Jogging Our Memories

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JOGGING OUR MEMORIES by Eric Lo

description

A book about Alzheimer's disease

Transcript of Jogging Our Memories

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JOGGING OUR MEMORIES

by Eric Lo

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Table of Contents

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For My Grandma

Foreword

What Alzheimer's IsIntroductionOverview of Alzheimer'sThe Disease in Our BrainThe SignsEarly Symptom

Present SituationCostWorldwide Alzheimer'sThe Effects in USDeaths from Alzheimer's DiseaseCaregiversAssistance

InterviewAbout

Salvaging Memories

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Alzheimer's disease has cost us a lot in research, medicare and health care. But the effect of this disease is not only about money, but also about the family members of those afflicted with Alzheimer’s disease. The health care costs of Alzheimer's disease patients are more than triple those of other older people with the disease, and that doesn't even include the billions of hours of unpaid care from family members. As the disease progresses, people lose the ability to care for themselves and need help with eating, bathing, dressing and other daily activities. Eventually, they may need help with breathing and swallowing. It is really important for us to pay more attention to this dibilitating disease.

Foreword

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The total estimated worldwide costs of dementia are US$604 billion in 2010. – World Alzheimer Report 2010

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What Alzheimer's Is Present Situation Interview 13Salvaging Memories

Alzheimer’s disease can affect different people in different ways, but the most common symptom pattern begins with gradually worsening difficulty in remembering new information. This is because disruption of brain cell function usually begins in regions involved in forming new memories. As damage spreads, individuals experience other difficulties.1

Alzheimer’s disease is a progressive brain disorder that damages and eventually destroys brain cells, leading to loss of memory, thinking and other brain functions. Also, Alzheimer’s is not a part of normal aging, but results from a complex pattern of abnormal changes. It usually develops slowly and gradually gets worse as more brain cells wither and die. Ultimately, Alzheimer’s is fatal,

and currently, there is no cure. Alzheimer’s disease is the most common type of dementia, a general term used to describe various diseases and conditions that damage brain cells. Alzheimer’s disease accounts for 50 to 80 percent of dementia cases. Other types include vascular dementia, mixed dementia, dementia with Lewy bodies and frontotemporal dementia.

But today, there are more potential treatments in development than ever before as a result of the worldwide research effort to conquer this devastating disease. The Alzheimer’s Association is moving this research initiative forward by funding scientists who are searching for more answers and new treatments, collaborating with stakeholders, and raising the visibility of Alzheimer’s as a global health challenge.2

Alzheimer’s is a brain disease that causes problems with memory, thinking and behavior. Symptoms usually develop slowly and get worse over time, becoming severe enough to interfere with daily tasks.

Overview of Alzheimer’s

Introduction

Adams, Stephen. "Lithium 'slows Development of Alzheimer's' - Telegraph." Telegraph.co.uk - Telegraph Online, Daily Telegraph and Sunday Telegraph - Telegraph. Web. 28 Apr. 2011. <http://www.telegraph.co.uk/health/healthnews/8476615/Lithium-slows-development-of-Alzheimers.html>.

“About Alzheimer’s Disease | Alzheimer’s Association Research Center.” Alzheimer’s Association. Web. 04 May 2011. <http://www.alz.org/research/science/alzheimers_research.asp>.

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Right now, there are more potential new Alzheimer drug treatments in development and testing than ever before. New discoveries are fueling steady progress toward possible treatments to stop, slow and even prevent Alzheimer's. Because new drugs take years to produce from concept to market, it is critical that Alzheimer research continues to accelerate.3

But Rebecca Wood, chief executive of Alzheimer’s Research

UK, said it was “too soon to draw any firm conclusions” because of the small study size. Dr Anne Corbett, research manager at the Alzheimer’s Society, said: “We need more, larger clinical trials to test existing drugs like lithium if we are to find better treatments for people with Alzheimer’s. “Yet such trials are very expensive. We need greater investment in this area in order to help us develop better treatments for people with this devastating condition.”4

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"Treatment Horizon." Alzheimer's Association. Web. 02 May 2011. <http://www.alz.org/research/science/alzheimers_treatment_horizon.asp>.

