public and private sectors.”

Alzheimer's Reading Room


The plan, presented today at the Alzheimer’s Research Summit 2012: Path to Treatment and Prevention, was developed with input from experts in aging and Alzheimer’s disease issues and calls for a comprehensive, collaborative approach across federal, state, private and non-profit organizations.

More than 3,600 people or organizations submitted comments on the draft plan.

I would be interested in your comment on the HHS’ new website, www.alzheimers.gov . The website offers resources and support to those facing Alzheimer’s disease and their friends and family.

You can comment in the Add New Comment box below this article.

Subscribe to the Alzheimer's Reading Room

Email:

Obama Administration Presents National Plan to Fight Alzheimer’s Disease

Health and Human Services Secretary Kathleen Sebelius today released an ambitious national plan to fight Alzheimer’s disease.

The plan was called for in the National Alzheimer’s Project Act (NAPA) which President Obama signed into law in January 2011.

The National Plan to Address Alzheimer’s Disease  sets forth five goals, including the development of effective prevention and treatment approaches for Alzheimer’s disease and related dementias by 2025.

In February 2012, the administration announced that it would take immediate action to implement parts of the plan, including making additional funding available in fiscal year 2012 to support research, provider education and public awareness.

Today, the Secretary announced additional specific actions, including the funding of two major clinical trials, jumpstarted by the National Institutes of Health’s (NIH) infusion of additional FY 2012 funds directed at Alzheimer’s disease; the development of new high-quality, up-to-date training and information for our nation’s clinicians; and a new public education campaign and website to help families and caregivers find the services and support they need.

To help accelerate this urgent work, the President’s proposed FY 2013 budget provides a $100 million increase for efforts to combat Alzheimer’s disease. These funds will support additional research ($80 million), improve public awareness of the disease ($4.2 million), support provider education programs ($4.0 million), invest in caregiver support ($10.5 million), and improve data collection ($1.3 million).

“These actions are the cornerstones of an historic effort to fight Alzheimer’s disease,” Secretary Sebelius said. “This is a national plan—not a federal one, because reducing the burden of Alzheimer’s will require the active engagement of both the public and private sectors.”
The plan, presented today at the Alzheimer’s Research Summit 2012: Path to Treatment and Prevention, was developed with input from experts in aging and Alzheimer’s disease issues and calls for a comprehensive, collaborative approach across federal, state, private and non-profit organizations. More than 3,600 people or organizations submitted comments on the draft plan.

As many as 5.1 million Americans have Alzheimer’s disease and that number is likely to double in the coming years. At the same time, millions of American families struggle with the physical, emotional and financial costs of caring for a loved one with Alzheimer’s disease.

The initiatives announced today include:

Research -- The funding of new research projects by the NIH will focus on key areas in which emerging technologies and new approaches in clinical testing now allow for a more comprehensive assessment of the disease. This research holds considerable promise for developing new and targeted approaches to prevention and treatment. Specifically, two major clinical trials are being funded. One is a $7.9 million effort to test an insulin nasal spray for treating Alzheimer’s disease. A second study, toward which NIH is contributing $16 million, is the first prevention trial in people at the highest risk for the disease.

Tools for Clinicians -- The Health Resources and Services Administration has awarded $2 million in funding through its geriatric education centers to provide high-quality training for doctors, nurses, and other health care providers on recognizing the signs and symptoms of Alzheimer’s disease and how to manage the disease.

Easier access to information to support caregivers -- HHS’ new website, www.alzheimers.gov, offers resources and support to those facing Alzheimer’s disease and their friends and family. The site is a gateway to reliable, comprehensive information from federal, state, and private organizations on a range of topics.

Visitors to the site will find plain language information and tools to identify local resources that can help with the challenges of daily living, emotional needs, and financial issues related to dementia. Video interviews with real family caregivers explain why information is key to successful caregiving, in their own words.

Awareness campaign -- The first new television advertisement encouraging caregivers to seek information at the new website was debuted. This media campaign will be launched this summer, reaching family members and patients in need of information on Alzheimer’s disease.

