Guest commentary: What we should know about Alzheimer’s
December 3, 2018
Despite the fact that 5.5 million Americans now suffer from Alzheimer's, and that one out two baby boomers reading these words will be directly affected if they or their spouse reach the age of 75, it is a great tragedy that we usually only ponder the disease when the crisis is our own. As a dementia care provider for the past 20 years, I will attempt to address this information deficit, and I will try to answer some frequently asked questions:
What is Alzheimer's disease?
Alzheimer's disease is the irreversible degeneration and death of brain cells caused by protein deposits, which are often called "plaques and tangles." Because those deposits usually attack the hippocampus area of the brain, which controls short-term memory, the first symptom of the disease is the loss of short-term memory. One will get lost coming home, forget names of friends, or one's last meal. Gradually, memory becomes increasingly stricken and one can fail to recognize their own children, their recent past and sometimes their own names.
Is there a cure for Alzheimer's?
No. Currently, our medical establishment has failed to produce a cure or even a way to meaningfully slow the progress of the disease.
Are their different types of Alzheimer's?
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Yes, there is Early Onset Alzheimer's, which strikes someone in their 40s or 50s but accounts for only 5 percent of all Alzheimer's cases, and Late Onset Alzheimer's, which starts to affect people in their mid-70s.
Is Alzheimer's hereditary?
Early onset is clearly hereditary, as there is a 50 percent chance of passing the condition on to one's children. For Late Onset Alzheimer's, it is less clear, as over 100 different genes can impact the disease process creating the possibility, but not the certainty, of the disease.
What is the life experience like for someone afflicted with Alzheimer's?
As one loses their short-term memory, they become confused as they begin to retreat and become dominated by their long-term memories. They become time travelers, and they live increasingly in their past.
How should someone with Alzheimer's be cared for?
The greatest fear for someone diagnosed with Alzheimer's is that they will lose a connection with themselves through their loss of memory. Therefore, all care models should aspire to help the patient maintain a connection with themselves.
How can we help someone maintain a connection with themselves?
This can best be done by stimulating their long-term memories. Rather than talking about current events or recent activities, talk about long-term joyful memories like their parents, their wedding, or the birth of children.
Are there certain long-term memories that are more beneficial than others?
Sometimes long-term religious memories can be very powerful, depending on the person. Formative religious memories offer peace, familiar rituals and meaning.
Why do some people with Alzheimer's get angry, irrational and sometimes violent?
They are not responding to their present environment, but to a troubling or traumatic long-term memory. For years, these memories have been successfully suppressed, but as Alzheimer's progresses, those defenses break down, and the memories can come on with a vengeance. When these irrational behaviors occur, it is best to encourage a conversation about their feelings by asking simple questions that will relieve some of the emotional pressure.
When a patient no longer remembers their spouse or children, should we assume that person we knew is dead, and that their soul has passed on?
No. This is a common tragic mistake. Eighty-five percent of Peregrine Senior Living residents do not receive regular family visitors, compounding the tragedy of the disease. People with Alzheimer's continue to experience time and space, maintain their soul and remain connected emotionally to those around them.
The epidemic of Alzheimer's is the last great challenge of the baby boomer generation. Rather than accept isolating institutional care, we need to be thinking compassionately and creatively about what a meaningful model of care should look and feel like. And, since we are talking about our future selves, the stakes could not be higher.
Stephen Sarsfield Bowman is president of Peregrine Senior Living, which operates a senior living and memory care facility in Glenwood Springs.
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