Alzheimer's

The most common form of dementia, Alzheimer's is a progressive neurodegenerative brain disorder. It was first described by German psychiatrist and neuropathologist Alois Alzheimer in 1906, and was named after him. Normal brain cell function is gradually destroyed, leading to irreversible declines in memory, cognition, and behavior. But what causes things to go awry remains unknown. It may be that Alzheimer's has several causes or that the interplay between genetic makeup and certain risk factors determines who's affected. (Wiki; Spencer; Park)
In 2006, there were 26.6 million sufferers worldwide. Alzheimer's is predicted to affect 1 in 85 people globally, and the number of Alzheimer's patients will grow to 13.4 million by 2050. More than five million Americans currently suffer from Alzheimer's disease. There is no cure. There isn't a definitive test for Alzheimer's. Current therapies can only delay, not stop the onset of memory loss, confusion, and cognitive decline. (Wiki; Spencer; Park)
Causes: It is thought that the disease is caused by a buildup of protein-based plaques in the brain. The disease begins when the brain starts to churn out amyloid, a long protein which is then cut by enzymes into fragments. These fragments become molecularly sticky and clump together, forming a plaque. Once the plaques form, tau protein that maintains the integrity of the neural highway break down, leaving the equivalent of potholes that interrupt the electrical signals traveling along the nerve. With this disruption, nerve cells start to wither and die, leaving behind their remains. The result is a brain full of dead and dying neurons. The shutdown of neural connections leads to a drop in cognitive function. (Park)