Today’s announcement demonstrates the Obama administration’s continued commitment to taking action in the fight against Alzheimer’s disease.

In 2013, the National Family Caregiver Support Program will continue to provide essential services to family caregivers, including those helping loved ones with Alzheimer’s disease. This program will enable family caregivers to receive essential respite services, providing them a short break from caregiving duties, along with other essential services, such as counseling, education and support groups.

For more information on the national plan to address Alzheimer’s disease, visit: www.alzheimers.gov.
__________________________

National Alzheimer’s Project Act http://aspe.hhs.gov/daltcp/napa/

National Plan to Address Alzheimer’s Disease http://aspe.hhs.gov/daltcp/napa/NatlPlan.shtml

Alzheimers.gov http://www.alzheimers.gov

More Insight and Advice from the Alzheimer's Reading Room

Original content Bob DeMarco, the Alzheimer's Reading Room

Living with Bob and "Al"

Author: 
Sheri

On Mothers Day daughter number one ( the one who wears her heart on her sleeve) volunteered to stay home with Bob and "Al" while Sheri went out for a while with daughter number two  (the one who shields her heart with her sleeve). It was very nice to get a way for a few hours and not worry about anything. She loves her children very much and she is very proud of all three of them. On the way home Sheri and daughter number one decided to stopped to get some flowers for around the fountain. Sheri had Bob and daughter number two help fill the flower pots with dirt. Sheri was a little worried they may not have enough dirt, and spoke her concern out loud. "Al" overheard her and responded in his confident way, "well don't worry, if we run out of dirt we can just fill  the pots the rest of the way with butterflies."  :)

Dotty is Still With Us, Tuesday, 4 AM

Blog Title: 
Alzheimer's Reading Room


I'm re-learning something important here. I'm learning that the dementia clock is very different than the clock in the real world. Relative time is very different for the ill dementia patient. You have to be extremely patient, more patient than most of us can normally stand.
By Bob DeMarco
Alzheimer's Reading Room

It's 4 o'clock in the morning, I am awake. I slept for about 4 hours. I still had that heavy feeling when I woke up, but I was anxious to check Dotty out, and now I am wide awake.

Dotty is still with us, and is comfortable.

The truth right now I am a bit confused. Dotty had her best night in the last week plus. No moaning or talking, just rest.

I can't say that she is real aware so far, she went back to sleep after I gave her some water to drink.


Subscribe to the Alzheimer's Reading Room
Email:

Dotty ate more yesterday than any other day in the last  9 days. You can add chicken broth and pastina to her menu.

I don't want to mislead you.  Dotty is eating more; but, she is still not eating enough to maintain herself.

She is eating and drinking more. Please keep in mind this is a relative description.  Right now one might say she is eating more. Eating like a bird. A small bird.

Just now Dotty called out to me. The new yin and yang. Yes Mom? Are you Bobby? Yes, Mom its me. I want something to drink. The new new, she is asking for something to drink. For more than a week Dotty refused to drink, now she asks.

I am not implying that Dotty does not know who I am, but it appears she might not know as she continues on.

I just gave Dotty about two ounces of Boost. I waited a few minutes and then she drank some water.

I'm re-learning something important here. I'm learning that the dementia clock is very different than the clock in the real world. Relative time is very different for the ill dementia patient. You have to be extremely patient, more patient than most of us can normally stand.

I have to give Dotty a little little bit to eat or drink and stop. Wait, Wait. 15-30 seconds of standing can seem like a long time when you are on the regular clock. On the dementia clock it is much different. So I give Dotty a little bit. Wait. Give her a little bit more, wait.

Learning how to operate on the dementia clock, the Alzheimer's World clock, is mentally taxing. You really have to concentrate, and still it is hard to do. Why not, we are still operating on the real world clock. Learning to operate on this new and different clock is a must. You have to practice. Practice and concentrate if you want to succeed.