Adams, Stephen. “Lithium ‘slows Development of Alzheimer’s’ - Telegraph.” Telegraph.co.uk - Telegraph Online, Daily Telegraph and Sunday Telegraph - Telegraph. Web. 28 Apr. 2011. <http://www.telegraph.co.uk/health/healthnews/8476615/Lithium-slows-development-of-Alzheimers.html>.

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Dendrites

Axon

Electrical Impulses

A BRAIN WITH ADVANCED ALZHEIMER'S

Neuron

Neurotransmitter Molecules

Synapse

Receptor

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The real work of your brain goes on in individual cells. An adult brain contains about 100 billion nerve cells, or neurons, with branches that connect at more than 100 trillion points. Scientists call this dense, branching network a "neuron forest." Signals traveling through the neuron forest form the basis of memories, thoughts, and feelings. Neurons are the chief type of cell destroyed by Alzheimer's disease. Nerve cells connect to one another at synapses. When a charge reaches a synapse, it may trigger release of tiny bursts of chemicals called neurotransmitters. The neurotransmitters travel across the synapse, carrying signals to other cells. Scientists have identified dozens of neurotransmitters.

The Disease in Our Brain

5 “Neurons | Slide 5 | Alzheimer’s Association Brain Tour.” Alzheimer’s Association. Web. 04 May 2011. <http://www.alz.org/brain/05.asp>.

Alzheimer’s disease disrupts both the way electrical charges travel within cells and the activity of neurotransmitters. Scientists believe Alzheimer's disease prevents parts of a cell's factory from running well. They are not sure where the trouble starts. But just like a real factory, backups and breakdowns in one system cause problems in other areas. As damage spreads, cells lose their ability to do their jobs and, eventually die, causing irreversible changes in the brain.

It's the destruction and death of nerve cells that causes memory failure, personality changes, problems carrying out daily activities and other symptoms of Alzheimer's disease. 5

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Alzheimer's disease leads to nerve cell death and tissue loss throughout the brain. Over time, the brain shrinks dramatically, affecting nearly all its functions.6

Plaques and tangles tend to spread through the cortex in a predictable pattern as Alzheimer’s disease progresses. The rate of progression varies greatly.

ALZHEIMER'S CHANGES THE WHOLE BRAIN

A brain without the disease A brain with advanced Alzheimer's

How the two brains compare

6 “Neurons | Slide 7 | Alzheimer’s Association Brain Tour.” Alzheimer’s Association. Web. 04 May 2011. <http://www.alz.org/brain/05.asp>.

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Severe Alzheimer’s – may last from 1– 5 years.

Earliest Alzheimer's – changes may begin 20 years or more before diagnosis.

Mild to moderate Alzheimer stages – generally last from 2 - 10 years.

People with Alzheimer’s live an average of eight years, but some people may survive up to 20 years. The course of the disease depends in part on age at diagnosis and whether a person has other health conditions.

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What Alzheimer's Is Present Situation Interview 21Salvaging Memories

The most common early symptom is difficulty remembering newly learned information because Alzheimer changes typically begin in the part of the brain that affects learning. As Alzheimer’s advances through the brain it leads to increasingly severe symptoms, including disorientation, mood and behavior changes; deepening confusion about events, time and place; unfounded suspicions about family, friends and professional caregivers; more serious memory loss and behav-ior changes; and difficulty speaking, swallowing and walking.

Early Symptom

7 “Alzheimer’s Association - What Is Alzheimer’s.” Alzheimer’s Association. Web. 05 May 2011. <http://www.alz.org/alzheimers_disease_what_is_alzheimers.asp>.

Alzheimer’s disease and related dementias can cause a person to act in different and unpredictable ways. Some individuals with Alzheimer’s become anxious or aggressive. Others repeat certain questions and gestures. Many misinterpret what they see or hear.

These types of reactions can lead to misunderstanding, frustration and tension, particularly between the person with dementia and the caregiver. It is important to understand that the person is not acting that way on purpose.7

Most Alzheimer's patients are 65 or older, but the condition can strike much earlier. There's also a particular gene that ups the chance that you'll get it. None of these factors is destiny, so it's hard to predict with certainty who will develop the disease.

