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Puzzles To Remember

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.

Tuesday, April 2, 2013

Can Aerobic Exercise and Environmental Enrichment Slow Alzheimer's Disease?

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By Max Wallack
PuzzlesToRemember

The benefits of aerobic activities for those with Alzheimer’s has been accepted for some time. Improving oxygen flow to the brain is good for us all.

Bob DeMarco, editor of the AlzheimersReadingRoom,  has told us many times how much more alert and “more there” Dotty, his mom, was each time she emerged from the gym, even though Dotty had never gone to the gym until her late 80’s.

A new research article (Li et Al, 2013) is showing that, perhaps, Dotty improved so greatly from her trips to the gym were not despite the fact that she didn't start until her late 80’s, but because of that fact.

In this study, scientists who were already providing wild mice with a running wheel for exercise, decided to add a novel toy or object to explore to their cage each day. The results were amazing. While the mice doing aerobic exercise were less impaired when injected with amyloid beta from Alzheimer’s patients, those mice who were given the novel toys each day were significantly less impaired than those with the aerobic exercise alone.

Could it be that the novelty of going to the gym every day had a significant effect upon Dotty, above and beyond the exercise factor?

It looks like that is a very real possibility. We all know and have accepted the fact that following a familiar routine is best for those with Alzheimer’s disease. However, research shows that it is also important to add something novel to the daily routine.

Dotty’s trips to the Banana Boat were even more than getting into the bright light and socializing with those she knew. Meeting new people may have also been very good for her.

Now, I think back to our many trips with Great Grams. We took her everywhere with us. It was as if we continued to live our lives normally and included her, even when she was greatly impaired. I never really considered the fact that our trip to Hawaii, where she was amazed seeing, for the first time in her life, pineapples and bananas growing, may actually have slowed down her disease a bit. Perhaps my own life, bringing her along to weekly taekwondo sessions, provided beneficial novel experiences for her.

In the research paper, it states that “environmental enrichment” stimulates the hippocampus, the same area that is most impaired by Alzheimer’s disease. This meshes well with my convictions that puzzles of various kinds can be therapeutic.

So, along with a predictable, daily, comfortingly familiar schedule, we should also try to work in at least one novel experience daily. It can be a puzzle, a trip, a new story, coloring, or painting. It doesn't matter. What matters is the new experiences. And, of course, adding it to an aerobic activity reaps the most benefits.

Have your worked aerobic exercise into your daily caregiving routine? How about "environmental enrichment"?

What are you doing that seems to make the person living with dementia "more there", or happier?

Please tell us about it.
Max Wallack is a student at Boston University and a Research Intern in the Molecular Psychiatry and Aging Laboratory in the Department of Pharmacology and Experimental Therapeutics at Boston University School of Medicine. 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.

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Wednesday, March 27, 2013

Over 80 Alzheimer’s Facilities Supplied With Puzzles in the Last Month

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By Max Wallack
Puzzles to Remember

The last month has been very busy for PuzzlesToRemember. Springbok’s PuzzlesToRemember, specialized puzzles for those with Alzheimer’s, have been sent out to 21 Memory Cafes, 30 Alzheimer’s units, and 3 Adult Day Care Centers. In addition, new and gently used puzzles have been supplied to 31 nursing facilities around the globe, from France to the United States to Canada.

Many wonderful notes of appreciation were received.

From the Orchard House in Connecticut:

“Please know that your support will make it possible for us to provide social interaction for elderly individuals with Alzheimer’s from our area.” 

From Willow Brook in Arkansas:

“Thank you so much for the puzzle donation! Our residents in the SCU love them! They really work and complete the puzzles because of the large puzzle pieces. Thanks again.) 

From Bright Horizons in New York:

“I wish to express my sincere thanks for your donation of puzzles to our programs. They will be used and enjoyed by our many members, and your generosity is greatly appreciated.” 

I also have been fortunate to be in touch with Gaby from Monterrey, Mexico. At Gaby’s suggestion, I will sending Springbok PuzzlesToRemember, and Gaby will distribute them to Alzheimer’s facilities in Mexico. Gaby really understands the value of puzzles. In addition to supplying puzzles to Alzeheimer's  facilities, Gaby says,

 “Once or twice a week some of my neighbors (children) come to my house to play with puzzles. (See attached photos.) I knew puzzles help to stimulate minds. And I wanted to help them to improve their grades and abilities having fun.”