It seems right now that the dementia clock in this situation is even slower than the clock I learned to use to care for Dotty for the last eight and a half years.

I admire anyone that can have the patience, patience, patience you need right now. It is almost like you have to slow your heart rate down to 20 beats a minute to operate. So slow.

Dotty is still with us. It appears she might be with us longer than was expected. That Dotty, she just never stops proving everyone wrong.

There might be a difficult trade off here. Dotty might go on for a while here. A week, two weeks, or longer. Who really knows?

The trade off is, she might not know me as time goes on. I don't like this thought. But, its not up to me decide. I'll deal with any and all situations right now.

I'm ready, I'm prepared.

I slowed way way down. I'm on this new clock. This is a part of Alzheimer's World I didn't know about because I have never been to this "state". I am getting comfortable here.

I have another story to tell later. It is about establishing this new pattern of eating and drinking.

Love y'all. Thanks for the continued support.

More Insight and Advice from the Alzheimer's Reading Room

Bob DeMarco is the Founder of the Alzheimer's Reading Room and an Alzheimer's caregiver. The blog contains more than 3,511 articles with more than 297,100 links on the Internet. Bob lives in Delray Beach, FL.
Original content Bob DeMarco, the Alzheimer's Reading Room

An elder's sense of purpose and dignity must be balanced with their safety

Blog Title: 
Minding Our Elders&reg

Many of who have vulnerable loved ones would prefer to provide hands-on care ourselves. For some, that means considering whether to continue with outside employment or quit a job to care for our loved one full-time. In Discovering The True Cost Of At-Home Caregiving, NPR’s series “Family Matters: The Money Squeeze,” the lifetime cost of quitting a paying job to care for a loved one in the home is closely examined. 
Read more about balancing an elder's need to be useful with his or her dignity:
Purchase Minding Our Elders: Caregivers Share Their Personal Stories – paperback or e-book
 

A Quiet Mother’s Day with Alzheimer’s

Blog Title: 
Alzheimer's Speaks Blog

 A Quiet Mother’s Day with Alzheimer’s

All though our time was quiet, it was very nice.
We are in a stage where words don’t matter much… just being together is enough.
These are some photos of my daughter with her grandma… Precious

Resveratrol Clinical Trial for Alzheimer's Now Recruiting New Participants

Blog Title: 
Alzheimer's Reading Room



Resveratrol is derived from plants and is found in highest levels in red wine and the skin of red grapes. The Copenhagen City Heart Study (Treutlen et al 2002) reported that monthly and weekly consumption of red wine is associated with a lower risk of dementia.

Alzheimer's Reading Room


A phase II clinical trial examining the effects of resveratrol on individuals with mild to moderate Alzheimer’s disease has begun recruiting new participants.

More than two dozen academic institutions are participating (see the list below).

Resveratrol is derived from plants and is found in its highest concentration in red wine and the skin of red grapes.

There is compelling evidence that caloric restriction can improve overall health by activating a class of enzymes known as Sirtuins.

If you are interested in participating in this clinical trial read the inclusion and exclusion criteria below. Locations and contact information are also included.

Subscribe to the Alzheimer's Reading Room

Email:

RESVERATROL IN ALZHEIMER’S DISEASE STUDY

A Phase II clinical study of Resveratrol (RES) designed to evaluate the safety, tolerability and effectiveness of Resveratrol on cerebrospinal fluid (CSF) and other biomarkers for the treatment of Alzheimer's disease (AD).

Resveratrol is derived from plants and is found in highest levels in red wine and the skin of red grapes. The Copenhagen City Heart Study (Treutlen et al 2002) reported that monthly and weekly consumption of red wine is associated with a lower risk of dementia. There is compelling evidence that caloric restriction can improve overall health by activating a class of enzymes known as Sirtuins. Resveratrol is a substance found in some plants that directly activates sirtuins, mimicking the effects of caloric restriction and may affect regulatory pathways of diseases of aging, including AD.

