Puzzles To Remember: August 2011

PUZZLES TO REMEMBER is a 501(c)3 organization that provides puzzles to nursing homes, veterans facilities, and other facilities that care for Alzheimer's and dementia patients. Dr. Max Wallack founded Puzzles To Remember in 2008, and continues to act as an advisor and mentor. Hailey Richman is the Executive Director of PuzzlesToRemember. Since 2011, Hailey has been distributing puzzles to nursing facilities around the globe. Hailey is also the founder of KidCaregivers.com, where she provides advice for children dealing with dementia in their family members. Hailey has begun an international program called PuzzleTime which involves pairing youth members with people with Alzheimer's for an hour of shared jigsaw puzzle solving. Dr. Max Wallack serves as a mentor to the KidCaregivers program.

If you have puzzles that you would like to donate, please contact us at Puzzles2Remember@gmail.com and we will find a location near you where you can bring your puzzles. We can also provide you with a donation letter so that you can claim the value of your puzzles as a tax deduction.

To see a short video from WCVB Ch. 5 "BOSTON STRONG" about Max's efforts on behalf of Alzheimer's patients, click here.

To see a short video about Hailey's Puzzle Time Program, click here.

Monday, August 29, 2011

Clementoni Donates Puzzles for Alzheimer's Patients

By Max Wallack
Puzzles to Remember

Today, I received some beautiful puzzles from Clementoni’s Museum Collection. The puzzles are 1000 piece puzzles depicting the painting “Coronation of Napoleon” by David. They are beautiful, high quality puzzles. They are really too difficult for most Alzheimer’s patients, so I will have to put lots of thought into where they might do the most good. Perhaps they would be well used at a Senior Center where patients with Mild Cognitive Impairment meet regularly. It would also give these individuals an opportunity to appreciate some beautiful art.

Thursday, August 25, 2011

Do You Really Get to Choose the Facility for a Dementia Patient?

By Max Wallack

Great Grams (Gertrude Finkelstein) and Max Wallack
No matter how hard you try to keep a dementia or Alzheimer’s patient at home, eventually the day may come that it is not possible.

We had planned that that day would never come for Great Grams.

She had spent about a week in a major teaching hospital because of leg pain. The doctors tried a great number of medications. Nothing really seemed to help. I suspect the pain was really caused by some of her faulty wiring in her brain.

However, while she was in the hospital, the doctors realized just how much she had deteriorated mentally. She was choking on food and rarely communicated.

However, Great Grams had a compulsion to run, and she was going to run every chance she got. They had to hire a “sitter” to stay in the room with her. Even the sitter couldn’t handle her. When Great Grams saw a young child visiting someone, she was running to play with them. Eventually, they used diapers to tie her to the chair.

Great Grams had been on Reminyl. Her own doctor had told us that when a person who is on Reminyl stops taking the drug, they decline rapidly, quickly losing all the abilities that the drug had help maintain.

During that hospital visit, some physician decided that the Reminyl wasn’t doing her any good because she was in such poor condition. So, he stopped the drug. That was really the beginning of the end for Great Grams.

Great Grams came home with us soon after. She had been put on hospice home care. Included was a 24 hour nurse available by phone. The nurse was called many times those first few nights.

Great Grams wouldn’t sleep. We rented a special bed with sidebars. You would think that would work on a small 93 year old woman, wouldn’t you? Nope. All that did was make a higher surface from which Great Grams could fall on her climb out.

Grandma was exhausted. Grandpa slept on the floor at the door to Great Grams room just to keep her inside for a few hours so Grandma could rest.

After a few days, hospice took her off their list, saying they couldn’t handle her. They suggested maybe she had another urinary tract infection, and we should take her to the local hospital. Great Grams “agreed” to go, even taking off her rings and handing them to Grandma. She must have understood at some level.

Of course, the hospital did find a urinary tract infection. They always found one whenever they tested Great Grams. They kept her for several weeks. But, she did not improve. The doctor there, who had seen her only a few months earlier, was shocked at her deterioration. (No Reminyl).

In that hospital, she climbed out of the high bed frequently, and fell on the hard tile floor. Eventually, they also tied her down.