Additionally, this month I was contacted by over a dozen individuals, whom I helped find locations in their area to which they could bring their gently used puzzles.

I am amazed that, just this month, I have been able to supply more puzzles than I did during the whole first year of PuzzlesToRemember!

Springbok and I have been consulting about the development of additional Alzheimer’s puzzles. In particular, many people have been requesting that we develop more images that would be appealing to men.

I also had the opportunity to give a research poster presentation at the American Association for Geriatric Psychiatry’s annual meeting in Los Angeles. It was a great experience, and I learned a great deal.

 •
Max Wallack is a student at Boston University and a Research Intern in the Molecular Psychiatry and Aging Laboratory in the Department of Pharmacology and Experimental Therapeutics at Boston University School of Medicine.  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.

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Sunday, January 20, 2013

Alzheimer's Puzzles - Sharing Joy!

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By Max Wallack
Puzzles to Remember
Everyone knows that a picture can be worth a thousand words.  These pictures say it all! Watch the faces as the puzzle gets completed!


Max Wallack is a student at Boston University and a Research Intern in the Molecular Psychiatry and Aging Laboratory in the Department of Pharmacology and Experimental Therapeutics at Boston University School of Medicine.  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.

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Saturday, January 19, 2013

Smiles For Alzheimer's Patients

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By Max Wallack
Puzzles to Remember


About a year ago, I was contacted by Gabe and Daniela Badescu, a couple that was caring for four Alzheimer’s patients in their facility in Temecula CA, called Temecu Hills Assisted Living.

They had been searching for beneficial activities for their patients, especially ones that might bring a sense of accomplishment. They asked if I knew of any puzzles that might meet this need.

In response, I sent 2 Springbok PuzzlesToRemember.

After using the puzzles, Gabe wrote:

"Hi Max - we received the puzzle you sent us - Thank you! I've attached a picture of one our residents enjoying the puzzle. It is very rewarding for our residents to be able to participate in an activity where they can achieve rather than fail. It leads to satisfaction rather than frustration". 

From my several correspondences with the Badescus, I knew that they were providing the kind of care that every Alzheimer’s patient should have! 

The Badescus have since founded another Alzheimer’s facility nearby, Vintage Hills Assisted Living. Their new website is www.seniornest.com, and their facebook page is www.facebook.com/comforteldercare.

Several new Springbok PuzzlesToRemember are on the way to their new facility, where the puzzles are being used for the most lofty purpose: they make Alzheimer’s patients smile.











Max Wallack is a student at Boston University and a Research Intern in the Molecular Psychiatry and Aging Laboratory in the Department of Pharmacology and Experimental Therapeutics at
Boston University School of Medicine.  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.

 

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Tuesday, January 15, 2013

Alzheimer's Puzzles Donated in Honor of Dr. Martin Luther King's Legacy

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By Max Wallack
Puzzles to Remember


This weekend, PuzzlesToRemember will be donating specialized Alzheimer's puzzles to twenty facilities in Georgia and Alabama to honor the legacy of Dr. Martin Luther King and his belief that everyone deserves equal treatment and respect.








Max Wallack is a student at Boston University and a Research Intern in the Molecular Psychiatry and Aging Laboratory in the Department of Pharmacology and Experimental Therapeutics at
Boston University School of Medicine.  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.


 

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Monday, January 14, 2013

Alzheimer's Helpers

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By Max Wallack
PuzzlesToRemember

One hundred and twenty five sixth through eighth graders in Northern Kentucky will collect puzzles and bring them to nursing facilities in Northern Kentucky.

At Brighton Center, in an impoverished area of Northern Kentucky, a program called Youth Leadership Development offers an extensive after school program for teens ages 9 - 15. In this program, the youth go over their entire 34 week school curriculum, and they are encouraged to think about the future, including college and career fields.

The students are also encouraged to become involved in community service projects, helping them build self-esteem, confidence, and leadership skills.

 I am proud to announce that, under the direction of Michelle Bullis, the Coordinator to the Youth Leadership Development program, 125 students will become involved in the work of PuzzlesToRemember. After collecting puzzles, these students will have an opportunity to deliver these puzzles and interact with patients in nursing facilities. This will be a win-win situation with confidence being inspired on both sides!