In this study, people with AD will be given either Resveratrol or placebo (looks like the study drug but contains no active medication) for 12 months to determine whether daily Resveratrol therapy is beneficial in delaying or altering the deterioration of memory and daily functioning. Patients with a diagnosis of probable AD may qualify for participation in this study.

Patients that are eligible and agree to participate will be among 120 people enrolled in the study. The RES study is taking place at about 26 sites across the United States affiliated with the Alzheimer’s Disease Cooperative Study. Each research site will enroll approximately five participants. Participants who are already being treated for AD can continue on their FDA-approved AD treatments (must be on a stable dose for a minimum of 3 months prior to screening for the study). Participants cannot be enrolled in another clinical study during this time. Patient participation will last up to 12 months and will require up to 10 study visits. Some of these visits may be performed over multiple days. This is a double-blind, placebo-controlled study which means that study participants have a 50/50 chance of receiving either Resveratrol or the placebo and neither the site or the participant will know if they are receiving placebo or Resveratrol.

A small group of 15 participants will be asked to take part in a more detailed 24-hour PK analysis sub-study that will measure Resveratrol levels at 15 different time points over a 24 hour period at five different visits..

The U.S. Food and Drug Administration (FDA) has not approved Resveratrol for the treatment of AD and we do not know whether the use of Resveratrol can change the course the disease.

To be eligible for this study participants must:

  • Have a diagnosis of probable mild-to-moderate AD
  • Age greater or equal to 50
  • Be in good general health
  • Are fluent in English or Spanish
  • Are willing and able to undergo in-clinic assessments, two lumbar punctures to gather cerebral spinal fluid (CSF), three MRIs, and blood and urine tests.ave a reliable study partner that can accompany the participant to all study visits and has more than two days a week of contact with the participant.
  • Able to abstain from ingesting large quantities of Resveratrol-containing foods, including red wine (one or two glasses of red wine or red grape juice or one serving of red grapes daily is acceptable).
  • Able to abstain from ingesting herbal/natural preparations or dietary supplements containing Resveratrol.

Any of the following will exclude participation:

  • Significant neurological disease other than AD
  • Depression, major psychiatric disorders and behavioral problems
  • Alcohol or substance abuse within the last two years
  • History of cancer within five years prior to screening (history of skin melanoma or stable prostate cancer are not excluded)
  • Any significant systemic illness or unstable medical condition
  • Participants will be screened at the research sites to determine if they are eligible for the study.

To learn how to participate contact the NIA's Alzheimer's Disease Education and Referral (ADEAR) Center at 1-800-438-4380 or by email to adear@nia.nih.gov.

Or, for direct contact

BannerHealth Alzheimer’s InstituteAZ602-839-6279
University of California IrvineCA949-824-8726
University of California San DiegoCA858-246-1306
University of Southern CaliforniaCA323-442-7594
Yale UniversityCT203-764-8100
USF Health Byrd Alzheimer’s InstituteFL813-974-4355
Mayo Clinic, JacksonvilleFL904-953-8035
Rush University Memory ClinicIL312-563-4111
University of KansasKS913-945-5033
University of KentuckyKY859-323-1331
Johns HopkinsMD410-550-9022
University of MichiganMI734-647-7760
Mayo Clinic, RochesterMN507-293-4711
Cleveland Clinic Lou Ruvo CenterNV702-483-6026
Columbia UniversityNY212-305-7661
Mount Sinai School of MedicineNY646-284-7547
New York University Med CenterNY212-263-5708
University of RochesterNY585-760-6562
Case Western Reserve UniversityOH216-464-6467
University of PennsylvaniaPA215-615-3084
Medical University of South CarolinaSC843-740-1592 ext. 40
Baylor College of MedicineTX713-798-5325
University of Texas, SWMCTX214-648-9376
University of WashingtonWA206-764-2339
Georgetown UniversityDC202-687-0413
Howard UniversityDC202-865-3776

More Insight and Advice from the Alzheimer's Reading Room

Original content Bob DeMarco, the Alzheimer's Reading Room

Dotty is Still with Us, 10 AM

Blog Title: 
Alzheimer's Reading Room


By Bob DeMarco
Alzheimer's Reading Room


Dotty is still with us this morning.