Then, the hospital decided they could no longer keep her, and that she was too ill to be cared for at home. They said we had to get her out of there within a few days, or the bill of almost a thousand dollars a day would be ours to pay.

A few days later, an “opening” happened in a dementia ward in a facility in a neighboring town. We were told we basically had no choice. Great Grams would be sent there in an ambulance.

Grandma went over to see the place. She had read about nursing homes. One thing she had read was to make sure there was no urine odor.

When Great Grams went to the dementia ward, she was almost knocked off her feet by the stench of urine! When the nurse showed Grandma what would be Great Grams’ bed, Grandma saw a small insect crawl across it. It was a nightmare!

HOWEVER, first impressions can be wrong. It turned out that the odor had been caused by a defective bathroom toilet which was being repaired. Insects were never seen again.

And –MOST IMPORTANT OF ALL- the nurse in charge of the unit was a man with a huge heart! He treated each patient as if they were his own mom. He had eyes “in back of his head” and was aware of where each patient was and what they were doing.

Each afternoon, he would put on Sousa marches and march in the halls with each patient who could do it. His staff took their cues from him and treated the patients with respect.

They made every attempt to avoid restraints. They even put mattresses on the floor on both sides of Great Grams’ bed for when she got up at night.

Every day, after breakfast, chairs were all lined up around the nurses’ station so the patients could sit and be entertained by watching the nurses come and go. When one patient had a visitor, it was a visitor for all the patients.

We still hoped to take Great Grams home. The head nurse told us that the hospital had “warned him” that we still felt that way.

However, Great Grams continued to decline rapidly. She couldn’t and wouldn’t eat. Soon, we had to give permission for restraints because she kept falling and falling. The head nurse was very, very kind to her. She couldn’t have been in a better place.

It didn’t matter that the rug was old. It didn’t matter that the nurses’ station was all scuffed and banged up. It didn’t matter that the physical therapy was in the basement of this old, old building which had once been a factory.

It mattered that the people who cared for Great Grams were very kind.

The last time I saw Great Grams, a few days before her death, she was restrained in a chair sitting near the nurses’ station, watching everything. She played tug of war with me -- pulling me toward her so strongly that I really could barely free myself. Then, she would pull again. She was still communicating with me.

Wednesday, August 24, 2011

American Express Gives Its Support to PuzzlesToRemember

By Max Wallack
Puzzles to Remember

I want to take this opportunity to thank American Express for its ongoing support of PuzzlesToRemember. Several employees at American Express have pledged to make monthly donations, and American Express is matching those donations.

I receive many donated puzzles, and they all have the potential to bring feelings of joy and fulfillment to Alzheimer’s patients. However, I also rely on companies with heart, like American Express, to supply the funds that it costs to ship the puzzles to where they can do the most good.

Thank you again!

Saturday, August 20, 2011

Alzheimer's Dilemma: I Don't Want My Grandchildren to See Me Like This

By Max Wallack
Puzzles to Remember

As an editor for the Alzheimer’s Reading Room, I get some interesting questions, but none has been so difficult to answer as the question above.

This question has been on my mind for a while. I can imagine that this subject alone could be the focus of an entire course in medical ethics. Below are my thoughts. I am interested in learning what you think about this issue.

If an early stage Alzheimer’s patient, still capable of making rational decisions, said they did not want to see their grandchildren, for whatever reason, I would try to abide by that decision.

I don’t think this would be good for the grandchildren. I would try to explain the decision to the children by saying the grandparents' brain is overwhelmed right now, and can’t bear to deal with any additional emotions -- even the love of the grandchild.

However, if an early stage Alzheimer’s patient, capable of making rational decisions, said they did not want to see their grandchild later, some time in the future, I would not react in the same way. I think each person should be allowed to change his/her mind.

What is good today, may not be what is best tomorrow, and this is especially true for Alzheimer’s patients.

My plan would be to ask the Alzheimer’s patient at the time when the visit would take place. If, at that time, the patient beamed at the idea of seeing the grandchildren (which, in my opinion, would be very likely), I would consider the patient to have made a different decision, under different circumstances.

Often Alzheimer’s patients who can no longer speak, light up when they see their loved ones. I remember how overjoyed great grams was when she saw me.

