Special to the Star-Herald
On Nov. 7, 2008 I attended a lecture by Robert B. Portney, MD, a renowned geriatric neuropsychiatrist on the faculty of Harvard Medical School. He explored the issues and broad scope of dementia in today’s society, the various treatments of dementia and how those treatments are viewed by health professionals. I walked away with a lay person’s perspective and observations. I write this article for all those who care and know someone with dementia. This subject is very personal for me. You see my husband, Larry, was diagnosed on Friday, Jan. 31, 2003 at 3:03 p.m. in his physician’s office with Alzheimer’s. He was only 61, a university business professor and had two advanced degrees to his name. Neither one of us knew what having Alzheimer’s meant. It proved to be the beginning of a long period of reading, attending workshops, and adjustments. As for my husband, he was joyful because at last he knew that what he was experiencing was not just “in his head” but that the condition even had a name. We were then able to do research and learn to support his illness with compassion, dignity and love.
We soon discovered that the world was not quite ready for the onslaught of Alzheimer’s because it was difficult to get answers and guidance. Fortunately for him his psychiatrist recommended Aricept(tm) and Nemanda(tm) as the medical cocktail from the beginning. The drugs allowed him to function within an assisted living setting in ease and comfort. He was even able to assist other residents with small tasks such as pulling their shades or calling the bingo games on Saturdays. Now that he has moved into the late stages of Alzheimer’s, he is confined to a community living center where he is able to get physical therapy, have regular balanced meals prepared for him, and attend activities where he is a passive participant but surrounded with numerous opportunities for interactions. Environment enrichment is key in maintaining an optimal level of functioning. Still, it is important for him to have his quiet time in his private room that is decorated with lots of framed pictures, a small bookcase with his favorite Harry Potter books and movies. His ability to recall the lyrics when Barbara Streisand sings or the Brothers Four allows me to enjoy a glimpse of times past. Every moment of cognition becomes even more precious than the one before when someone is in the advanced stages of Alzheimer’s.
Dr. Portney’s recent lecture started with the customary disclosures of conflicts of interest with the drug companies. Then he listed the limitations of a person with dementia. The memory of new information and of previously learned information becomes impossible to recall. Language deteriorates both in the way the individual speaks and the way he or she understands speech. Communication becomes difficult and frustrating for a person with dementia, sometimes to the point of exasperation. There is a decreased ability to do basic functions such as brushing the teeth, brushing the hair, and dressing. Agnosia, defined as a loss of the ability to recognize sounds, shapes, smells, items and familiar people, steadily increases. When agitated, the drugs given to patients with dementia may increase their symptoms and complicate their perception of the world around them. Executive functions such as planning simple tasks, organizing their living space, and following sequences become impossible.
In a review of 96 studies it was demonstrated that the drugs for Alzheimer’s do work by considerably delaying the need for long-term placement (Raina et al, 2008). There is a 50 percent decrease of symptoms when the combination of Aricept(tm) and Nemanda(tm) are used in the treatment of Alzheimer’s (Arri et al, 2008). Drugs for Alzheimer’s do work in controlling behavior by improving interaction. In particular, there is less incontinence and functioning in general does improve. When the time comes that Aricept(tm) and/or Nemanda(tm) stop being effective and a noticeable lack of quality of life is evident, Dr. Portney recommends considering the cessation of all other life-extending drugs.
Diet, lifestyle and heredity seem to be factors that are used to determine whether an individual may have increased chances of developing Alzheimer’s. However, just being unfit and obese will not mean one will develop Alzheimer’s. Dr. Portney further stated that in a study of males aged 65-85, those who walked four miles a day had a 60 percent reduction in getting particular form of dementia while those who walked two miles a day had a 35 percent reduction. The statistics were the same for women.
Information and interactions gained by attending such high level lectures on dementia is indispensable for the lay person who has to care for a person with Alzheimer’s. Exposure to current information offers hope and knowledge that is indispensable. Dealing with Alzheimer’s is monumental (Hill, 2008) for any lay person and any support is welcomed.
Ethelle G. Lord, M.Ed., DM (candidate) is married to a person with Alzheimer’s. She has cared for him for the past 10 years. He is now in the advanced stages of the disease and is in long-term care. Lord is the senior associate at Teamwork Development Associates, an adjunct professor of business at the University of Maine in Presque Isle, and is completing her doctorate of management in organizational leadership at the University of Phoenix. She is a mother and grandmother. She resides in Mapleton.
