ALZHEIMER’S DISEASE: Lest you forget

(Last of Three Parts)

“Most people with Alzheimer’s live for seven to 10 years after diagnosis, spending five years under vigilant care.” – Dr. Socorro Martinez, an internal medicine practitioner who specializes in neurology

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At the age of 83, Hollywood actor Gene Wilder died at his home in Stamford Connecticut last year. Jordan Walker-Pearlman, the “nephew/child” of the legendary actor, read this statement for the world to know: “It is almost unbearable for us to contemplate our life without him.

“The cause was complications from Alzheimer’s disease, with which he co-existed for the last three years. The choice to keep this private was his choice, in talking with us and making a decision as a family.

“We understand for all the emotional and physical challenges this situation presented we have been among the lucky ones – this illness-pirate, unlike in so many cases, never stole his ability to recognize those that were closest to him, nor took command of his central-gentle-life affirming core personality. It took enough, but not that.”

“Every age has its own way of dying,” wrote Lev Grossman in an article which appeared in “Time.” “The 19th century had consumption, the 20th century had the heart attack, and the 21st century will be the age of Alzheimer’s disease.”

Recent studies show there are about 18 million people around the globe who are suffering from Alzheimer’s, the most common cause of dementia, an umbrella term for several symptoms related to a decline in thinking skills.

Asians seem to have lower risk of developing Alzheimer’s disease compared to those living in Western countries based on studies done in China and Taiwan. But when Asians move to Western countries, they are most likely to develop the disease. For instance, Alzheimer’s is more common among Japanese living in Hawaii than those living in their mother country.

“About 5 percent of men and 6 percent of women over 60 years of age are affected with Alzheimer’s,” said Dr. Wang Xiangdong, who was adviser of the mental health and control substance abuse program of the regional office of World Health Organization (WHO) when interviewed by this author some few years back. “With the ageing of populations, this figure is projected to increase rapidly over the next 20 years.”

Despite the advance of medical science, there is still no cure for Alzheimer’s. The current “treatment” is still making the remaining years of someone with Alzheimer’s comfortable. But unlike in industrialized countries, nursing homes or hospital facilities are not available in most parts of the country.

Health experts say the basic responsibility for management of the patient with Alzheimer’s rests with the family. “Alzheimer’s is a long-term illness that requires a lot of care and love from family members,” says Dr. Paul Pasco, a neurologist working with the Philippine General Hospital.

For someone having Alzheimer’s disease, the family is the microcosm of the whole world. The family has to become aware of the condition and how it is likely to progress. In the beginning of the disease, family members must choose among themselves who will be responsible for taking care of someone with the disease.

Actually, Alzheimer’s has two victims: the patient and the caregiver. In most cases, Alzheimer’s is more agonizing for the caregiver than for the patient. It is not only physically demanding but also emotionally draining. In most instances, a caregiver experience stress which usually manifest through denial, anger, social withdrawal, anxiety, depression, exhaustion, sleeplessness, irritability and lack of concentration.

“The family seeks help usually when the caregiver is under stress looking after the elderly,” suggests Professor Kua Ee Heok, a consultant psychiatrist from the National University of Singapore.

Studies done in the United States found that caregivers of Alzheimer’s patients – compared to other people their age – have 70 percent more physician visits, are 50 percent more likely to suffer depression, and use 40 percent more medications.

Every now and then, family members should give appreciation to the caregiver to ease the agony. Listen to the words of Miyuki Tanaka, a Japanese daughter-in-law, who has been taking care of her husband’s mother having Alzheimer’s: “The most painful thing for me now is that in spite of what I have done, no one is grateful to me.

She further wrote: “My husband is busy with his work and could not even say thank you. He has a younger sister who comes to visit her mother once in a while. Before leaving and without saying thanks, she usually say, ‘Please be kind to mother.’ I am not asking for much. I only want a word of gratitude.”

The caregiver should not neglect his health. “The Alzheimer’s patient can’t change the course of his disease, but the caregiver must learn to take care of himself,” advises Dr. Pasco. “He must not neglect his health.”

For instance, Prof. Heok suggests that caregivers should be given a break by taking over caregiving responsibilities for a few days. “We sometimes advise the caregivers to bring those with Alzheimer’s to a day care center where trained nurses could take care of them,” he says.

In most instances, families may also benefit by joining self-help groups or support groups. If there is no support group in the area, families may wish to start a new group. “Psychosocial interventions – including education, support, counseling and respite care – are extremely important in Alzheimer’s, both for patients and family caregivers,” reminded Dr. Xiangdong.

Charles Colton, British churchman and writer, wrote: “Body and mind, like man and wife, do not always agree to die together.” Such is the case of Alzheimer’s. Until today, science is still baffled why the brain dies before the body, leading to the mind-snatching disease.

Although there is still no cure, or way to prevent the onset of the disease, there are those who believe some level of cure is possible. As Dr. Manolete Renato Guerrero, chairman of the Department of Nuerosciences at the Davao Medical School Foundation, puts it: “There will come a time when Alzheimer’s disease will become a thing of the past.”