The Signs

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If you or someone you know is experiencing any of the signs, please see a doctor. Early diagnosis gives you a chance to seek treatment and plan for the future. Memory loss that disrupts daily life is not a typical part of aging. It may be a symptom of Alzheimer's, a fatal brain disease that causes a slow decline in memory, thinking and reasoning skills.

THE 10 WARNING SIGNS OF ALZHEIMER'S

One of the most common signs of Alzheimer's is memory loss, especially forgetting recently learned information. Others include forgetting important dates or events; asking for the same information over and over; relying on memory aides (e.g., reminder notes or electronic devices) or family members for things they used to handle on their own. What's a typical age-related change? Sometimes forgetting names or appointments, but remembering them later.

Some people may experience changes in their ability to develop and follow a plan or work with numbers. They may have trouble following a familiar recipe or keeping track of monthly bills. They may have difficulty concentrating and take much longer to do things than they did before.What’s a typical age-related change? Making occasional errors when balancing a checkbook.

Memory loss that disrupts daily life

Challenges in solving problems

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Difficulty completing familiar tasks

Confusion with time or place

Trouble understanding visual images

People with Alzheimer's often find it hard to complete daily tasks. Sometimes, people may have trouble driving to a familiar location, managing a budget at work or remembering the rules of a favorite game. What's a typical age-related change? Occasionally needing help to use the settings on a microwave or to record a television show.

People with Alzheimer’s can lose track of dates, seasons and the passage of time. They may have trouble understanding something if it is not happening immediately. Sometimes they may forget where they are or how they got there. What’s a typical age-related change? Getting confused about the day of the week but figuring it out later.

For some people, having vision problems is a sign of Alzheimer’s. They may have difficulty reading, judging distance and determining color or contrast. In terms of perception, they may pass a mirror and think someone else is in the room. They may not realize they are the person in the mirror. What’s a typical age-related change? Vision changes related to cataracts.

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Misplacing things

A person with Alzheimer’s disease may put things in unusual places. They may lose things and be unable to go back over their steps to find them again. Sometimes, they may accuse others of stealing. This may occur more frequently over time. What’s a typical age-related change? Misplacing things from time to time, such as a pair of glasses or the remote control.

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6New problems with speakingPeople with Alzheimer’s may have trouble following or joining a conversation. They may stop in the middle of a conversation and have no idea how to continue or they may repeat themselves. They may struggle with vocabulary, have problems finding the right word or call things by the wrong name, such as calling a “watch” a “hand-clock”. What’s a typical age-related change? Sometimes having trouble finding the right word.

Every individual may experience one or more of these signs in different degrees. Again, if you notice any of them, please see a doctor.

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Decreased or poor judgment

Withdrawal from social activities

Changes in mood and personality

People with Alzheimer’s may experience changes in judgment or decision-making. For example, they may use poor judgment when dealing with money, giving large amounts to telemarketers. They may pay less attention to grooming or keeping themselves clean. What’s a typical age-related change? Making a bad decision once in a while.

A person with Alzheimer’s may start to remove themselves from hobbies, social activities, work projects or sports. They may have trouble keeping up with a favorite sports team or remembering how to complete a favorite hobby. They may also avoid being social because of the changes they have experienced.What’s a typical age-related change? Sometimes feeling weary of work, family and social obligations.

The mood and personalities of people with Alzheimer’s can change. They can become confused, suspicious, depressed, fearful or anxious. They may be easily upset at home, at work, with friends or in places where they are out of their comfort zone. What’s a typical age-related change? Developing very specific ways of doing things and becoming irritable when a routine is disrupted.

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10"Alzheimer's Association - 10 Signs of Alzheimer's." Alzheimer's Association. Web. 11 May 2011. <http://www.alz.org/alzheimers_disease_10_signs_of_alzheimers.asp>.

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Costs were attributed to informal care (unpaid care provided by family and others), direct costs of social care (provided by community care professionals, and in residential home settings) and the direct costs of medical care (the costs of treating dementia and other conditions in primary and secondary care).