In Alzheimer’s World, we have learned that the truth is not always the best medicine. Not allowing the interaction between two people who need and love each other because of a desire to keep an old promise, just isn’t the way things work best in Alzheimer’s World.

In Alzheimer’s World, there is only today, and the today of both the grandparent and grandchild would be best served by allowing them to interact.

It could be harmful to the grandchild if they are not allowed to see the grandparent. I think it would be very frightening to a child to think that the grandparent was so bad off that it would be too horrible to see them.

The imagination can be even more frightening than the reality, even in this horrific disease. Perhaps even more devastating would be thinking that the grandparent didn’t want to see them. I think it would be easier to accept that someone can’t know me because they are very ill; than to accept that someone who loved me, no longer wants any involvement with me.

There is no question that this is a very difficult moral dilemma.

I am interested to see how others feel about this subject.

Monday, August 15, 2011

Springbok’s PuzzlesToRemember are Being Shipped to 11 Additional Alzheimer’s Facilities

By Max Wallack
Puzzles to Remember

This week 11 additional Alzheimer’s Facilities will be supplied with puzzles. These will be the specialized Alzheimer’s puzzles made by Springbok in consultation with PuzzlesToRemember.

These puzzles will have either 36 or 12 large, easy to handle pieces. They are colorful and have serene, memory-provoking themes. These puzzles can be seen and ordered here.

I receive consistent feedback that Alzheimer’s patients are greatly enjoying the feeling of success they receive from working on these puzzles.

200 Puzzles Being Delivered to Facilities in northern Arizona

By Max Wallack
Puzzles to Remember

Earlier this week, I heard from Deirdre, who lives in northern Arizona. Deidre has 300 beautiful puzzles that she wants to donate for the use of our senior citizens. All of her puzzles are in great condition, and some are completely new.

I am happy to say that I contacted the Veteran’s Facility in Prescott AZ, and they are overjoyed that Deirdre will be delivering 100 of her puzzles to their location. I know these veterans will enjoy the puzzles.

Another facility, the Peaks Senior Living in Flagstaff, responded:

I am the Life Enrichment Director at The Peaks. We would love to have donated puzzles.
We are a wonderful community with our Independent living, Assisted Living, Memory, and Skilled Nursing.

Deirdre will be delivering 100 puzzles to their location.

I am sure we will be able to find a good home for the remaining puzzles.

Thank you Deirdre! Your puzzles will bring joy and satisfaction to many people!

Masterpieces Puzzles Donates Puzzles to PuzzlesToRemember

By Max Wallack
Puzzles to Remember

I want to thank Masterpieces Puzzles for donating a case of puzzles to PuzzlesToRemember. These puzzles will appeal to many of our senior citizens who are avid sports fans.

Many of the puzzles are about Stadiums such as Fenway Park, Yankee Stadium, and Rigley Field. They will probably bring back some very happy memories.

Thank you!

Thursday, August 11, 2011

Alzheimer's and "Rise of the Planet of the Apes"

By Max Wallack
Puzzles to Remember

I bet, at first look, it seems strange for me to be writing about the new movie Rise of the Planet of the Apes on the Alzheimer’s Reading Room. However, after seeing this movie, not only do I think it is one of the best movies I have ever seen, I think it is an amazing social commentary about Alzheimer’s disease.

The story line is about a geneticist who was doing research on a drug for Alzheimer’s disease. The drug contained a virus that he was testing on chimps. One chimp showed a particularly good response to the drug, and she was singled out to be worked with. Her intelligence increased dramatically.

Then, we see the scientist at home. He is taking care of his father who has Alzheimer’s disease. The portrayal of the father is extremely realistic. His is quite advanced in the disease and has a hired caregiver at home when the geneticist is at work. We see the father lash out in frustration at the hired help, who then quits her job.

Back at the lab, the star chimp, “Bright Eyes,” is forced out of her room, and suddenly becomes very agitated and destructive. There is much havoc in the lab, and Bright Eyes is killed. Back in her room, the geneticist finds a tiny, newborn chimp, and he realizes that Bright Eyes had reacted so wildly because she had been forced to separate from her newborn.

