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Caring for older adults with dementia is stressful, especially when they become physically or verbally aggressive, wander away from home, develop paranoia or hallucinations, engage in inappropriate or repetitive behaviors, or refuse to let caregivers help them.

This story also ran on The Washington Post. It can be republished for free.

Upward of 95% of patients experience these neuropsychiatric symptoms of dementia, which tend to fluctuate over time and vary in intensity. Theyre the primary reasons people with dementia end up in assisted living facilities or nursing homes. At some point, families and friends trying to help at home simply cant manage.

When people think about dementia, they usually think about forgetfulness and memory impairment, said Mary Blazek, director of the geriatric psychiatry clinic at the University of Michigan. But its behavioral and psychological disturbances that are most disruptive to patients and caregivers lives. About ‘Navigating Aging’

Navigating Agingfocuses on medical issues and advice associated with aging and end-of-life care, helping Americas 45 million seniors and their families navigate the health care system.

To contact Judith Graham with a question or comment,click here.Read More Columns

Now, help is available from a first-of-its-kind website created by prominent experts in this field. It offers free training in a comprehensive approach to managing neuropsychiatric symptoms of dementia a method known as DICE based on several decades of scientific research as well as extensive clinical practice.

The websites goal is to give people tools to better manage often-distressing situations, said Helen Kales, chair of the Department of Psychiatry and Behavioral Sciences at UC Davis Health in Sacramento, California, and one of DICEs creators. Users learn that neuropsychiatric symptoms are caused by changes in the brain that increase peoples vulnerability. Nine video modules and two simulations provide comprehensive information and problem-solving techniques.

More than 16 million unpaid caregivers primarily family members and friends help people with dementia live at home. (An estimated 20% of patients live in institutional settings.) The most common form of dementia, Alzheimers disease, affects nearly 7 million Americans 65 and older.

DICE is also designed to help avoid the knee-jerk prescribing of psychoactive medications that have potentially serious side effects, Kales said. Several medical organizations recommend that non-pharmaceutical approaches to troublesome behaviors be tried before drug therapy, but, in practice, this doesnt routinely happen. Email Sign-Up

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Drugs prescribed for dementia include antipsychotic medications, such as Risperidone, which carry a black-box warning noting an increased risk of sooner-than-expected death in elderly patients; anticonvulsants, such as gabapentin, for which use has been on the rise despite concerns about safety; benzodiazepines, such as Ativan, which are associated with an increased risk of falls and, thus, fractures; and Celexa and other such antidepressants that have limited data supporting their effectiveness in easing dementia symptoms.

DICE is a mnemonic a pattern of letters meant to serve as a memory aid that stands for Describe, Investigate, Create, and Evaluate, the four pillars of this approach. At its core is an assumption people with dementia engage in disturbing behaviors for often-unrecognized reasons that can be addressed once they are understood.

Take an example on the website featuring Jennifer, a 55-year-old caregiver for her mother, Betty, 85, whom she tries to bathe daily in the late afternoon. When Betty resists getting into the tub, Jennifer insists, Lets go! I have things to do. Betty responds by smacking her and shouting, Leave me alone. It hurts.

DICE asks caregivers to step back from the heat of the moment and examine issues from three perspectives: the person with dementia, the caregiver, and the environment. All can contribute to distressing situations and all need to be considered in fashioning a response.

Examining the problem by using a who, what, when, how, why prompt can reveal several potential issues: The patient. Betty has arthritis and may experience pain getting in and out of the tub. She may feel tired and overwhelmed in the late afternoon. The caregiver. Jennifer may become easily frustrated when she encounters resistance adopting a scolding and commanding tone rather than breaking down what Betty needs to do in simple steps. The environment. The bathroom tends to be cold, with overly bright lights, tepid bathwater, and no grab bars around the tub.

Some possible solutions discussed on the website: Offer Betty an over-the-counter pain reliever before her bath. Try baths in the morning, not the afternoon. Relax expectations that shell have a daily bath and offer sponge baths several times a week. Install grab bars around the tub, and make sure the water temperature is comfortable. Use a nicely scented soap and play music to help Betty relax. Speak calmly, making simple statements.

These embody strategies shown to improve neuropsychiatric symptoms associated with dementia: recognizing and addressing underlying medical issues such as pain, infections, or delirium; simplifying the tasks a person with dementia is expected to perform; and establishing daily routines that give structure to the day.

Other important steps: Engage the person in activities that are meaningful to them, including social interactions. Reduce clutter and the potential for overstimulation in the environment. Make sure the person is using hearing or vision aids, if needed. Get them outside and exposed to light.