Costs of informal care and the direct costs of social care generally contribute similar proportions of total costs, while the direct medical costs are much lower. However, in low and middle income countries informal care accounts for the majority of total costs and direct social care costs are negligible.

Nearly two-thirds of all people with dementia lived in low and middle income countries, this proportion being set to grow because the sharpest

Worldwide Alzheimer’s

According World Alzheimer’s Report 2010, Alzheimer’s disease and other dementias worldwide in 2010, increasing to 65.7 million by 2030 and 115.4 million by 2050. The cost of dementia will continue to increase at an alarming rate.

8 “WorldAlzheimerReport2010.” Alzheimer’s Association. Web. 01 May 2010. <http://www.alz.co.uk/research/files/WorldAlzheimerReport2010ExecutiveSummary>.

Cost

increases in the numbers of people with dementia will be in rapidly developing regions including Latin America, China and India. People with dementia, their families and friends are affected on personal, emotional, financial and social levels. Lack of awareness is a global problem, leading to common misunderstandings about Alzheimer’s disease and other forms of dementia.

Alzheimer’s disease was first identified more than 100 years ago, but research into its symptoms, causes, risk factors and treatment has only gained momentum in the last 30 years. While research has revealed a great deal about Alzheimer’s, with the exception of certain inherited forms of the disease, the cause or causes of Alzheimer’s disease remain unknown.8

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Australasia

Asia Pacific High Income

Oceania

Asia (Central)

Asia (East)

Asia (South)

Asia (Southeast)

Europe Western

Europe (Central)

Europe Eastern

North America High Income

Caribbean

Latin America Andean

Latin America (Central)

Latin America Southern

Latin America Tropical

North Africa / Middle East

Sub-Saharan Africa (Central)

Sub-Saharan Africa (East)

Sub-Saharan Africa Southern

Sub-Saharan Africa (West)

COST PER PERSON WITH DEMENTIA

6059

2862

4078

903

1601

12891

7667

9092

3663

5536

8243

6881

3926

1081

1122

6834

969

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"World Alzheimer Report." Alzheimer's Disease International. Web. 04 May 2011. <http://www.alz.co.uk/research/world-report>.

29057

30122

48605

US dollar

32370

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THE COST OF ALZHEIMER’S IN U.S.

$ - billions

Total costs

Medicare costs

Medicaid costs

172

2010 2050

1000

88

2010 2050

627

34

2010 2050

178

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The Effects in U.S.

Alzheimer's disease to cost United States $20 trillion over next 40 years –– The report, “Changing the Trajectory of Alzheimer’s Disease: A National Imperative”

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A new report from the Alzheimer’s Association, “Changing the Trajectory of Alzheimer’s Disease: A National Imperative”

“Alzheimer’s Disease Overview | UCI MIND.” UCI MIND - Institute for Memory Impairments and Neurological Disorders. Web. 05 May 2011. <http://www.alz.uci.edu/alzheimers-disease/alzheimers-disease-overview/>.

A new report from the Alzheimer's Association, Changing the Trajectory of Alzheimer's Disease: A National Imperative shows that in the absence of disease-modifying treatments, the cumulative costs of care for people with Alzheimer's from 2010 to 2050 will exceed $20 trillion, in today's dollars. The report, which examines the current trajectory of Alzheimer's based on a model developed by the Lewin Group for the Alzheimer's Association, also shows that the number of Americans age 65 and older who have this condition will increase from the 5.1 million today to 13.5 million by mid-century. 9

"We know that Alzheimer's disease is not just ‘a little memory loss' — it is a national crisis that grows worse by the day," said Harry Johns, president and CEO of the Alzheimer's Association. "Alzheimer's not only poses a significant threat to millions of families, but also drives tremendous costs for government programs like Medicare and Medicaid."