She is resting comfortably, but continues to go down hill slowly.

Her urine appears to be okay, and I will get a better read on that once the Hospice nurse arrives.

Her pulse is dropping.

Subscribe to the Alzheimer's Reading Room

Email:

My sister Joanne and my brother Bill are both here with us.

They were both able to speak with Dotty when they arrived.

Communication is becoming difficult.

Yesterday was a great day for Dotty and she was pleased that everyone was here for Mother's Day, and she was able to communicate that to us.

Surprisingly, she drank more than the previous days, and I was able to feed her tiny amounts of water, water melon, ice cream, rice pudding and ensure the entire day. She actually asked for water several times, which was a first.

One thing for sure, I am tired and a little dulled out. However, I did get some good sleep the last two days.

I might be getting a little ornery, but I'll try to hold myself in check. Nothing to be gained by raining on everyone's parade. On the other hand, sooner or later its all gonna come out. Which will be a good thing because I will channel it properly.

Speaking of parades, I think we had a darn good parade here the last 8 plus years. Especially in the last year and a half.

I am starting to feel anxious already to tell caregivers around the World our story. Specifically how both Dotty and I overcame the burden and found the joy together.

My real purpose in the world will be to tell people how we found the joy, but I suppose I will be telling some stories about my real life cartoon character Dotty.

Pretty soon it will be me and Harvey. Harvey needs a few repairs, but I intend to hold on to him, maybe take him out in the world with me.

Dotty did make me laugh and smile at least once each day during this difficult and trying period.

I am not yet feeling lonely.

No way I am ever going to feel alone thanks to all of you.

All in, I feel like a very fortunate man.

More Insight and Advice from the Alzheimer's Reading Room


Bob DeMarco is the Founder of the Alzheimer's Reading Room and an Alzheimer's caregiver. The blog contains more than 3,511 articles with more than 297,100 links on the Internet. Bob lives in Delray Beach, FL.

Original content Bob DeMarco, the Alzheimer's Reading Room

Living with Bob and "Al"

Author: 
Sheri

Sheri  was only able to bring a few plants with her from her "Life through the Fence Post " garden.The garden she had to leave behind with the foreclosure of their family home. She has been waiting patiently to see if any of them survived the hasty transplant in November right before the frozen tundra froze over. About three weeks ago she was thrilled to see that her clematis was growing quickly up the arch in her new "not quite her garden' garden. There were several small and weak vines but none the less it made her heart happy, it gave here a feeling of a re-birthing of sorts and it had the first tiny flower bud on it. Yesterday afternoon Bob was trying to do something nice for Sheri. "Al" had the weed whacker and in just an instant the clematis was gone. Anger swept over her and she wept. She realized it was not just about the clematis, it was about all the things it represents.The loses this past year and the feeling that Alzheimer's has ripped the roots of her life right out of the ground. At least the clematis ... will grow back.

NPR investigates the true cost of giving up a job to be a family caregiver

Blog Title: 
Minding Our Elders&reg

Many of who have vulnerable loved ones would prefer to provide hands-on care ourselves. For some, that means considering whether to continue with outside employment or quit a job to care for our loved one full-time. In Discovering The True Cost Of At-Home Caregiving, NPR’s series “Family Matters: The Money Squeeze,” the lifetime cost of quitting a paying job to care for a loved one in the home is closely examined. 
Read more about the true cost of caregiving:
Purchase Minding Our Elders: Caregivers Share Their Personal Stories – paperback or e-book
 
 

A Letter to Dotty

Blog Title: 
Alzheimer's Reading Room


By Max Wallack Alzheimer's Reading Room

 Dear Dotty,

Happy Mother’s Day, Dotty. I will miss you.

I was “introduced” to you not long after Great Grams passed. You have kept alive for me the real life day-to-day coexistence with someone who is deeply forgetful.