Risk factors for Alzheimer's: (Spencer)
1. Age: Age is the most significant established risk factor for Alzheimer's disease. One in 7 people over age 71 has some form of dementia, and 2.4 million of these have Alzheimer's, according to the latest National Institutes of Health data. The percentage of people with Alzheimer's rises from just 2.3 percent of those ages 71 to 79 to 18 percent of those ages 80 to 89, and 29.7 percent of those 90 or older. Some estimates say as many as half of all people over age 85 have Alzheimer's disease.The total number of people with the disease doubles with every five-year age jump after age 65.
2. Gender: Women live longer than men, on average, and Alzheimer's disease risk rises with age. Research indicates that a lack of estrogen after menopause may contribute to the fact that slightly more women are affected. Taking hormone-replacement therapy has not been shown to protect against Alzheimer's. Vascular dementia is more common in men than women, probably because more men develop contributing factors such as hypertension and vascular problems.
3. Family history: People with a family history of Alzheimer's are more likely to develop the disease. The risk is thought to rise with each relative who had it.
It's unknown, though, exactly how much of this association is due to genetic factors and how much is due to shared lifestyle factors. Most experts believe that some combination of the two is responsible. Even when an immediate family member has the disease, however, your increased risk is only slightly higher than if your family had no history of dementia.
Up to 80 percent of Alzheimer's risk may have a genetic component, according to a 2006 study of more than 12,000 Swedish twin sets -- a greater influence than was previously thought. But having a relative with the disease does not doom a person to a similar fate; even among identical twins, when one male twin had it, almost half of the time the other twin did not. Among female twins, the other twin developed Alzheimer's 60 percent of the time, a difference researchers attributed to the fact that women generally live longer than men.
One kind of genetic test identifies a person's risk of developing Alzheimer's disease but doesn't guarantee whether or not he'll develop the condition. Everyone inherits a form of the apolipoprotein (APOE) gene from each parent. Apolipoprotein helps carry cholesterol in the blood. Its three most common forms are APOE-e2, APOE-e3, and APOE-e4. Those who have two copies of APOE-e4 seem to be at the highest risk of getting Alzheimer's and of developing symptoms earlier in life. Having one copy of APOE-e4 also elevates the risk. Only about 15 percent of people carry the APOE-e4 form.
A second type of existing genetic test for Alzheimer's disease can predict with certainty who develops one rare form of the disease. This is early-onset familial Alzheimer's disease, which strikes between the ages of 30 and 65 and stretches through multiple generations. It accounts for less than 5 percent of all cases.
4.Smoking: Evidence is growing that smoking raises the risk of developing Alzheimer's disease by as much as 50 percent. In late 2007, Dutch researchers who tracked almost 7,000 people age 55 or older for 7 years reported that current smokers were more likely to develop dementia than people who had never smoked or had quit. Interestingly, the effect was more pronounced for people who did not have the APOE-e4 gene (the type known to be most vulnerable to the disease). Smoking didn't raise the already elevated risk of Alzheimer's in those who had the APOE-e4 gene. (Spencer)
5. Head injury: Prior head injury -- even years earlier -- is linked with a greater risk of developing Alzheimer's, though it's not clear why. That's not to say that any youthful bump will lead to Alzheimer's. The injury itself isn't thought to directly cause the disease, although it may hasten the process. But the more severe the trauma, the greater the risk of developing Alzheimer's, according to a large study of World War II veterans. The most concerning are thought to be falls with head injuries that occur later in life.
6. Education: People with lower education levels are more often affected by Alzheimer's disease. Researchers theorize that longer education helps the brain develop stronger, denser, more complex connections between brain cells, creating more cognitive reserve. This positions the brain to be better able to withstand the abnormal stresses associated with Alzheimer's disease and compensate for the changes that occur.
7. Diet and nutrition: Although there's no "Alzheimer's-prevention diet," a growing body of research indicates that nutrition influences brain health and may protect against or postpone cognitive decline. Specifically, your overall risk of Alzheimer's may be lower if you consume:
· B vitamins: People who are folate (B-9) deficient may run triple the risk of developing dementia, according to recent South Korean data. Previous research showed vitamin B-12 to be protective.
· Vitamin E: Those who consume the highest dietary amounts of this antioxidant have a lower incidence of Alzheimer's. Vitamin E supplements have not been shown to have the same protective effect.
· Vitamin C: Another antioxidant, vitamin C, seems to have a protective effect in certain people, though possibly only in dietary form. Antioxidants counter the effects of oxidative stress, which is linked to nerve cell damage and death. Over-the-counter vitamin C supplements did not reduce Alzheimer's risk in a recent study of 2,969 people 65 and older.
· A heart-healthy diet: People who consume a generally balanced diet that avoids too much fat and includes complex carbohydrates are less likely to develop conditions that are Alzheimer's risks, including obesity, diabetes, and cardiovascular disease.
8. Exercise: Regular exercise reduced the risk of dementia by as much as 40 percent in a 2006 study of nearly 2,000 people age 65 and older. This was the first study to factor in one's pre-existing physical condition. And those most frail at the start of the study showed the greatest protection against dementia if they exercised. The threshold that made a difference: physical activity for at least 15 minutes, three times a week. Exercise both lowers the risk of obesity and cardiovascular conditions linked to Alzheimer's and reduces the risk of developing dementia.
Previous research has shown that the variety of activity engaged in is more important than the intensity of a workout, when it comes to providing brain benefits. (Variety of workouts had no benefit, though, to those with the APOE-e4 gene variation most commonly associated with Alzheimer's.)
9.Mental stimulation: Just as physical activity exercises the body, "cognitive activity" exercises the brain. Numerous studies now support the "use it or lose it" idea that mental workouts lower the risk of dementia. For example, participants in the Religious Orders study who attended museums, worked puzzles, and read newspapers were 47 percent less likely to develop Alzheimer's after four years than those who did such activities less frequently.
Brain-stretching activities can't prevent Alzheimer's, but they help the brain better withstand the physical changes associated with it. What's key: The stimulation should be ongoing.
10.Social stimulation: Isolation is a risk factor for developing dementia, probably because there's less opportunity for mental stimulation. But a surprising 2007 study also found that people who were around others but felt lonely (emotional isolation) were also at higher risk for Alzheimer's. This sense of loneliness wasn't a result of the disease (as is often the case with depression) but a clear precursor.

Symptoms: Short-term memory loss is one of the most noticeable signs of Alzheimer's disease. But the disease process usually begins before symptoms are noticed. To assess someone's risk of becoming one of the more than 5 million Americans with Alzheimer's, it's helpful to understand the risk factors that increase the odds of developing the condition. (Spencer).