Ms. Bullis also plans to bring in speakers to talk with the youth about Alzheimer's disease. Ms. Bullis says her project is about "the youth taking control and learning through experience."

The Brighton Center also offers these teens a wealth of other opportunities. They have collected school supplies for needy students. They maintain a community garden. They write thank-you cards to our veterans. They also have a teen coalition that focuses on anti-bullying awareness and a drug free lifestyle.

All this is taking place in an area where there are 3,000 homeless youth and young adults! Yet, these students improve their own lives by helping others. This is philanthropy at its best!

As these students collect and deliver their puzzles to nursing and Alzheimer's facilities, I will post photos of their project and their success. You can learn more about the Brighton Center here.
 •
Max Wallack is a student at Boston University and a Research Intern in the Molecular Psychiatry and Aging Laboratory in the Department of Pharmacology and Experimental Therapeutics at Boston University School of Medicine.  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.

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Tuesday, January 8, 2013

5 New Alzheimer's Puzzles Created by Springbok

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By Max Wallack Puzzles to Remember

Springbok has created 5 new puzzles in their Springbok PuzzlesToRemember line. These are specialized puzzles for Alzheimer's patients. Here is what Springbok says about each puzzle in this series:


"This puzzle is from the specially created line of Springbok Puzzles: Puzzles to Remember. Designed for those who suffer from Alzheimer’s Disease, the extra large pieces allow for easy gripping and minimize the frustration caused by regular-sized pieces. The artwork is chosen for its beauty, and is a sharp contrast to other puzzles with a similar piece count designed for children. Many customers value these puzzles for not only the aforementioned reasons, but also as a source of comfort, joy and as a way to connect with a loved one." 

Here are images of the new puzzles. Clicking HERE should bring you to the Springbok site where they can be ordered:











All of these puzzles are 36 large sized pieces, with the exception of Coral Carnival, which is now available in 12 extra large sized pieces, as well as the 36 piece size.

Springbok has also donated 400 of these puzzles to PuzzlesToRemember.  This puzzles will be sent to Alzheimer's facilities, Adult Day Care centers, and Memory Cafes.

Max Wallack is a student at Boston University and a Research Intern in the Molecular Psychiatry and Aging Laboratory in the Department of Pharmacology and Experimental Therapeutics at Boston University School of Medicine.  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.

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Thursday, December 27, 2012

Why Do Alzheimer's Patients Wander?

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By Max Wallack
Puzzles to Remember 
Previously, I had heard about Alzheimer’s patients wandering as a non-goal directed behavior. People with Alzheimer’s disease frequently pace and are restless. It is reasonable that they might wander to an area which is now unfamiliar to them and become disoriented and lost.

The goal-oriented wandering is usually understood as searching for a place and time that the Alzheimer’s patients remembers that gave them peace and comfort.

The type of wandering that my family dealt with was escapist wandering. My Great Grams, who passed away from dementia in 2007, knew she was “in trouble” (her words), and always felt she needed to escape. She just didn’t understand that the fearful thing that she needed to escape was within her own brain.

Great Grams made many escapes. What she feared most was not having a home. What she feared was being put into a nursing institution or hospital. She would escape when she was fearful that we, her family, would put her into such a facility. The sad part of this was that her escapes would often make her greatest fears a reality.

The worst of Great Grams’ escapes came early one morning. Grandma and Grandpa were home with Great Grams. Grandma was still sleeping. Often Great Grams would plan her escape. One way we had a heads up was that we would notice that she would put on her nightgown on top of all her other day clothes, so she would be ready for her escape.

On this particular morning, Great Grams quietly snuck out of the house. The house is on top of a steep hill. Once you walk down the long street, you reach a major street. Keep in mind, Great Grams was about 92, and she had Paget’s disease of the bone, which, in her case, produced leg pain and a weak bowed left leg. Well, somehow Great Grams managed to run down that entire hill to the main street. Grandpa noticed she was gone, and ran after her. He didn’t even have time to put shoes on.

Now, Great Grams was a very fearful woman. She had been a fearful person her whole life. She was afraid of traffic, afraid of strangers, etc. Well, this fearful woman started flagging down trucks out on the major road to beg for help because we were “going to kill her”.