I lost Great Grams when I was only ten. While I don’t think my memories of her fade, I know you were instrumental in reminding me about her, each and every day. You entered my life just about the time that my decision to devote my life to helping Alzheimer’s patients was being made. You strengthened my decision with every story, every video, and every cinch cast.

You confirmed my belief that there was “more there.” I could hear it in your singing and see it in your beautiful coloring.


I relished cheering on your feistiness, even when you were giving Bob a hard time. Perhaps I shouldn’t admit it, but I always felt a sense of triumph and you made me laugh when you did find those chips and stabbed open those bags.

As smart as Bob is, you were able to outsmart him, again and again. I also applaud your optimism: your belief that later, or tomorrow, you will be able to do more.

Shortly after we “met”, it was Mother’s Day, 2009. I remember Bob’s story about how you would take beautiful bouquets of flowers and cut the stems a little shorter every day, until there were only blossoms left. Bob said he used to be upset, but then realized how much joy “rearranging” the flowers gave you. When I heard that, I went out and bought the nicest Mother’s Day card that I could find with a beautiful bouquet of flowers on the front. I sent that card to you, but it came back saying no one by that name lived there. I even sent it out a second time, but it came back again. A few days ago while straightening out, I came across that very card. It will forever remind me of you.

Love, Max

Max Wallack is a student at Boston University Academy. His great grandmother, Gertrude, suffered from Alzheimer's disease. Max is the founder of PUZZLES TO REMEMBER. PTR is a project that provides puzzles to nursing homes and veterans institutions that care for Alzheimer's and dementia patients.

Mother's Day History, Quotes and the Mother's Day Song

Blog Title: 
Alzheimer's Reading Room



Dotty was born about 20 blocks from the famous Wanamaker's department store in Philadelphia where the first big Mother's Day celebration was held in the United States. Dotty is 94 years old this Mother's day and will soon be 95....
By Bob DeMarco
Alzheimer's Reading Room
May, 2011


Anna Marie Jarvis

Mother's Day was first established in the United States by Anna Marie Jarvis, following the death of her mother Ann Jarvis on May 9, 1905. She had the help of Philadelphia merchant John Wanamaker.

The first official Mother's day took place in 1908. It was celebrated in Andrew's Methodist Episcopal Church in Grafton, West Virginia where Anna's mother had been teaching Sunday school. It was also celebrated on a larger scale in a large auditorium at the famous Wanamaker's store in Philadelphia. Wanamaker's was one of the first department stores in the United States.

Mother's Day became a recognized holiday on May 8, 1914.

Ironically, Anna Jarvis became an opponent of Mother's Day because she believed it had become too impersonal and too commercialized. She actually spent her entire fortune fighting the commercialization of Mother's Day. She preferred a personal letter to the "greeting card".

Anna Jarvis was arrested in 1948 for disturbing the peace while protesting against the commercialization of Mother's Day, and she was quoted as saying,

she wished she would have never started the day because it became so out of control.

The sale of greeting cards for Mother's Day ranks third, behind Christmas and Valentine's day.

Happy Mother's Day from Dotty and Bob.

Don't forget, you can share this with others by using the share button, or emailing the link to this article.

“A mother is the truest friend we have, when trials heavy and sudden, fall upon us; when adversity takes the place of prosperity; when friends who rejoice with us in our sunshine desert us; when trouble thickens around us, still will she cling to us, and endeavor by her kind precepts and counsels to dissipate the clouds of darkness, and cause peace to return to our hearts.”
-- Washington Irving

“All that I am, or hope to be, I owe to my angel mother”
-- Abraham Lincoln

“God could not be everywhere, and therefore he made mothers.”
-- Rudyard Kipling

“Some mothers are kissing mothers and some are scolding mothers, but it is love just the same, and most mothers kiss and scold together.”
-- Pearl S. Buck

More Insight and Advice from the Alzheimer's Reading Room

Original content Bob DeMarco, the Alzheimer's Reading Room

Happy Mother's Day, and More There

Blog Title: 
Alzheimer's Reading Room



When Joanne went into Dotty's room she was basically out it. I said rather loudly, Mom, Joanne is here. Dotty's eyes snapped wide open and she started talking to Joanne.