The CEO of the company orders the study stopped, and he orders all the chimps who have been given the virus to be killed. The CEO no longer wants to continue the study. He is afraid they will be sued because the chimp went wild. All the chimps are killed, but the geneticist brings the newborn home with him and presents it as a gift to his father.

The father is delighted, and we get to see how caring for the baby chimp actually becomes very meaningful to the dad’s life. Like many Alzheimer’s patients, he becomes alive when he has something that he is responsible for.

The geneticist is distraught that his research is put aside after he has spent five years on the preparation of his virus, ALZ 112. His dad is progressing with Alzheimer’s to severe stages. The geneticist decides to inject the virus into his dad.

There is a remarkable change. After a few weeks, his dad returns to his cognitive former self. He even expresses, “I am not sick, anymore.” He even appears to play the piano better than he ever had.

Meanwhile, the infant chimp, now named Caesar, is growing. His early intelligence is hard to miss. By the age of three years old, he is more intelligent than a human three-year-old. He is able to learn sign language. It is obvious he has inherited or contracted the virus from his mom.

After about five years, the father’s symptoms of Alzheimer’s begin to reappear, and his deterioration is rapid. The geneticist conducts tests and realizes that his dad is producing antibiodies to the virus. He sets out to create another, stronger virus, ALZ 113, that can help his dad.

At one point, we see the father wander out of the house and get into a car that a neighbor has left the keys in. It’s not a good situation, but it’s one we have become familiar hearing about. The neighbor comes out and angrily pulls the dad out of the car as Caesar watches.

Caesar is very protective and runs to help the father. The chimp bites the neighbor’s finger, and animal protection is called. Against the geneticist’s will, Caesar is removed from his home and placed in a zoo-type refuge.

We get to see a lot of Caesar in that setting. It, to me, appeared like what it must feel like to be an Alzheimer’s patient in a locked ward. Caesar is smart enough to know how bad things are for him. He is empathetic with the other apes who are suffering.

The refuge operates like the nightmare nursing facilities of the past. Everything out front is cheery for visitors, and caged-up and horrific when the visitors are gone.

Meanwhile, the scientist has succeeded in producing ALZ 113, which he thinks will work. He tries to get the CEO to resume testing in chimps. The CEO is adamantly opposed to the drug. Only when the scientist says that the drug has potential to increase intelligence in “normal” people does the CEO become interested. It is a sad social commentary. The CEO was unwilling to risk a lawsuit to return Alzheimer’s patients to normal intelligence, but when he thought he would make a fortune with a drug that boosted normal intelligence, he was willing to go full speed ahead.

When the geneticist’s dad becomes very ill, he brings home the ALZ 113, with the intention of injecting his dad. His dad, on his deathbed, refuses the injection. He knows it’s his time. The dad dies, and the geneticist places the ALZ 113 drug in his refrigerator.

Meanwhile, Caesar is becoming more and more distressed with the horrendous treatment of his fellow apes. He breaks out, visits the geneticist’s home, and steals the vials of ALZ 113. Caesar brings them back to the refuge, where he doses all the apes with the ALZ 113.

After that point, the movie becomes an action movie of humans vs very smart apes.

I know that most people will comment on the animation and computer graphics of this movie. They are, indeed, unbelievably fantastic. The ape movements were realistic. One scene, where the apes were playing with an oil can, was right out of a Jane Goodall film.

What I found most amazing was the realism about Alzheimer’s and Alzheimer’s research that was in the movie. The dad with Alzheimer’s was depicted painfully accurately. The resistance on the part of the imagined pharmaceutical company to producing something that would only help Alzheimer’s patients and could expose them to a lawsuit, felt all too real.

I have just a few more comments. I wonder whether the fact that Charlton Heston, the star of the first “Planet of the Ape” movie, who passed away from Alzheimer’s disease in 2008, had an impact on the production this movie.

I suspect that this movie will become a good beginning for very many ethics discussion and courses for scientists.

My own Alzheimer’s mice will be arriving in my lab this week. At one point during the movie my grandmother leaned over and whispered to me, “You better not create any super intelligent Alzheimer’s mice that want to take over the world.”

No, but I’d sure like to develop that virus that gives another five healthy years to Alzheimer’s patients.