Total costs of care for individuals with Alzheimer's disease by all payers will soar from $172 billion in 2010 to more than $1 trillion in 2050, with Medicare costs increasing more than 600 percent, from $88 billion today to $627 billion in 2050. During the same time period, Medicaid costs will soar 400 percent, from $34 billion to $178 billion. One factor driving the exploding costs by 2050 is that nearly half (48 percent) of the projected 13.5 million people with Alzheimer's will be in the severe stage of the disease — when more expensive, intensive around-the-clock care is often necessary.1⁰

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The disease can be especially torturous when it creeps up on those in their 30s and 40s. As these patients move through Alzheimer's early stages, they are forced to cope with the dread of not knowing what is happening to them, often in the years when they're raising young children and building financial security.11

In the absence of disease-modifying treatments, the cumulative costs of care for people with Alzheimer’s from 2010 to 2050 will exceed $20 trillion. According toworld Alzheimer report; dementia costs to will exceed $600 billion in 2010. About 35 million people have dementia worldwide and the figure is likely to double every 20 years, to nearly 66 million in 2030 and 115 million in 2050.

So, if you are 25 years old now, the cost you will spend when you are 65. After age 65, the chances of developing Alzheimer's disease, the most common

form of dementia, doubles every five years. If you are 45 years old now, that will affect you when you are 85, At age 85, people have about a 50 percent chance of developing Alzheimer's, and you children or grand-children will face the disease at the same time as well.12

“If dementia care were a country, it would be the world’s 18th largest economy, If it were a company, it would be the world’s largest annual revenue, exceeding Wal-Mart and Exxon Mobil.” – World Alzheimer’s Report

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Wang, Shirley S. “When Alzheimer’s Hits at 40 - WSJ.com.” Business News & Financial News - The Wall Street Journal - Wsj.com. Web. 05 May 2011. <http://online.wsj.com/article/SB122661621189526173.html>.

“World Alzheimer Report: Dementia Costs To Exceed $600 Billion In 2010.” Breaking News and Opinion on The Huffington Post. 21 Sept. 2009. Web. 05 May 2011. <http://www.huffingtonpost.com/2010/09/21/world-alzheimer-report-dementia-cost_n_732736.html>.

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+66%

-20%

-13%

-29%

-8%-3%

Alz

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CHANGES IN SELECTED CAUSES OF DEATH, 2000 – 2008

National Center for Health Statistics. Deaths: Final Data for 2000 & 2008

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Alzheimer’s is becoming a more common cause of death as the populations of the United States and other countries age. While other major causes of death continue to experience significant declines, those from Alzheimer’s disease have continued to rise. Between 2000 and 2008 (preliminary data), deaths attributed to Alzheimer’s disease increased 66 percent, while those attributed to the number one cause of death, heart disease, decreased 13 percent.

The increase in the number and proportion of death certificates listing Alzheimer’s reflects both changes in patterns of reporting deaths on death certificates over time as well as an increase in the actual number of deaths attributable to Alzheimer’s.

The different ways in which dementia eventually ends in death can

Deaths from Alzheimer’s Diseasecreate ambiguity about the underlying cause of death. Severe dementia frequently causes such complications as immobility, swallowing disorders and malnutrition. These complications can significantly increase the risk of developing pneumonia, which has been found in several studies to be the most commonly identified cause of death among elderly people with Alzheimer’s disease and other dementias. The situation has been described as a “blurred distinction between death with dementia and death from dementia.”Regardless of the cause of death, 61 percent of people with Alzheimer’s at age 70 are expected to die before age 80 compared with30 percent of people at age 70 without Alzheimer’s. 13

13 “Page Not Found.” Alzheimer’s Association. Web. 11 May 2011. <http://www.alz.org/Facts_Figures_2011.pdf>.

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“Having your relationship with a person change dramatically as he or she forgets events, information and even your name can be an emotional shock.” – Beth Kallmyer, director of client and informa-tion services at the Alzheimer's Association.

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People feel they don't know how to interact with an Alzheimer's patient, and withdraw because they don't want to see their friend or relative in such a state.

Unpaid caregivers are primarily family members, but they also include other relatives and friends. In 2010, they provided 17 billion hours of unpaid care, a contribution to the nation valued at over $202 billion. Eighty percent of care provided at home is delivered by family caregivers; fewer than 10 percent of older adults receive all of their care from paid workers.

