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Memory Care

Many Americans enjoy healthy and active years long into their 80s, 90s and beyond, but others aren’t as fortunate. Today an American develops Alzheimer’s disease every 68 seconds. Dementia is the second largest contributor to death among older Americans, second only to heart failure. While deaths from other major diseases decreased from 2000 to 2010, deaths from Alzheimer’s increased 68 percent according to the Alzheimer’s Association.
   
One of the greatest mysteries of Alzheimer’s is why the risk grows so dramatically with age. Scientists worldwide are struggling to find answers. At this time there is no treatment to cure, delay or stop the progression of Alzheimer’s disease. The reality is that FDA-approved drugs will only slow progressive symptoms for about six to twelve months for about half the people who take them.
  
There is another silent epidemic that accompanies this ravaging disease. It is the devastating toll it takes on caregivers, the families and friends that provide hours of unpaid care. The majority of caregivers rate their emotional stress as very high and more than a third report symptoms of depression.
   
The World Alzheimer Report 2013, released in September, revealed the traditional system of “informal” care of people suffering from Alzheimer’s and dementia by family, friends and communitys will need much greater support and is calling for national debates about long-term care. The report, published by Alzheimer’s Disease International, the umbrella organization of 79 Alzheimer associations around the world, states that more attention needs to be paid to maintaining and enhancing quality of life; helping those affected, and their families to “live well with dementia.
   
Roger Baumgart, CEO, Home Instead Senior Care, which offers a free online curriculum to family caregivers, said that studies consistently show that older adults want to age at home, and with support, they can age at home. “However, two-thirds of the calls we get every day are from families in crisis. Caregiver stress is a driver for transition to institutional care.”
   
When caregivers can no longer cope, there are options. In response to the growing need for memory care, assisted living facilities are converting some units and wings to memory care; others are building full facilities.

If one partner is suffering mild to moderate dementia, moving to the right senior facility can provide relief from both the stress of caregiving and the worry of leaving them alone.  One person can even continue to work if they desire, knowing their partner is in a safe and stable environment. In Chicago, The Admiral at the Lake, offers a stimulating environment for seniors, plus on-site assisted living, memory support and skilled nursing care, if needed. By eliminating caregiver stress, both are able to enjoy their years together without unduly burdening one partner.
   
In an assisted living facility with memory care, dementia sufferers can still enjoy some independence. Staff are trained to gently guide and direct residents who may become lost or confused. Rehab programs such as cognitive therapies as well as physical and occupational therapies help with some symptoms. Music and art therapies may reduce some agitation. Many facilities have outdoor areas designed for safety. Communal dining experiences provide social interaction.
   
The benefits of finding a facility staffed with professionals trained in memory care can make the difference between a loved one simply being “housed” in a nursing home versus having a caring staff that can find ways to communicate and comfort those battling such a debilitating disease.

Finding Ways to Communicate
Even if your loved one is in a memory care facility with trained professionals, family members and friends can learn new ways to communicate when visiting a loved one with dementia and alleviate a lot of the frustration on both sides. Ongoing communication benefits the dementia sufferer who may have more difficulty expressing thoughts and emotions, as well as understanding others.
   
The Alzheimer’s Association offers some simple tips. Be patient and offer reassurance. Make sure the person feels that what they say is important. If they cannot find words, ask for a gesture. Never criticize or argue and don’t interrupt. Look for feelings behind the words that may provide clues.
   
When speaking, use short, simple words and sentences. Try to be as direct as possible and speak slowly. Give some extra time for response. Avoid statements that are too complicated or vague and confusing.
   
Every person’s brain reacts differently and it may take some trial and error to decipher the most effective way to communicate.

The Human Aspect
Instead of just learning about patients with dementia in the classroom, some medical students are discovering first-hand how people live with Alzheimer’s on a daily basis. At the Northwestern University Feinberg School of Medicine, the Buddy Program has been pairing patients with dementia and medical students since 1998. Other programs have been spreading to medical schools around the country. The dementia sufferers are “mentors” who show the students what living with the disease can be like. Many of the paired mentors and students go out to museums, take walks, or share a simple meal giving the medical students insight into life with the disease and having it take on a human face.

It May Not Be Dementia
There are a litany of causes that can interfere with memory. They can include severe stress, cigarette smoking, drug and alcohol abuse, B12 deficiency, and head injuries to name a few.  Many of these causes can be alleviated if properly identified.
   
Get enough sleep. A new study conducted by the University of California, Berkeley, found a connection between poor sleep and memory storage.  Younger sleepers who have a better quality of sleep are better able to store and retain information. As people age those memories are not stored as well due to deteriorating sleep patterns.
   
The Berkeley researchers conducted brain scans of subjects in their 20s and in their 60s and 70s as well as giving them memory exercises.  None of the participants had memory problems. But the study found older participants’ sleep quality to be 75 percent less than their younger counterparts and results of memory tests were 55 percent worse. The difficulty of the older subjects to achieve the deep sleep makes it harder for the brain to generate brain waves that carry daily memories from the hippocampus to the prefrontal cortex for long term memory.
   
Sleeping pills are not the answer to deeper sleep.  They can, in fact, be the cause of memory loss by interfering with chemicals in the brain.
   
Drugs used to treat other maladies can also cause memory loss.  For example, just last year, the FDA required drug companies to put a warning label on statins about the possibility of memory loss.  Statins also deplete cholesterol levels in the brain—which contains a quarter of the body’s cholesterol—which needs it to form connections between nerve cells.
   
Tricyclic antidepressants have shown to cause memory impairment in about a third of adults and over half have difficulty concentrating. Hypertension drugs (Beta-blockers) are prescribed for high blood pressure and some heart problems are thought to block some chemical messengers in the brain resulting in memory problems.
   
Even some antihistamines can inhibit brain activity in memory and learning centers. Other common drugs to watch out for are narcotic painkillers, Parkinson’s drugs, and incontinence medications. o

The “Hygiene Hypothesis”
There is a well-established link between high income, highly industrialized countries with cleaner environments and high sanitation levels and a higher risk of certain allergies and autoimmune diseases.  This “hygiene hypothesis” shows that inhabitants of sanitized countries have far less exposure to a range of bacteria, viruses and other microorganisms that have been around since the dawn of human history. This lack of exposure can lead to insufficient development of T-cells that attack invaders in the bloodstream.
   
In a new study published by the journal Evolution, Medicine and Public Health entitled Hygiene and the world distribution of Alzheimer’s disease, researchers at the University of Cambridge used age standardized data to compare levels of hygiene and the prevalence of Alzheimer’s. Switzerland and Iceland, for example, have 12 percent higher rates of Alzheimer’s than countries like Ghana and China with their high rates of infectious disease. Countries that are highly urbanized with more than three quarters of the population concentrated in cities, have 10 percent higher rates of Alzheimer’s than places like Bangladesh where only a tenth of the population is concentrated in cities. The discrepancy of Alzheimer’s rates can be up to 36 percent higher in highly sanitized urban environments.

Published: October 12, 2013
Issue: November 2013 Issue