Original content Max Wallack, the Alzheimer's Reading Room

Wednesday, August 10, 2011

Nestlé USA Donates $1000 to PuzzlesToRemember

By Max Wallack
Puzzles to Remember

Nestlé USAs donation is part of an award I received as one of 25 Nestlé Very Best in Youth. I will make good use of this money to provide puzzles to patients who will really benefit from them, and I thank Nestlé for their generous contribution.

I would also like to share with you some of the details and photos of my amazing visit to Los Angeles as a guest of Nestlé. Before the “official” festivities began, I had the opportunity to tour Warner Brothers Studios and Paramount Studios. Those were very interesting tours.

Most of the other “winners” arrived on Thursday. We were greeted by the smiling faces of Nestlé employees, who had set up a hospitality suite in our hotel. We were welcome to visit the hospitality suite at any time for drinks, for conversation, and, of course, for Nestle candy.

On Thursday afternoon, the boys were fitted for tuxes. (The girls had each received $100 to buy dresses.) Dinner on Thursday was our first official event. At this dinner, I met Henry, my official personal host from Nestlé USA. I cannot describe in sufficiently glowing terms how nice a person Henry is. He was friendly, encouraging, easy to talk to, and genuinely interested in and supportive of my work. Here is a photo of myself and Henry.

Dinner on Thursday was in a beautiful ballroom at the Hilton hotel. There was a surprise guest speaker. Hill Harper of CSI, New York, gave an inspiring presentation. He told the winners not to accept that something is too difficult, but to believe that we can do even more than meet our aspirations. Here is a photo of me with Hill Harper.

Even though Nestle planned for Saturday to be the most memorable day of our trip, for me, Friday will always be the most unforgettable. In the morning, we were taken to Nestlé headquarters for breakfast. Then, the winners were taken by bus to the Midnight Mission on Skid Row in Los Angeles. We packaged lunches and served lunches to the homeless who had come to the mission for food. Many of them asked me for extra packets of salad dressing. At that point, I really couldn’t understand why they wanted so much salad dressing. I wondered if they were actually eating straight salad dressing.

An eye-opening moment for me occurred when I saw a man actually get arrested in hand cuffs and taken away. What had he done? He had jumped the wall to get into the Mission grounds so he could get into the food line which had already closed.

The next time I saw Henry, I asked him why the homeless people kept asking for salad dressing, and my saddest imaginings were confirmed. These people were so hungry that they were eating salad dressing. It is one of the few things they can get “extra” of, and it has a high calorie content, which they desperately need.

I know that Alzheimer’s disease is a terrible disease, and we need treatments and cures. But, I have to say, having gone through seeing all the horrors of Alzheimer’s disease, that the plight of some of the people at the Midnight Mission is even more horrible.

Friday afternoon, all the winners were given tickets to Universal Studios. We headed out for hours of rides, shows, and fun. I noticed while I was there that many kids (not the Nestlé kids) had “front of the line” passes. They had paid an extra $72 to be able to get to the front of the lines and not have to wait to go on the rides.

That’s when I was hit by the poignant reality of my day. These people paid $72 to not wait in line for a ride while the man at the mission had been arrested for jumping a wall to get further up in line to get food because he was so hungry! That is one thought, one reality, that I will never forget.

Friday night, Nestlé took over the entire pool area at the hotel. They had a great dinner, a pool party, and a karaoke contest. Here are some photos of me singing with a group and singing alone.

Henry, my sponsor was one of the three Nestlé judges. They made us all laugh, and everyone had a great time.

Saturday, was planned as the culmination of our weekend. We had a nice breakfast together. After that, we attended break-out sessions, where the winners brainstormed about different causes and how we can make the world a better place. These were the nicest group of students with whom I have ever worked. I’m sure that every one of them will make an important difference in the world. They were all friendly, bright, ambitious, and, yet, humble.

Our Saturday night, black tie event, began at 4:30. Nestlé had taken over two ballrooms at the Hilton. They had run a red carpet down the length of the halls. The 24 winners walked the red carpet as they were photographed. Here’s a photo of me on the red carpet.

Henry sat next to me at the banquet, and we had a chance to talk. I am very fortunate to have been matched with a person of the caliber of Henry. I think he will become a lifelong friend.