Let’s picture that scene. A tiny woman in her 90’s is standing on a major street corner with a man around 60. This man, wearing no shoes, is arguing with the woman.(He was trying to convince her to come home.) It didn’t take long for a truck to stop and offer help.

Then, the unbelievable happened. Great Grams, this tiny fearful woman with the bad leg, climbed up into the truck with this strange man. Her fears had driven her to do what she feared.

Fortunately, we learned later that the truck driver lived nearby, and he had accurately assessed the situation. He said he felt sorry for Grandpa.

He drove Great Grams to the police station, where she continued her accusations. The police sent her to the hospital by ambulance. She was then transferred to a psychiatric facility for several weeks, before she came home once again.

What Great Grams did, could not be considered wandering, in my mind, until I read the article explaining escapists. Great Grams ran in terror, and she usually ran toward what she feared most. She was an escapist.
 •

Max Wallack is a student at Boston University and a Research Intern in the Molecular Psychiatry and Aging Laboratory in the Department of Pharmacology and Experimental Therapeutics at Boston University School of Medicine.  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.

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Wednesday, December 26, 2012

Alzheimer's: Good Genes Gone Bad

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By Max Wallack
Puzzles to Remember

Many diseases are caused, at least in part, by bad genes, including phenylketonuria, alkaptonuria, Tay-Sachs disease, porphyria, and early-onset Alzheimer's.

Other conditions, like late-onset Alzheimer's, have complex causes, but certain genes are known to increase the risks.

Biologists have long wondered, if conditions like these are harmful, why hasn't natural selection eliminated them from our populations?

In case after case, it turns out that the allele, or gene variation, responsible for a disease sometimes confers a benefit that may explain why natural selection has not weeded it out of the population.

The best-studied example of this phenomenon is sickle-cell anemia, a disease caused by a mutation, HbS, in the gene for hemoglobin. Red blood cells in people who have two copies of the HbS allele have a greatly reduced oxygen-carrying ability, and under certain conditions they assume deformed, sickle-like shapes that clog the body's capillaries and produce painfully swollen joints, deformed skull bones, and an enlarged spleen. Without the proper drugs, people with sickle-cell anemia usually die before adulthood.

The HbS allele, however, is relatively frequent in many parts of Africa (and also in Laos and Cambodia). It turns out that a single copy of the HbS allele greatly reduces the chances of being bitten by malaria-carrying mosquitoes, or of actually getting malaria even if bitten. In swampy places where malaria mosquitoes abound, natural selection favors the HbS/HbA (heterozygous) condition, explaining the high prevalence of the HbS allele in many parts of the world. Other disease-causing genes that confer resistance to malaria include those causing thalassemia and G6PD deficiency.

Other possible examples are numerous. The gene that causes Tay-Sachs disease is thought to confer a degree of resistance to tuberculosis, a disease that once ravaged many European populations and that still persists in several of the poorest parts of the world. The gene causing cystic fibrosis is thought to have protected Medieval populations against the bubonic plague, and possibly also against tuberculosis

Huntington's disease is a genetic disorder that kills its victims after age 40, but the gene persists in many human populations because the people who eventually die from Huntington's may have a reproductive advantage and often have a greater-than-average number of children before they get the disease.

The Rh factor is a blood cell antigen that causes many infant deaths each year if an rh-negative mother makes antibodies against her Rh-positive baby. As in Huntington’s disease, the condition persists in the population because rh-negative mothers seem, on average, to have more children than other women.

One of the genes commonly associated with late-onset Alzheimer's disease is called ApoE4. Recent discoveries have shown that the ε4 allele of this gene, even when present in just a single copy, enhances memory performance in healthy teenagers, compared to the more common ε2 and ε3 alleles (see references at the end of this article).

In other words, the allele has cognitive benefits in terms of efficient memory earlier in life, but increases the risk of Alzheimer's disease much later in life. The same allele also reduces the chances of certain infections, including Chlamidia.(the most common sexually transmitted infection) and Giardia (a parasitic disease).

People who could avoid these infections and could learn better and remember more efficiently in their teens or young adult years might leave more children, even if they were destined to have Alzheimer's disease in old age. Natural selection would favor such an allele, especially in times past, when average longevity was well below 60 years and few people lived old enough to develop Alzheimer's.