Only a qualified physician can conclude with high certainty that a living person has Alzheimer's disease. But the following eight symptoms are strongly associated with the disease. If you detect these signs in someone, it would be wise to seek a medical evaluation.
Alzheimer's symptom #1: Memory lapses (Spencer)
1. Does the person ask repetitive questions or retell stories within minutes of the first mention?
2. Does she forget the names of recent acquaintances or younger family members, such as grandchildren?
3. Are memory lapses growing progressively worse (such as affecting information that was previously very well known)?
4. Are they happening more frequently (several times a day or within short periods of time)?
5. Is this forgetfulness unusual for the person (such as sudden memory lapses in someone who prided herself on never needing grocery lists or an address book)?

Having problems with memory is the first and foremost symptom noticed. It's a typical Alzheimer's symptom to forget things learned recently (such as the answer to a question, an intention to do something, or a new acquaintance) but to still be able to remember things from the remote past (such as events or people from childhood, sometimes with explicit detail). In time, even long-term memories will be affected. By then other Alzheimer's symptoms will have appeared.
Alzheimer's symptom #2: Confusion over words
1. Does the person have difficulty finding the "right" word when she's speaking?
2. Does she forget or substitute words for everyday things (such as "the cooking thingamajig" for pot or "hair fixer" for comb)?
3. Of course it's normal for anyone to occasionally "blank" on a word, especially words not often used. But it's considered a red flag for Alzheimer's if this happens with growing frequency and if the needed words are simple or commonplace ones.
This can be a very frustrating experience for the speaker. She may stall during a conversation, fixating on finding a particular word. She may replace the right word with another word. This substitute could be similar enough that you could guess at her meaning ("hair dryer" instead of "hairdresser"), especially early on in the disease process. Or it could be completely different ("bank" instead of "hairdresser") or nonsensical ("hairydoo").
Alzheimer's symptom #3: Marked changes in mood or personality
1. Is the person who's usually assertive more subdued (or vice versa)? Has the person who's reserved become less inhibited (or vice versa)?
2. Does s/he withdraw, even from family and friends, perhaps in response to problems with memory or communication?
3. Has she developed mood swings, anxiety, or frustration, especially in connection with embarrassing memory lapses or noticeable communication problems?
4. Has she developed uncharacteristic fears of new or unknown environments or situations, or developed a distrust of others, whether strangers or familiar people?
5. Do you see signs of depression (including changes in sleep, appetite, mood)?
Mood shifts are a difficult sign to link decisively to Alzheimer's disease because age and any medical condition may spark changes in someone's mood, personality, or behavior. In combination with other Alzheimer's symptoms, however, changes such as those described above may contribute to a suspicion of the disease.
A person with Alzheimer's may also become restless and/or aggressive, but usually in later stages of the disease.
Alzheimer's symptom #4: Trouble with abstract thinking
1. How well does the person handle relatively simple mathematical tasks, such as balancing a checkbook?
2. Is she having trouble paying bills or keeping finances in order, tasks she previously had no problem completing?
3. Does she have trouble following along with a discussion, understanding an explanation, or following instructions?
Abstract thinking becomes increasingly challenging for someone with Alzheimer's, especially if the topic is complex or if the reasoning is sequential or related to cause and effect.
Alzheimer's symptom #5: Difficulty completing familiar activities
1. Has the person begun to have trouble preparing meals?
2. Is she less engaged in a hobby that once absorbed her (bridge, painting, crossword puzzles)?
3. Does she stop in the middle of a project, such as baking or making a repair, and fail to complete it?
4. Has she stopped using a particular talent or skill that once gave her pleasure (sewing, singing, playing the piano)?
5. Activities with various different steps, however routine and familiar, can become difficult to complete for a person with Alzheimer's. Your parent might become distracted or lose track of where she is in the process, feeling confused. Or she might just lose interest altogether and leave a project unfinished.
Alzheimer's or some other form of dementia is especially suspect when the difficult or abandoned activity is something the person formerly delighted in and excelled at, or used to engage in frequently.
Alzheimer's symptom #6: Disorientation
1. Has the person begun to be disoriented in new or unfamiliar environments (such as a hospital or airport), 2. asking where she is, how she got there, or how to get back to a place she recognizes?
2. Has she become disoriented in an environment she knows well?
3. Does she wander off and get lost in public (or get lost when driving or after parking)?
4. Does she lose track of the time, day, month, or year? For example, after being reminded about a future doctor's appointment over the phone, she may start getting ready for the appointment right away. Or she may have trouble keeping appointments and remembering other events or commitments.
These examples of disorientation are all typical Alzheimer's symptoms, more so in later stages of the disease but sometimes early on as well.
Alzheimer's symptom #7: Misplacing items
1. Does the person "lose" items often?
2. Do they turn up in unusual places (such as finding a wallet in the freezer)?
Losing track of glasses, keys, and papers happens to most adults sometimes, whether due to age or just a busy lifestyle. However, it may be a symptom of Alzheimer's if this behavior escalates and if items are sometimes stored in inappropriate or unusual places, and your parent doesn't remember having put them there.
Alzheimer's symptom #8: Poor or impaired judgment
1. Has the person recently made questionable decisions about money management?
2. Has she made odd choices regarding self-care (such as dressing inappropriately for the weather or neglecting to bathe)?
3. Is it hard for her to plan ahead (such as figuring out what groceries are needed or where to spend a holiday)?
Difficulty with decision-making can be related to other possible symptoms of Alzheimer's, such as lapses in memory, personality changes, and trouble with abstract thinking. Inappropriate choices are an especially worrisome sign, as your parent may make unsound decisions about her safety, health, or finances.
Many of these Alzheimer's symptoms go unnoticed for a long time. That's because they're often subtle or well concealed by the person (or a spouse), who may be understandably freaked out by the changes she's noticing in her own behavior. Some patterns of behavior take time to make themselves obvious. (Spencer)