Nestlé had hired a 12 piece band to entertain, and the awards were presented by the CEO of Nestlé as well as their spokesperson, Blake Griffin! Below is a photo of me receiving my award.

The music, the food, and the company were the best! I probably had just about the best time in my life. Below is a picture of me enjoying the party.

After the banquet hall closed at 11:15, the winners all went to another room to just talk and be friends. I stayed until 1:30 because my parents had asked me to not stay out after 1:30. I later found out that most others had stayed together until 3am. Even though these students were from very diverse backgrounds, we all understood each other, and we all shared common goals. We could have talked for days!

Sunday morning was our good-bye breakfast. Frankly, I had never had the experience before where people who had just met 3 days earlier were hugging each other and truly feeling sad to part; such were the connections we made.

Henry invited my family to breakfast on Monday morning, since we were staying over. Spending time with Henry is always enjoyable. Being a manager of international markets, Henry has friends all around the world. He has already made connections between his friends at BU and me. If Henry is representative of Nestlé employees, then no wonder the company is so successful!

Nestlé plans to continue to keep in touch with its winners and be supportive of their projects.

I had one more important thing to do before I could leave L.A. Back last fall, I received a phone call from a TV producer for the Fran Drescher Talk Show. She asked me to fly to L.A. to be on one of the pilot shows to talk about Alzheimer’s Disease. I wanted to, and I’m a big fan of Fran Drescher, but I just couldn’t leave all my classes at that time.

The TV producer and I spoke on the phone and by email several times, and she mentioned that she knows many people working in the field of Alzheimer’s disease, and that she would like for us to meet some time. So, on Monday, I met this TV producer for a lunch which lasted over two hours because we had so much to talk about.

On Wednesday, I’ll be returning to work at the Pharmacology lab. I love my job there. I understand a colony of mice for me to work with has been ordered while I was away. I have been working with a drug that seems to actually make a difference in the degradation of Amyloid Precusor Protein into Amyloid Beta.

Hill Harper said to believe I can outreach my aspirations. I aspire to make a real difference to patients with Alzheimer’s and their caregivers.

A Big Thank You from Fairways of Augusta

By Max Wallack
Puzzles to Remember

Today, I received this nice note:

“We wanted to send you a little note with a Big Thank You for the puzzles. We have enjoyed the quality time they allow us to spend together.”

Sincerely,
Our Family at Fairways of Augusta

I hope your family of residents continues to enjoy the puzzles and finds them calming and helpful.

Saturday, August 6, 2011

Puzzles Will be Shipped to Eleven Alzheimer’s Facilities This Week

By Max Wallack
Puzzles to Remember

I am happy to say that puzzles have been being donated at a generous rate. I spent today packing up cartons of puzzles that will be shipped to an additional eleven Alzheimer’s facilities this week.

I have also been in touch with several manufacturers that have agreed to make additional puzzle contributions.

Every response from nursing facilities has stated that the patients are greatly enjoying the puzzles.

Thursday, August 4, 2011

Many Puzzles Donated to Help Alzheimer’s Patients

By Max Wallack
Puzzles to Remember

Just a few weeks ago, PuzzlesToRemember had its puzzle inventory depleted. The public has stepped up and there have been many contributions in the past two weeks.

The local library collection boxes and bank location have yielded over 100 puzzles. In addition, I have been contacted by people around the country who wanted to contribute their puzzles.

Kerry, from the Philadelphia area, had over 100 puzzles to donate. I gave her the addresses of facilities in her area that could use the puzzles.

Rori from Minnesota also wanted to donate, and I sent her my flier and the location of an Alzheimer’s facility close to her home.

Rosanna from Florida, who has donated previously, had four big cartons of puzzles ready to go. Since, Rosanna doesn’t drive, I am trying to arrange for someone to pick up her puzzles and bring them to an Alzheimer’s center.

Kori, from Northern Kentucky, needed addresses to bring her 50 puzzles.

Martin writes that he plans to set up a puzzle collection site in Houston TX and then bring the puzzles to facilities in his area.

Thank you everyone, and please continue contacting me about where to bring your puzzles!