Caring for a person with Alzheimer’s or another dementia is often very difficult, and many family and other unpaid caregivers experience high levels of emotional stress and depression as a result. Caregiving may also have a negative

impact on the health, employment, income and financial security of caregivers. However, a variety of interventions have been developed that may assist individuals with the challenges of caregiving. 14

Caregivers need help. A few hours here and there to get away from it all is an important step in improving their lives. Some time to enjoy the world outside their home or reconnect with others. Forty percent of Alzheimer’s caregivers end up suffering from depression -- that’s four out of 10. Alzheimer’s kills the brain of the person suffering from Alzheimer’s, and it will also try to kill the brain of the Alzheimer’s caregiver. Both the caregiver and patient need to talk and interact with other human beings.15

Like it or not, if you are a family member or friend of an Alzheimer's caregiver and you are not helping them — you have abandoned them. I am sure this sounds harsh, but it's not even close to the harshness of your own behavior. — Bob DeMarco, Special to the Daily Vail CO Colorado

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Petersen, RC; Smith, GE; Waring, SC; Ivnik, RJ; Tangalos, EG; Kokmen, E. “Mild cognitive impairment: Clinical characterization and outcome.” Archives of Neurology 1999;56:303–308.

DeMarco, Bob. “Are Alzheimer’s Caregivers the Forgotten? | VailDaily.com.” Vail Colorado | VailDaily.com News. Web. 10 Apr. 2011. <http://www.vaildaily.com/ARTICLE/20110410/NEWS/110419990/-1/RSS>.

Caregivers

Assistance

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60% 67%of family caregivers are women.

AGES OF ALZHEIMER CAREGIVERS, 2010

caregivers have less than a college degree

under 35

10%23%

33%21%

2%11%

older 85

35 – 44

66 –

84

45 – 54

55 – 64

Created from data from the Alzheimer’s Association 2010 Women and Alzheimer’s Poll, October 2010

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66% 70%caregivers are married caregivers are white

44%

50% 26%

55%of family caregivers are employed full or part time

of unpaid Alzheimer’s and other dementias caregivers live in the same household as the person for whom they provide care

of family caregivers have children under 18 years old and living with them

caregivers are the primary breadwinners of the household

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Alexandra Morris, the Family Care Specialist of Alzheimer’s Association. She is also working in Geriatric Care Management Services which assist families in managing the challenges of aging, including dependency, illness, dementia or placement. Alexandra provides in-home assessments on functioning, activities of daily living and social needs to help elders and their families meet their goals throughout life.

About Alzheimer’s Association, in 1979, Jerome H. Stone and representatives from several family support groups met with the National Institute on Aging to explore the value

This is an interview with Alexandra Morris, the Family Care Specialist of Alzheimer’s Association. She will share her work experience and also educate people about how to live with Alzheimer’s family members.

16 “Alzheimer’s Association - About Us.” Alzheimer’s Association. Web. 11 May 2011. <http://www.alz.org/about_us_about_us_.asp>.

Interview

About

of a national, independent, nonprofit organization to complement federal efforts surrounding Alzheimer’s disease. That meeting resulted in the April 10, 1980, formation of the Alzheimer’s Association with Mr. Stone as founding president.

Today, the Association reaches millions of people affected by Alzheimer’s across the globe through our national office and more than 75 local chapters. As the largest donor-supported, voluntary health organization for Alzheimer’s, the Association is a catalyst for advancements in Alzheimer research and care.16

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Could you explain your title and a bit about the Alzheimer's Association?The Alzheimer's association provides support for primary caregivers and educates the community about the disease. I am a family care specialist, which means that i provide direct support to families that are coping with the disease.

What are the services that you offer?First, we offer a 24 hour 7-day per week help-line that is connected to an 800 number, which is routed locally during the day, and our Chicago office during the nights and weekends. So there is always a trained individual available.Also, we have follow-up services called Family Connections, where we call the families back to see if they readier any further services, help or counseling for basic issues.

If there are more challenges with what the family is dealing with, such as behavioral issues, family can't agree, all the way up to abuse or abandonment: These cases go directly to me and I handle them personally. In these situations we follow the people for as long as they readier help.