(To be continued)

Sources:
Alice Park. "Alzheimer's Unlocked".Time (Oct 25, 2010),pp. 53-59.
Paula Spencer. http://www.caring.com/articles/alzheimers-symptom-misplacing-items#ixzz1IfZU2ILr.
http://www.caring.com/articles/education-and-diet-alzheimers-risk#ixzz1IfhdlnDX.
http://en.wikipedia.org/wiki/Alzheimer%27s
http://www.caring.com/alzheimers#ixzz1IqtT7T2i
http://www.caring.com/articles/late-stage-alzheimers-health-care#ixzz1Iqw4Od00
http://www.caring.com/end-stage-alzheimers#ixzz1IqvRd6Gc
By Maria M. Meyer, Mary S. Mittelman, Cynthia Epstein, and Paula Derr,
http://www.caring.com/articles/severe-alzheimers#ixzz1Iqv0CgUE
http://www.caring.com/articles/moderate-alzheimers#ixzz1IqudDonU
http://www.caring.com/articles/mild-alzheimers#ixzz1Iqu5g8oJ

For more information, please check:
Alzheimer's Disease Centers (ADCs)
Alzheimer's Disease Education and Referral (ADEAR) Center
Alzheimer's Association
UCSF Memory and Aging Center
Richard Taylor. Alzheimer's From the Inside Out
National Institute on Aging. nia.nih.gov/Alzheimer's
Alzheimer's Association. alz.org

The Heart of the Practice

One of the most accomplished Tibetans masters of the seventeenth century, Tsele Natsok Rangdrol, explains the heart practices of the bardos --this life, dying, dharmata, and becoming-- in terms of the state of our present understanding of the nature of thoughts and emotions, and of mind and its perceptions:

Recognize this infinite variety of appearances as a dream,
As nothing but the projections of your mind, illusory and unreal,
Without grasping of anything, rest in the wisdom of your Rigpa, that transcend all concepts:
This is the heart of the practice for the bardo of this life.

You are bound to die soon, and nothing then will be of any real help.
What you experience in death is only your own conceptual thinking.
Without fabricating any thoughts, let them all die into the vaast expanse of your Rigpa's self awareness:
This is the heart of the practice for the bardo of dying.

Whatever grasps at appearance or disappearance, as being good or bad, is your mind.
And this mind itself is the self-radiance of the Dharmakaya, just whatever arises.
Not to cling to the risings, make concepts out of them, accept or reject them:
This is the heart of the practice for the bardo of dharmata.