By Bob DeMarco
Alzheimer's Reading Room


Dotty

Happy Mother's Day to all the mother's around the World. A special wish to all of the mother's on this website.

Dotty is still with us this morning. Happy Mother's Day mom.

A special thank you to everyone in the Alzheimer's Reading Room for your kind thoughts, words of encouragement, and prayers.


Dotty is still with us this morning. Dotty did open her eyes and is able to communicate a bit. Joanne is here with us. Thank goodness.

When Joanne arrived last night Dotty had her eyes closed and had not said anything intelligible for several hours.

When Joanne went into Dotty's room she was basically out it. I said rather loudly, Mom, Joanne is here. Dotty's eyes snapped wide open and she started talking to Joanne.

A wonderful moment. I went outside and said out loud, thank God.

Right now I am thinking about many people, but two are in the front of my mind. Judy Berry and Max Wallack.

Judy Berry is the founder of the Dementia Care Foundation and Lakeview Ranch. Right before I read about Judy and her kind wonderful works I had finally made it on to the path to Joy. I had learned over and over that Dotty was capable of more. This "more" is what propelled me along as an Alzheimer's caregiver. But, at the time I was reluctant to write about our life because after all I was a one man band. After learning about Judy and what she was accomplishing, I had no doubt that when it comes to dementia patients, there is more.

Later on, Max Wallack wrote an article, "I Remember Better When I Paint". Max wrote,

Many families have negative attitudes, feeling that the person is “no longer there”. It is important to realize that the person is always there. We need to help the Alzheimer’s person find things the person will enjoy, and they will become “more there.”

Max was thirteen years old when he wrote that article.

After reading that article instead of saying there is more than you can imagine, I started saying there is more there. Might sound like a subtle difference, but it was much more than that for me. It propelled me along in my belief that dementia patients are capable -- more there.

If you have any doubt that there is more there, I suggest you read this article by Judy Berry, I Am Still Here.

I remember thinking at the time, I won't forget this article.

From Mother's Day, 2011. Dotty also talks and sings with Harvey in the second half of the video.

More Insight and Advice from the Alzheimer's Reading Room


Bob DeMarco is the Founder of the Alzheimer's Reading Room and an Alzheimer's caregiver. The blog contains more than 3,511 articles with more than 297,100 links on the Internet. Bob lives in Delray Beach, FL.

Original content Bob DeMarco, the Alzheimer's Reading Room

Blog Title: 
karen


http://act.alz.org/site/TR/Walk/OK-OklahomaandArkansas?px=6221126&pg=personal&fr_id=1573
Happy Mothers Day ! This is the first mom's day without mom. I was ok till today. Yesterday I was busy with my son . He took me to a Razorback Baseball Game for Mom's Day. One of my Favorite things to do is go to a game with him. This picture is of all of us.  Looks like I was a hand full even back than. Yes I am the baby of the family. Can't you tell? Spoiled rotten. 
At my new job I get to take my clients or friends really where ever they need to go and one of my ladies likes to visit a friend in an assisted living facility. This Friday the facility had a new lady and all the time we were there she was getting up from the dining room table and trying to leave . She said she was looking for her family. Than she needed to find a restroom. In 15 mins. she went to the restroom 2 times and tried to go outside to find her family 3 times. The staff was on there toes. They were trying to get supper served and comfort her. I almost cried. That is the way mom was in her early stages of Alzheimer's. I can't tell you how many times she went to the restroom. Every 5 mins some days.And mom wondered off a few times before we decided she needed full time care.  The sad thing is for this lady was her family was not coming back most likely. But the staff had to tell her over and over they would be there later . Of course maybe the family would come see her that evening. I am sure they will be there today to see her. She will be looking for them all day I bet. This disease robs the heart and soul from families. She was walking all over the place . She could live a long fruitful life if she did not have this awful disease. Her family has lost the mom they had and now she is someone who needs constant care because she will wonder off and get lost or hurt. Please Pray that we find  a cure for Alzheimer's soon. I Miss my Mom today. My real mom not the one that Alzheimer's made her the last years of her life. Rest In Peace Earlene Ruth Hudson.