Are these services free?Yes, they are free. We do ask for donations, but we do not charge anything for these services.

Within support, are there other services?In the bay area, we offer many support groups, which are organized by county. The basic caregiver support group is for someone who is taking care of a parent or spouse. We also offer early stage groups—I lead one of those—the person with dementia participates along with the primary person in their life who is helping them. There are also tailored support groups, such as those only for adult children, or certain ethnicities. So if we feel that there is a need, we do our best to try and meet it.

What type of education services are offered?We offer a variety of classes for folks: Both professional and family education. These include Compassionate Communication and Challenging Behavior and Home Safety for People with Dementia. Also there are classes available for the general public such as Know the Ten Warning Signs and Maintain Your Own Brain.

Beyond these are there other services?There are early stage services for people with dementia, some of which we do need to charge for because a professional needs to facilitate them. also, we charge for conferences, but the majority are free.

AN INTERVIEW WITH ALEXANDRA MORRIS

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What areas does this chapter service?This chapter services all of northern california and northern nevada, so we cover a vast area and we also have several offices to help provide services.

You mentioned services specifically for minority groups. How are those handled?We have staff dedicated specifically to address minority groups; one person for African American, two for Asian and another for Hispanic.

These are the core groups that we are specifically reaching out to in the greater San Francisco bay area. This allows us to offer more full and more services by focusing our efforts on fewer groups rather than offering fewer services to many groups.

How are the services tailored?The support that I am talking about is groups that are tailored to the needs of that specific group. For instance, African Americans tend to be a little reticent about reading something and saying "That sounds good, let's do that.". So we spend a lot of time investing in that community; going through churches, talking to pastors and making connections with places that they are used to receiving support already. That way there is a bit more trust rather than if they just read something in the newspaper.

With Asian groups, we find that they respect education, so what we try to do is offer education in their specific language and encourage other services such as support groups or respite programs. We find that to be more effective, we need to be more integrated into the different communities.

Do you focus your services differently based on factors such as age?We have found that typically, the younger feel a bit more comfortable connecting with us in what I would describe as more common ways; such as groups and education services. So they are a bit easier to reach. With the older, we find that we need to develop a bit more trust.

What is the most important thing that families can do?We would like for families to reach out to us earlier. Research shows that most families wait an average of 29 months after diagnosis; which means that they struggle with the news on their own for over two years before they pick up the phone and call anybody, so one of our goals is to get connected with people right away. We now have a program with Kaiser Permanente and several doctors groups where the doctor asked for permission to put the family in contact with us upon diagnosis.

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Is it a goal then to help families achieve balance?Yes. part of my job is to help families navigate all of the issues that come up with respecting an adults autonomy and keeping them safe, while maintaining the highest quality of life possible. So we help families maintain balance with every change that comes as a result of this condition.

So it sound liked Alzheimer's is a progressive disease and most of your services are focused toward the caregiver. How does this effect, or help, the person diagnosed with the disease?By helping the caregiver, through education and our other services, we are teaching them a new skillet, a new way to get through the day. This leads to a better quality of life for the families, including the person with dementia.

Do some people believe that Alzheimer's is not a disease; that it is just a natural part of aging?For those people, I show them pictures of a persons brain before the disease, and then a picture of a persons brain that has the disease. it can be quite upsetting to see the difference, but it usually drives home the point that this is a disease.

It is better for people to realize that this is a disease. for those people that wish to not believe it, I tell them that we can choose to be right, or choose to be kind. I think it is more important to be kind. It is challenging. There is a lot of loss and a lot of big feelings about what is happening.

What does the association need most now? It is alway about resources. We have reasonable/attainable goals each year, usually targeted around reaching out to different groups. In the san francisco bay area, we believe based upon the numbers that there are about 100,000 people with Alzheimer's disease.

We currently reach only about 15% of those. Additional resources would help us put more effort in areas, such as outreach, to reach more people. However, once those people are reached, we then need additional resources to help service them. So it is always about resources.

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What Alzheimer's Is Present Situation Interview 53Salvaging Memories

Do volunteers help with that?We have a strong volunteer base, which is great, but someone needs to help manage those volunteers. So it is difficult to bring in a lot of volunteers without having additional staff to manage them.