Samsara is your mind, and nirvana is also your mind,
All pleasure and pain, and all delusions exist nowhere apart from your mind.
To attain control over your own mind;
This is the heart of the practice for the bardo of becoming.

Source:
Sogyal RinpocheThe Tibetan Book of Living and Dying(New York, NY: HarperCollins, 1992).

Religion and Moral or Spiritual Training

Do humans need religions? The Dalai Lama said religious rituals, temples and religions are luxuries. What we need is to build the temple inside, and to devote ourselves to daily spiritual practice. Everybody has the capacity to transform him-/herself morally and spiritually if s/he wants to attain liberation from negative emotions, false perceptions, and the cycle of birth and death full of sufferings. Spiritual practice is fundamentally dedicated to this transformation. Buddhist teachings provide us the methods and guidelines, and the Buddha is our Master. Of course in life we may encounter various teachers, and learn from many others in various situations. However, it is the practitioner who embarks on the spiritual journey , and who takes the most responsibility in his/her spiritual transformation and ultimate liberation.


Source:
The Dalai Lama: My Spiritual Journey (New York, NY: HarperCollins, 2010). Collected by Sofia Stril-Rever, and translated by Charlotte Mandell.

Stress

Stress can be caused by both internal and external factors, and we should distinguish false from real stressors. Although it is harder for us to change our situation and the environment, at least we can examine ourselves, and change our way of living or thinking, and reduce internal stressors. Sometimes we impose more pressure on ourselves than necessary, without knowing it. For example, setting too high standards to achieve, or thinking that only you yourself, and nobody else, can do the task makes your life more stressful. People may feel too worried and fearful. Worries and fears usually come from lack of knowledge, lack of self-confidence or lack of control of the situation.

What should we do then? Lower your standards, and learn to accept the imperfectness in life. Delegate responsibilities to others, but do not expect others to do exactly as you would like them to. Research for information to help you solve the problem, or get help from others by sharing, discussing, and asking for their opinions. Do not keep to yourself, but build up a support network. You may even seek professional advice and assistance.
You may need to break a big task into smaller chunks, and tackle one at a time. Most importantly, remember to take care of yourself, and reward yourself whenever you make some good progress, however little it seems. Your mental response can make or break how well you weather the storm. A valuable insight is that stress swamps the immune system, making existing symptoms worse and speeding disease. New research says stress also piles on abdominal fat, which nobody wants.


For more information, go to:
http://www.caring.com/blogs/caring-currents/stress-causes#ixzz1IHiz3jAo
By Paula Spencer (2005), Caring.com senior editor.

The Environment and Our Choices

The environment is not a question of religion or morality; it is a question of survival of all beings. Life on earth depends on nature, and we simply cannot survive if we act against it. Moreover, we must take into consideration future inhabitants of the earth. Our responsibility is to hand down to our children and grandchildren a healthy world, if not a healthier world than we found it. One person's capacity is limited, but together we can make a huge change in preserving the earth's resources, and protect the environment. (Stril-Rever, pp. 152-153).

Since the 1990s many United Nations declarations have been written to inspire people around the world to a new sense of interdependence and share responsibility (universal responsibility) for the well-being of humanity and all living beings on earth. When we look at the earth from outer space, we don't see borders of separate nations, we see only ONE PLANET. Why don't we join together to bring forth a sustainable global society founded on respect for nature, universal human rights, economic justice, and a culture of peace?

Humanity is facing two choices: either to form a global partnership to care for the earth and one another, or to risk the destruction of ourselves and the diversity of life on earth. The choice is ours. To survive, we need to have fundamental changes in our values, institutions, and ways of living. We also must identify ourselves with not only our local communities but also the whole earth community, and live with a sense of humility, universal responsibility, and human solidarity. (Stril-Rever, pp. 158-159).

Source:
The Dalai Lama: My Spiritual Journey (New York, NY: Harper Collins, 2010). Collected by Sofia Stril-Rever and translated by Charlotte Mandell.

Rebirth and Reincarnation Part 2

Reincarnation is described as the continuity of the highest level of the subtle mind or consciousness from one life to another. Reincarnation is not a simple physical birth of a person. At a certain high level or stage, you may develop a certain spiritual realization, then the birth through karma will cease. With will power, you can choose your rebirth. This type of rebirth is called reincarnation. Reincarnation allows a Buddha or a Bodhisattva to continue his/her efforts to liberate all sentient beings from sufferings. Its purpose is to facilitate the continuation of a being's work, which may have important consequences (Stril-Rever, pp. 65-67).

