Have we made progress with Alzheimer’s management and treatment?

  • A recent Huffington Post article on what we’ve learned about Alzheimer’s disease during the last 30 years caught my eye because it’s easy to think there’s been no progress. We can’t reliably prevent the disease, though lifestyle seems to work into the prevention strategy for many health ills. We can’t cure the disease, though we have some medications available that can slow the progression of cognitive decline in some individuals. So where is the progress?


    Progress starts with awareness

    We just closed out National Alzheimer’s Awareness Month, an awareness campaign that we now take for granted. However, according to the article, it wasn’t until 1982 that Ronald Reagan declared an official "Alzheimer's Awareness" week. We now also have World Alzheimer’s Awareness month during September, and World Alzheimer’s Awareness Day on Sept. 21. So, progress has been made in awareness of the disease. This awareness translates into research, better understanding and care of individuals who have dementia, and much more support and information for the family caregivers who provide the backbone of Alzheimer’s and dementia care.

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    Drug therapies

    There are now five drug therapies approved by the FDA for treatment of Alzheimer’s symptoms, and many other drugs that are used for symptoms that are not AD specific. Still, there is no medication for prevention or cure. While significant research is being conducted, more funding is needed to find a cure for AD.


    Understanding people with Alzheimer’s and other dementias

    In the late 80s, my dad had brain surgery that was supposed to prevent dementia. He’d suffered a brain injury during World War II, and scar tissue was holding back fluid in his brain. The theory – generally correct – was that by inserting a shunt in his brain to drain the fluid, Dad would be spared dementia as an extension of his injury. Unfortunately, the surgery backfired, sending Dad into instant dementia that lasted for ten years, until his death.


    During Dad’s first years in a nursing home, where he needed care after surgery, psychiatrists believed that dementia patients should be “brought back into reality.” I quickly found that the heartbreaking, fruitless task of trying to drag a person who lived in his own reality back into mine was something I couldn’t stomach. I instinctively understood that the only way to keep Dad reasonably content was to get into his reality the best that I could.


    My method brought one irate dressing down from the nursing home psychiatrist. Amazingly, however, a few years later, a new psychiatrist noticed how I was working with dad. He asked me where I learned that “technique,” and I was highly praised when I answered that I didn’t learn it anywhere – I was his daughter and I saw what worked with my dad. I know I wasn’t the only family caregiver who operated on instinct, only later to discover that professional opinion eventually had caught up.


  • In 1992, internationally renowned social worker Naomi Feil published "Validation: The Feil Method, and suddenly there was a name – and scientific evidence – for what many family caregivers had been practicing from gut instinct.

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    The Huffington Post article states that, “Today, thousands of professional caregivers are trained to use validation techniques, through which they are able to tune into the inner reality of the person with dementia. This method helps build trust and restore the person's dignity.”


    To my mind, validation therapy is one of the biggest steps forward in the care of dementia patients, because it uses dignity as its foundation. With dignity in mind, many nursing homes and assisted living centers have made huge progress in how they interact with AD patients. They’ve also made changes in the atmosphere of the living centers, the choices people are given for food, and the activities they are offered.


    Unfortunately, there are still far too many nursing homes and assisted living centers that have not caught up to current knowledge about how people with Alzheimer’s and other dementias should be treated. However, progress is being made because families are demanding changes.


    Technology advancing care

    High tech help is advancing in the form of GPS trackers for shoes, to sensors set around people’s homes that can let caregivers know every movement of their elder during the day. There are robotic pets and talking pillboxes. Much more is on the horizon. High tech efforts will be a boon to caregivers, however human hands will still be the most effective tool.


    In the end, loving touch, empathy and validation can go a long way toward providing a type of contentment for the elder with dementia. And for now, contentment may be the best we can hope for.


    Have we come a long way in the last few decades? Yes. We understand more about care and nurturing. We've made some progress in medicine, as well.  Is there still a long way to go? That’s obvious. Until we have a cure for Alzheimer’s, we aren’t “there” yet. There’s much work to be done.


    For more information about Carol visit www.mindingourelders.com or www.mindingoureldersblogs.com.  


Published On: December 08, 2011