Another, much rarer gene, TREM2, has recently come to light in Europe. Certain people in Iceland, Norway, and several other countries suffer from a condition, sclerosing leucoencephalopathy, in which the bones break down internally and an unusual dementia begins around 40-45 years of age. The dementia begins very slowly, but worsens dramatically after a few years and usually causes death before age 50.

Researchers studying the families of people with this disease found that carriers of the allele responsible for the disease were likely to develop Alzheimer's disease. Researchers also found that the normal allele of this gene helps maintain certain types of cells, including white blood cells, bone-eating osteoclasts, and microglial cells in the brain. The microglia patrol brain tissue and scavenge away the amyloid beta whose buildup forms the plaques that causes Alzheimer's disease. The mutated version of the TREM2 gene interferes with this scavenging activity, allowing the amyloid beta to accumulate and cause Alzheimer's.

Researchers who study the immune system are hopeful that studies of this scavenging activity in the brain can lead to a treatment for late-onset Alzheimer's.

REFERENCES


Max Wallack is a student at Boston University and a Research Intern in the Molecular Psychiatry and Aging Laboratory in the Department of Pharmacology and Experimental Therapeutics at
Boston University School of Medicine.  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.

Read More....

Saturday, December 8, 2012

Memory Cafes are Truly a Wonderful Thing for Alzheimer's Patients and Their Caregivers

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 Memory Cafes began in the Netherlands in 1997. The idea was the brainstorm of Bere Miesen, a Dutch psychiatrist.

By Max Wallack
PuzzlesToRemember

Miesen wrote:

“The Alzheimer’s café is an informal way to make contact with each other, to receive a consultation and feel at home. In the Netherlands, patients feel they have a place to just be. This way the patient and their family don’t have to deny or avoid the illness.”

By the year 2000, Dr. Miesen’s original café was attended by between 100 and 150 people each month. By that time, there were already 10 Memory Cafes in Holland. One caregiver at these early cafes commented,

“It is very difficult for carers to get time for themselves, recharge their batteries or receive respite support. The isolation they experience is sometimes unbearable.”

In November 2000, the first Memory Café opened in the United Kingdom. Today, most communities in Great Britain have one or two Memory Café meetings every month.

John and Susan McFadden from Wisconsin became involved in early Memory Cafes in the United States.  They describe them as a

“place where persons with early-stage dementia and their “carers” can come together to share social time unhampered by stigma, awkwardness or discomfort. One of the goals is to make certain no distinction is made between those who are living with memory loss and those who are not—all participants are simply enjoying time with one another. . . . Often, important ongoing friendships are formed.”

The McFaddens also offer these quotes from participants in the Memory Cafes:

“This time here when I come to the Memory Café, is the only time I feel like I am me again.’”

“I come in with a stranger and go home with my husband.”


The first Memory Cafes in the U.S. appear to have originated around 2008. Today, on the ThirdAge Services website, Carole Larkin provides a list of where they currently are, as well as a detailed pamphlet about how to begin a Memory Café in a new area. Click on Memory Cafe when you get to ThirdAge Services to find this information.

On my site, PuzzlesToRemember. I have included many photos of Alzheimer’s patients and their caregivers enjoying Springbok’s PuzzlesToRemember at Memory Cafes.

Memory Cafes are a Wonderful Thing for Alzheimer’s  Patients and Caregivers

One thing is clear, we need MANY MANY more Memory Cafes in the United States. Just watch this video to see how thankful the members of one U.S. Memory Café are to the UK Memory Cafes that they used as a model:





Max Wallack
Max Wallack is a student at Boston University and a Research Intern in the Molecular Psychiatry and Aging Laboratory in the Department of Pharmacology and Experimental Therapeutics at Boston University School of Medicine. 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.

Related content.

Original content the Alzheimer's Reading Room

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PUZZLES TO REMEMBER was founded in 2008 by Max Wallack, in memory of his great-grandmother, Gertrude Finkelstein, who died of Alzheimer's disease in 2007.
Puzzles To Remember is registered in Massachusetts as a public charity. Contributions are welcome, and are tax deductible under sec. 501(c.)3 of the Internal Revenue Code.

For more information, write to us at Puzzles2Remember@gmail.com