In August 2007 the official Chinese news agency announced a new rule about the recognition of"living buddhas," an expression the Chinese use to designate reincarnate masters. Henceforth, "all requests for recognition of a reincarnation of a 'living buddha' must be approved by the Bureau of Religious Affairs," under penalty of law. The Dalai Lama has commented on these measures with humor:

This bizarre decision proves that its authors who somehow pride themselves in delivering 'reincarnation permits' understand nothing about either reincarnation or Buddhism. (Stril-Rever, pp. 68-69)

In the speech he gave when he presented the Nobel Peace Prize to the Dalai Lama, Egil Aarvik observed:

The process of recognizing a reincarnation implies entering what is, for a Westerner, terra incognita, where beliefs, thought and action exist in a dimension of existence of which we are ignorant, or that perhaps we have simply forgotten.
(Egil Aarvik, Oslo, December 10, 1989; quoted by Stril-Rever, p. 69)

The notion of the transmigration of the soul definitely does not exist in Buddhism. In Buddhism there is no independent and unchanging entity (something called "a soul" or "an ego"). What provides the continuity between lives is the ultimate subtlest level of consciousness (Sogyal, p.90). The Dalai Lama explains:

There are different levels of consciousness. What we call innermost subtle consciousness is always there. The continuity of that consciousness is almost like something permanent, like the space particles. In the field of matter, that is the space particles; in the field of consciousness, it is the Clear Light...The Clear Light with its special energy, makes the connection with consciousness."

(His Holiness the Dalai Lama, in a dialog with David Bohm, in Dialogs with Scientists and Sages: The Search for Unityedited by Renee Weber. London: Routledge and Kegan Paul, 1986, p. 237).

The successive existences... are not like the pearls in a pearl necklace held together by a string, the "soul,"... rather they are like dice piled one on top of the other. Each dice is separate, but it supports the one above it, with which it is functionally connected. Between the dice there is no identity, but conditionality.

(H. W. Schumann. The Historical Buddha London: Arkana, 1989, p. 139).

"As one form changes into another, so is the mind born and broken up thence I tell my disciples how uninterruptedly and momentarily birth-[and death] takes place."(The Lankavatara Sutra)

Buddhist scriptures provide a clear account of this process of conditionality in the set of questions and answers between the Buddhist sage Nagasena and King Milinda:

The King asked Nagasena: "When someone is born, is he the same as the one who just died, or is he different?"
Nagasena replied: "He is neither the same, nor different...Tell me, if a man were to light a lamp, could it provide light the whole night long?"
"Yes"
"Is the flame which burned in the first watch of the night the same as the one that burns in the second... or the last?"
"No."
"Does that mean there is one lamp in the first watch of the night, another in the second, and another in the third?"
"No. It's because of that one lamp that the light shines all night."
"Rebirth is much the same: one phenomenon arises and another stops, simultaneously. So the first act of consciousness in the new existence is neither the same as the last act of consciousness in the previous existence, nor is it different."

Perhaps the best way of explaining rebirth is using an analogy of the flame and the candle. The flame burns until the candle is almost finished. As the flame begins to flicker out, a second candle is lit from the first. The flame of the first candle now dies out completely, leaving only the second candle burning. The flame burns away the second candle and, again, just before it reaches its end and flickers out, a third candle is lit from that . . . and so on, and so forth. The flame flickers and burns continuously and the candles are constantly being used up and renewed. The candles represent physical bodies; the flame, the mind. The two work harmoniously together — an interplay of mind and body. This combination of mind and body is what we usually think of as 'ourselves'. The body gets older and older as the years roll by until it falls into decay and, like the candle, is incapable of being used any more. The mind, like the flame, twists and turns constantly, the same yet not the same, different yet not different, from moment to moment, day to day, year to year, and from life to life. There is nothing permanent or static in the candle or the flame; they are constantly changing. There is nothing permanent or static in the mind and body either. In this impermanence there is no eternity and no annihilation. Instead there is a re-becoming process.