If safety, psychosis, or major depression are urgent concerns, then consider using psychoactive medications after consulting a physician.

Of course, this isnt a comprehensive list of recommendations. Nor is it prescriptive. What works for one person with dementia may not work for another.

Using DICE is an iterative process that involves creativity and frequent evaluation to assess whether strategies are working, Kales said. If not, new interventions should be tried.

Although this is the first time family caregivers can access the DICE toolkit, the program has been available to health care professionals for a while. Notably, all of Wisconsins dementia care specialists have been trained in DICE over the past few years (every county in that state has a specialist who helps families with dementia).

Its a really pragmatic approach thats put together in a very thoughtful fashion, said Art Walaszek, a professor of psychiatry and medicine at the University of Wisconsin School of Medicine and Public Health whos been involved in that effort.

Other dementia training programs are available, some of which review behavioral and psychiatric symptoms in less depth, and they, too, are increasingly available online. Another valuable resource, Best Programs for Caregiving, launched in March, lists evidence-based programs across the country and their availability. Enter a ZIP code to find information that previously hasnt been assembled in one place. This site, too, is very much worth consulting.

Were eager to hear from readers about questions youd like answered, problems youve been having with your care, and advice you need in dealing with the health care system. Visitkffhealthnews.org/columniststo submit your requests or tips.

Judith Graham: khn.navigatingaging@gmail.com, @judith_graham Related Topics Aging Navigating Aging Caregiving Dementia Nursing Homes Contact Us Submit a Story Tip

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Pakistan allocates 2,000MW power for Bitcoin mining and AI centers

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Pakistan allocates 2,000MW power for Bitcoin mining and AI centers

Pakistan allocates 2,000MW power for Bitcoin mining and AI centers

Pakistan has allocated 2,000 megawatts of surplus electricity exclusively for Bitcoin mining and artificial intelligence centers.

The move is part of a broader digital transformation plan spearheaded by the Pakistan Crypto Council and backed by the Ministry of Finance, according to a May 25 report by local news outlet 24NewsHD TV Channel.

In the first phase, the government plans to channel excess power into AI infrastructure and crypto mining operations. Finance Minister Muhammad Aurangzeb said the decision is expected to attract billions in foreign investment while generating high-tech employment across the country.

The initiative’s second phase will introduce access to renewable energy for mining operations, aiming to balance growth with environmental responsibility.

Related: Trump-backed World Liberty Financial partners with Pakistan Crypto Council

Pakistan unveils tax incentives to attract investors

Per the report, interest from international Bitcoin (BTC) miners and AI firms has already picked up. Officials confirmed that multiple foreign delegations have visited Pakistan in recent months to explore potential partnerships.

To further incentivize investment, the Ministry of Finance announced a package of tax incentives for AI centers and duty exemptions for Bitcoin miners.

Bilal Bin Saqib, CEO of Pakistan’s Crypto Council, reportedly welcomed the development, calling it a “turning point” for the country’s digital economy.

Saqib claimed that with clear regulations and a transparent framework, Pakistan could emerge as a significant player in the global crypto and AI sectors.

Saqib first proposed using the country’s runoff energy to fuel Bitcoin mining at the Crypto Council’s inaugural meeting on March 21.

The meeting included lawmakers, the Bank of Pakistan’s governor, the chairman of Pakistan’s Securities and Exchange Commission (SECP), and the federal information technology secretary.

Related: Pakistan proposes compliance-based crypto regulatory framework — Report

Pakistan creates Digital Asset Authority

On May 21, Pakistan’s Ministry of Finance endorsed the creation of a dedicated body to regulate blockchain-based financial infrastructure in the country.

The Pakistan Digital Assets Authority (PDAA) will serve as a regulatory body to oversee licensing and regulating exchanges, custodians, wallets, tokenized platforms, stablecoins, and decentralized finance applications.

The PDAA will also be tasked with tokenizing national assets and government debt, facilitating monetization of Pakistan’s surplus electricity through regulated Bitcoin mining, and helping startups build blockchain-based solutions at scale.

Pakistan ranked highly in Chainalysis’ 2024 crypto adoption index, coming in ninth, mainly due to strong retail adoption and transactions at centralized services.

Pakistan allocates 2,000MW power for Bitcoin mining and AI centers
Pakistan ranked highly in Chainalysis’ 2024 crypto adoption index, coming in 9th. Source: Chainalysis

Data from Statista also shows Pakistan’s crypto market is “experiencing rapid growth,” estimating the number of crypto users to amount to over 27 million by 2025, out of a population of 247 million.

