Is there anything that you would suggest doing for the person with Alzheimer’s to sort of make things a little easier on them?
Initially there’s a lot of I think just unawareness because to them, they seem fine initially, and they’re not aware. If someone’s aware of their memory loss…there’s this thing called pseudodementia. It looks like dementia, but it’s not. And that presents as depression. So someone who’s very depressed may be forgetful and may look like they have dementia. I had one patient that was working nights and presented to my clinic very, very forgetful, and once they switched shifts, they were able to sort of regain some of their memory. And, in fact, they weren’t demented at all, they just had swing-shift – you know, worker’s syndrome.
But in order to make life easier, I think we have to go down to the basics. You have to keep a routine. You have to make life very relaxed for the patient. I think when we talk about respite, one of the things that sometimes families do is they split the care. So grandma spends Monday-Friday with daughter A and then the weekends with daughter B. Then in the summer, when both daughters are away, [grandma] goes to the son’s house, you know, in another part of town. That’s very confusing for the patients, and as they decline in function, they may not be able to tolerate all these changes. So it may be that the patient needs to stay put in the same household, and the children need to come and take care of the patient there, instead of moving the patient. So making it convenient and easy for the patient as opposed to the caregiver, sometimes, is the key.
Have you found there to be any correlation between other diseases and developing Alzheimer’s?
Sometimes people think that it may be associated with things like diabetes, high blood pressure, cardiovascular illnesses. But those tend to be more associated with the cardiovascular dementias – strokes and so forth like we talked about before are more associated a different kind of dementia. There are other types of dementia, for instance, Lewy Body dementia, which presents more like a parkinsonian type with movement disorders and so forth. There’s frontaltemporal dementia (FTD), which again, is a different type of dementia and has different presenting symptoms. FTD may be associated with hallucinations and so forth. So again that’s why you need to go to a geriatric assessment clinic and have a full in-depth evaluation, which often times takes 3-4 hours. You’re going through the patient’s medications, recent blood work – including thyroid function tests, exposures to toxins or vitamin deficiencies that may present with memory impairment, so going to a full-assessment clinic is key.
Do you think we’ll see a cure for this in the near future?
You know, there are a lot of people working on this – working on diagnoses and treatment. Hopefully, we’ll have a cure in the future. I think we need to remain optimistic and at this point, remember that there are things that we can do to prevent the progression and try to treat the patients as they progress with diginity and love – which I think is the most important part. It is a disease that takes away your dignity and takes away your [inaudible]. So I think it’s really an illness that is very sad, not only for the patient but the family members that are watching the patient fail. So hopefully. We need to stay positive and work together to create future successes and hopefully a cure.
Any final points you would like to add?
Especially when talking about Latinos with this illness, there are two points that I wanted to make. One is that, as Latinos, we often take on the role of providers and managers of our household, so if we are the ones affected by the illness, it’s often evident when the household starts to fail – when those gears are not working in unison like they used to. Often times husbands and sons have a hard time sort of taking over, so now that we’re seeing more men involved with the household duties, I’m hoping that will be an easier transition when their loved women may be affected.
And at the same time, if the Latinas end up being the caregiver, they spend a lot of time taking care of the household duties as well as the patient. It’s a full-time job, and now that more Latinas are in the workforce, it creates a bit of a struggle to keep things going. I think a lot of us end up having a lot of guilt issues because we feel like we need to be at home, but we’re also trying to earn a paycheck and raise a family at the same time that our loved ones are suffering. So I think support groups are a wonderful thing.
The other thing we didn’t talk about is the idea of daycares – adult day healthcare or respite care. Again I think our communities tend not to use those as much, I don’t know why. Maybe it’s a feeling of, you know, we can do it ourselves. But those programs are there to help and create respite to the caregiver so that the patient can stay at home longer. Often times those programs are paid for by Medicaid or, in California, MediCal. So if a patient qualifies, it something to be taken advantage of and used.