Are there classes specifically for children?No. we have an early onset group to support the primary caregiver and give them advice for how to manage problems so that they can go home and work with their own teenage children.

What are other areas of need?There is a great need to devote money toward research before this becomes an enormous problem. But we also need participants for the studies. So there are three areas of need: money for services, getting us connecting with the people that need the services, money for research, and also participants for the studies.

Does the government subsidize services related to patient care for people diagnosed with Alzheimer's?As of last year, medicare will now pay for cognitive screens, so part of our job is to get that message out there. Unfortunately, beyond that medicare only pays for medical coverage, so doctors visits are covered, but none of the other services required for taking care of Alzheimer's patients, or there families are covered.

Thank you for your time. there is a lot of important information to get out about Alzheimer's and the work that your organization provides. I hope that with additional resources, Alzheimer's can be better understood and possibly even cured or prevented one day.Yes, I hope so too. Thank you very much.

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What Alzheimer's Is Present Situation Interview 59Salvaging Memories

ProblemMost associations or organizations focus on educating adults, but a lot of children need to face their families with Alzheimer’s, most are their grand parents or even their parent. Children feel fear and stress. It’s important to encourage kids not to be afraid and help them to learn about Alzheimer’s.

SolutionWe can educate children about Alzheimer’s when they are young, because some children are already suffering and others might face this disease in the future.I would like to cooperate with middle and high schools and discuss the disease in class, thus students could chose this disease in their volunteer hours for school and start to learn Alzheimer’s. I will design a game that students can play and also learn about the disease.

MaterialsGame card, Guide book, Manual, Visual book, Poster, etc.

School Volunteer Opportunity

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SUPPORT IS HERE!

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What Alzheimer's Is Present Situation Interview 61Salvaging Memories

ProblemIt is really hard to take care of an Alzheimer’s patient alone at home. In a lot of communities, people don’t know who has Alzheimer’s in their neighborhood, thus reducing chances to get support for those Alzheimer’s caregivers.

SolutionI would like to create supports nearby those Alzheimer’s caregivers. Collect people who would like to provide their support to take care Alzheimer's patients, and make websites to connect them and caregivers. Show people where have supports in their neighborhood.

MaterialsWebsite

Resources Map

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What Alzheimer's Is Present Situation Interview 63Salvaging Memories

Coffee ShopCampaign

ProblemIt is hard to see the awareness and information about Alzheimer’s appearing in our daily life, such as billboards, posters. Also, according to research published in the Journal of Neuroscience, caffeine intake not only appears to protect against Alzheimer's but may actually help those who already have the disease.

SolutionWe can educate people about Alzheimer’s in the place where they will pass every day. I would like to cooperate with coffee shop, such as Starbucks, and have an area in their store to show brochure, and also print on the coffer cups to educate people who come to consume in the store.

MaterialsBrochure, Coffee cup, Apron, hat, etc.

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Photographic Exhibit

ProblemPeople still don’t have enough understanding about Alzheimer’s disease.

SolutionI would like to make a campaign about photographic collection, the subject will be Alzheimer's disease. I would collect photograph from all over the world and make exhibitions to make people more aware.

MaterialsPoster, Brochure, Exhibition venus design, etc.

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What Alzheimer's Is Present Situation Interview 67Salvaging Memories

ProblemAlzheimer’s has no pill can cure and can not be prevented

SolutionThe only thing we can do is attend to our parents more, and spend more time with them. Thus we might find Alzheimer's symptoms in the early stage. So, we can teach the culture of Asian family relationships and their culture of care and compassion for their elderly.

MaterialsCampaign, Book, etc.

CompassionateCulture

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Design: Eric LoEmail: [email protected]

Class: GR600 Visual Communications LabInstructors: Phil Hamlett & Hunter Lewis Wimmer ESL Supporters: Amy Shipley & Diep LeSpecial thanks: Joe LashPaper: Classic Crest, 65/ 176 g/m2Print Production: Epson R2400Binding: Eric Lo

May 20, 2011