Magazine: Bitcoin bears eye $69K, CZ denies WLF ‘fixer’ rumors: Hodler’s Digest, May 18 – 24

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Crypto investor charged with kidnapping, torturing an Italian for passwords

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Crypto investor charged with kidnapping, torturing an Italian for passwords

Crypto investor charged with kidnapping, torturing an Italian for passwords

A Manhattan crypto investor is facing serious charges after allegedly kidnapping and torturing an Italian man in a disturbing bid to extract access to digital assets.

John Woeltz, 37, was arraigned on Saturday in Manhattan criminal court following his arrest on Friday. He stands accused of holding a 28-year-old Italian man captive for weeks inside a luxury townhouse in Soho, reportedly rented for $30,000 per month.

According to police reports cited by The New York Times, the victim arrived in the US on May 6 and was allegedly abducted by Woeltz and an accomplice.

The attackers are said to have stolen the man’s passport and electronic devices before demanding the password to his Bitcoin (BTC) wallet. When he refused, the suspects allegedly subjected him to prolonged physical abuse.

Crypto investor charged with kidnapping, torturing an Italian for passwords
Source: Mario Nawfal

Related: Violent crypto robberies on the rise: Six attacks that targeted investors

Crypto victim beaten, electroshocked

The victim described being beaten, shocked with electricity, assaulted with a firearm and even dangled from the upper floors of the five-story building.

He also told police that Woeltz used a saw to cut his leg and forced him to smoke crack cocaine. Threats were also reportedly made against his family.

Photographic evidence found inside the property, including Polaroids, appears to support claims of sustained abuse. The victim managed to escape on Friday and alert authorities, leading to Woeltz’s arrest.

Woeltz was charged with four felony counts, including kidnapping for ransom, and entered a plea of not guilty. Judge Eric Schumacher ordered him to be held without bail. He is expected back in court on May 28.

A 24-year-old woman was also taken into custody on Friday in connection with the incident. However, she was seen walking freely in New York the next day, and no charges against her were found in the court’s online database.

Authorities have yet to clarify the relationship between the suspect and the victim or whether any cryptocurrency was ultimately stolen.

Related: Crypto crime goes industrial as gangs launch coins, launder billions — UN

Crypto executives turn to bodyguards

Executives and investors in the crypto industry are increasingly seeking personal security services as kidnapping and ransom cases surge, especially in France.

On May 18, Amsterdam-based private firm Infinite Risks International reported a rise in requests for bodyguards and long-term protection contracts from high-profile figures in the space.

French authorities have responded by introducing enhanced protections for crypto entrepreneurs and their families, including security briefings and priority access to police assistance.

This comes amid a recent surge in kidnappings and ransom attempts. David Balland, the co-founder of hardware wallet company Ledger, was kidnapped in January 2025 and held for ransom for several days before being rescued by French police.

In May 2024, the father of an unnamed crypto entrepreneur was freed from a ransom attempt after French law enforcement officials raided the location in a Paris suburb where the individual was being held hostage by organized criminals.

Magazine: Bitcoiner sex trap extortion? BTS firm’s blockchain disaster: Asia Express

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Gail’s backer plots rare move with bid for steak chain Flat Iron

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Gail's backer plots rare move with bid for steak chain Flat Iron

A backer of Gail’s bakeries is in advanced talks to acquire Flat Iron, one of Britain’s fastest-growing steak restaurant chains.

Sky News has learnt that McWin Capital Partners, which specialises in investments across the “food ecosystem”, has teamed up with TriSpan, another private equity investor, to buy a large stake in Flat Iron.

Restaurant industry sources said McWin would probably take the largest economic interest in Flat Iron if the deal completes.

They added that the two buyers were in exclusive discussions, with a deal possible in approximately a month’s time.

The valuation attached to Flat Iron was unclear on Sunday.

Flat Iron launched in 2012 in London’s Shoreditch and now has roughly 20 sites open.

The chain is solidly profitable, with its latest accounts showing underlying profits of £5.7m in the year to the end of August.

It already has private equity backing in the form of Piper, a leading investor in consumer brands, which injected £10m into the business in 2017.

Flat Iron was founded by Charlie Carroll, who retains an interest in it, but the company is now run by former Byron restaurant boss Tom Byng.

Houlihan Lokey, the investment bank, has been advising Flat Iron on the process.

McWin has reportedly been in talks to take full control of Gail’s while TriSpan’s portfolio has included restaurant operators such as the Vietnamese chain Pho and Rosa’s, a Thai food chain.

A spokesman for McWin declined to comment.

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