Living with Bob and "Al"

Author: 
Sheri

Sheri was working in her "not her garden" garden. She needed to mow around the fountain so she picked up the wooden border around it. While she was mowing Bob picked up the border and wrapped it around the post leg of the swing. A few minutes later Sheri sat down on the swing to take a break and Bob sat down with her. "Al" looks down and says "well now that looks cute... why did you only wrap one?"  :)

Celebrating Mother’s Day any way we can

Blog Title: 
Minding Our Elders&reg

Dear Readers: Many of you have mothers who are in assisted living centers or nursing homes. You may be able to bring them to your home or take them out for dinner for Mother’s Day. However, a significant number of you realize that taking your own mother out of her environment will only distress her. If your mother has dementia, she may not even understand what you are doing or why this day is different from all the others.Under any circumstances, there’s real anguish in watching the slow mental and/or physical decline of a beloved elder. 
Read more about how to celebrate with a mother who may not understand:
Purchase Minding Our Elders: Caregivers Share Their Personal Stories – paperback or e-book
 

On a Scale of One to Ten I Would Call Me an 8 Right Now

Blog Title: 
Alzheimer's Reading Room



The big question though, would I be feeling this way without you all?

By Bob DeMarco
Alzheimer's Reading Room


I'm pretty tired but there is good news all the way around. I just had a nap for one straight hour. Right in the bed next to Dotty.

In 4 hours or so Joanne will be here. Two heads are better than one, so are 4 hands as I learned this week.

I'm doing pretty good I think. I am physically tired but emotionally I am doing good.

I started getting prepared for this many years ago. It is paying off right now.

Subscribe to the Alzheimer's Reading Room

Email:

Dotty is pretty stable at the moment. Kinda sweet.

Dotty told me she thought I was a good son this morning, and pretty much that was what I needed.

It seems more like a see-saw right now than a roller coaster.

I am not looking forward to night time. The last three nights have been a real emotional and physical roller coaster.

Dotty had a little bit of morphine. The lowest dose. They said it will also help her breathing. Oh yeah? Hmm.

Now I have to get some water in her every 15 minutes, and swab her lips and her cheeks on the inside.

A hospice in Dallas should hire Carole Larkin, full time, to go around and talk to people that are in a situation similar to the one Dotty and I find ourselves in at this time. Carole knows more than I imagined, and she knows how to talk to an Alzheimer's caregiver. She is more than worth the fee she charges.

I'll have more to say on that topic later.

I would be interested in hearing how others feel when it comes to Hospice and Alzheimer's. These people are wonderful, but I don't think they are ready for the growing number of dementia patients they are likely to be seeing.

If I say Dotty can't feel pain, Dotty can't feel pain.

The nurse that came today was excellent as far as nursing goes. She needs some dementia training. Not because of her demeanor, because an end stage Alzheimer's patient is not going to be able to tell you what day it is, etc. I suppose that is part of the standard test to give the morphine. I am not sure because I didn't think to ask.

Carole could whip these nurses into shape pretty quick.

I don't think I would have been so calm, cool and collected 20 years ago.

Bottom line right now.

Things are still going better than I could have ever expected. Certainly better than whatever it was I had envisioned.

I am feeling fortunate at this moment in time.

The big question though, would I be feeling this way without you all?

Absolutely Not.

More Insight and Advice from the Alzheimer's Reading Room


Bob DeMarco is the Founder of the Alzheimer's Reading Room and an Alzheimer's caregiver. The blog contains more than 3,511 articles with more than 297,100 links on the Internet. Bob lives in Delray Beach, FL.

Original content Bob DeMarco, the Alzheimer's Reading Room