Sources:
Sylvia Cranston & Carey Williams, Reincarnation: A New Horizon in Science, Religion, and Society, (New York, NY: Julian Press, 1984).

http://www.knowbuddhism.info/2009/03/rebirth-reincarnation-and-recognition.html

The Dalai Lama: My Spiritual Journey. (New York, NY: HarperCollins, 2010). Collected by Sofia Stril-Rever, translated by Charlotte Mandell.

Sogyal Rinpoche. The Tibetan Book of Living and Dying. (New York, NY: Harper Collins Publishers, 1992).

http://www.buddhanet.net/funbud10.htm

The Dalai Lama

The Dalai Lama is the only living religious and political leader whom I wholeheartedly admire and respect. Many books have been written about him, which reveal his wisdom and compassion, as well as his unique humbleness and greatness. Many Buddhists consider him a living Buddha, but he insists that he in only "a simple Buddhist monk." (Johnson, p. 225)

"I'm nothing special. I'm just another human being, just like you. When you listen to my talk, just listen to another human being....If the audience considers the Dalai Lama very special, then my talk is useless." (Johnson, p. 230)
(His Holiness the Dalai Lama, "Ethics for Our Time" lecture,University of California, Santa Barbara, April 24, 2009)

He says he has three commitments in life. His first commitment as a human being is the promotion of human values and those spiritual qualities which are fundamental to a happy life for the individual, the family, and the community. His second commitment as a Buddhist monk is the promotion of harmony among different religions. Despite different concepts and philosophies, all chief religious traditions bring us the same message of love, compassion, tolerance, temperance, and self-discipline. They also have in common their potential to help us lead a happy life. His third commitment as the Dalai Lama is Tibet, the well-being of the Tibetan people in their struggle for justice. He considers himself their free spokesperson in exile. (Stril-Rever, pp. 1-2)

The Dalai Lama's day begins at 3:00-3:30am whether he is on the road or at his residence in Dharamsala. As soon as he arises, he pays homage to the Buddha, and begins his morning prayers and meditation. He also does some exercise. In Dharamsala, especially during the rainy season, he may exercise indoors on a treadmill. Otherwise, he will walk outdoors. By dawn or around 5:00 am the Dalai Lama sits down to a hearty breakfast, usually bread, jam, fruit, and tea. After that he usually reads the paper, or goes to meetings. If there is no meeting, he reads Buddhist scriptures and books. The he practices analytic meditation on altruism (bodhicitta or enlightenment mind). He also meditates on emptiness. Bodhicitta and emptiness are the most important meditations in his daily practice. They help him throughout the day to stabilize his mind and support it from within. He has lunch around noon. At 12:30 or 1:30pm, he goes to his office and remains there for other meetings. After 4pm he returns to his personal residence. At 5:00pm he has evening tea. As a Buddhist monk he does not have dinner. He spends the rest of the evening saying prayers or meditation. Before going to sleep at 8pm, he examines what he did during the day. (Stril-Rever, pp.35-36; Johnson, p. 232)

When traveling, he commonly flies on commercial airlines, economy or business class rather than first class. "First class too much luxury. Too much drink. I'm a Buddhist monk," he said in Berkeley (April 25, 2009). He takes little with him, a small crimson bag is almost always slung on his shoulder. He does not use a computer or a mobile phone. His aids opened a Twitter account for him, and maintain his official website. (Johnson, p. 233)

Speaking to a group of ethnic Chinese at the Waldorf Astoria Hotel in New York City, May 4, 2009, the Dalai Lama said, "If I go back to China, I'll probably be handcuffed right at the airport." Such meetings have not always gone smoothly.
(Johnson, p.225)
Exile has forced on the Dalai Lama vast exposure to the modern world. In North America and Europe, his talks draw enormous crowds. The Dalai Lama is committed to non violence as a tool for change and espouses social equality as a necessary step toward genuine social harmony and peace. His battle to win greater freedom for Tibetans under China's yoke has given the Dalai Lama a distinct political hue. Like Pope John Paul II, the Dalai Lama is a strong critic of authoritarian one-party government. (Johnson, p. 227)

For all his fame, the Dalai Lama remains modest and humble, exhibiting consideration and caring. Tibetans consider him an emanation of the Buddha of Compassion. Those who have observed him for decades say the Dalai Lama gives equal treatment to nearly everyone. Pico Iyer, a British-born essayist and novelist, wrote that when the Dalai Lama goes to the White House, he shakes hands with writers and bodyguards as well as the American President. Matthieu Ricard, a French monk and translator for the Dalai Lama, said, "How often have I seen him, just after having bid goodbye to a president or a minister, go and shake hands with the doorman in his box, or with the telephone operator behind her glass window." (Johnson, pp.228-229)

The Dalai Lama routinely travels with a delegation of half a dozen people comprising of a translator, two attendants, a personal secretary, and two or three bodyguards. Most countries where he visits provide additional security. In the USA, the State Department gives him the protection accorded to a top-level visiting foreign dignitary. Once in Cambridge, Massachusetts, security aids to the Dalai Lama were alert to small protests from mainland Chinese students, but none turned out at the Memorial Church. It is easy to understand why. Some of the leading academic lights of Harvard arrived for his talk, giving him the imprimatur of the most prestigious university in America. No mainland Chinese student dared to go against the collective view of major Harvard dons. (Johnson, p. 233)

The Dalai Lama spends at least five and a half hours a day praying, meditating, or studying. He says he also prays during all the idle moments throughout the day, during meals or while traveling. As a Buddhist monk, he sees no differences between religious practice and daily life. In fact, religious practice is a 24/7 occupation. There are prayers for every activity, from walking up to bathing, eating, and sleeping. For tantric practitioners, exercises performed during deep sleep and dreaming are some of the most important, since they prepare them for dying.

The Dalai Lama's meditation focuses on emptiness and interdependence on the subtlest level. He uses different mandalas, visualizing himself as a series of deities (a practice called "deity yoga"). His mind then is on a level beyond sensory awareness, but it remains lucid in a pure awareness, not in a trance. Neither language nor everyday experience can translate or describe the experience of pure awareness.

One important aspect of his daily practice is about death. About this subject, the Dalai Lama says there are two things you can do in life: either you choose to ignore it, or you choose to confront and analyze it, so as to diminish the suffering it may cause. As a Buddhist, he accepts death as a normal process of life, a reality that will occur in samsara. He does not worry about it, but thinks it is like leaving behind used old clothing. Death is not an end in itself. As a Buddhist, the experience of death is essential, for at the moment when one dies, the most profound and beneficial experiences can manifest. For this reason, there are many great spiritual masters who take leave of earthly existence during their meditation. When that occurs, their bodies don't decompose until long after clinical death. (Stril-Rever, pp. 77-78)

The Dalai Lama often speaks of the promotion of human secular values and religious harmony as two of his commitments in life. He said, " Compassion, what I sometimes also call human affection, is the determining factor of our life." (Stril-Rever, p. 10).
True compassion does not stem from the pleasure of feeling close to one person or another, but from the conviction that other people are just like me, who want to be happy, and from the commitment to help them overcome what causes them to suffer. True compassion extends to enemies, too. It bears with it a feeling of responsibility for the welfare and happiness of others. In human relations it contributes to the promotion of peace and harmony. (Stril-Rever, p. 20)
At Harvard he said, "Differences of race, differences of color, differences of religions, differences of age --but fundamentally no differences. Mentally, emotionally, psychologically, we are the same." (Johnson, pp. 233-234)


Sources:
http://www.dalailama.com/

http://www.dalailama.com/messages/acceptance-speeches/nobel-peace-prize

Tim Johnson, How the Dalai Lama Conquered the World but Lost the Battle with China. Tragedy in Crimson. (New York, NY: Nation Books, 2011)

The Dalai Lama: My Spiritual Journey. Collected by Sofia Stril-Rever and translated by Charlotte Mandell. (New York, NY: HarperCollins, 2010).

Iyer, Pico. The Open Road: The Global Journey of the Fourteenth Dalai Lama (2008) Bloomsbury. ISBN 978-0307267603

Ron Gluckman.(February-March 1996)
http://www.gluckman.com/DalaiLama.html