Be Prepared for Flu Double-Whammy
Family caregivers of individuals with Alzheimer's disease have so much on their plates already-so many responsibilities, so many everyday challenges and everyday crises to deal with, and so many fears of what may come tomorrow or even later today. All the news about the pervasiveness of the HINI flu and the possibility that the seasonal flu is on its heels add yet another ingredient. It's an ingredient to be reckoned with.
If caregivers get sick, who will care for their loved ones? If their home health aides or employees at their loved ones' adult day centers fall ill, who will they rely on for respite? And, most of all, since caregivers typically are the most selfless human beings of all, if their loved ones get the flu, what special care will they need?
An article in the latest Journal of the American Medical Association highlights the concern, especially since most people with Alzheimer's disease are primarily 65+.
A study of more than 1,000 people hospitalized with H1N1 in California in four months since the pandemic began last April found that those 50+ were most likely to die; the death rate was up to 20 percent for hospitalized older patients, versus about two percent for those under 18. Nearly a third of all those hospitalized reportedly had no underlying conditions linked to an increased risk of flu complications, although a disproportionate number of them were obese.
The Centers for Disease Control and Prevention (CDC) has not made 65+ a priority sector for the H1N1 vaccine. But it has noted complications in older people when it has talked about H1NI. On its Web site, it says: "While people 65 and older are the least likely to be infected with 2009 H1N1 flu, those who do become infected are at greater risk of having serious complications from their illness."
Following the release of the journal article this week, the CDC's director, Thomas R. Frieden, M.D., M.P.H., reiterated in his weekly media briefing on Tuesday that since H1N1 is primarily affecting people under 65. "It doesn't change what our recommendations would be for vaccination."
He also emphasized, "What we've seen in that article as in our own data and data from around the country and the world is that the level of severity among those who become ill is similar to seasonal flu. So if they get it, it can be every bit as severe as seasonal flu."
My take-away: individuals and their families affected by Alzheimer's disease need to be prepared-for HINI, and its possible complications, and the seasonal flu. Even though reports of seasonal flu have not surfaced yet, they still need to keep seasonal flu as well as the H1N1 strain on their radar screen.
This week, the Alzheimer's Foundation of America (AFA) made that point when it unveiled its Top 20 list of flu facts for caregivers of individuals with dementia who believe they or the people they are caring for have the flu.
In releasing them, Richard E. Powers, M.D., the chairman of AFA's Medical Advisory Board and author of the flu fact sheet, advised: "Families should not become so fixated on the H1N1 that they ignore the seasonal flu. The seasonal flu can be equally dangerous in some circumstances if the person is not vaccinated."
So facing this possible flu double-whammy, what's a caregiver to do? Dr. Powers urges caregivers to be proactive, namely "vigilance and early aggressive treatment for the flu are the best plan of action. Good basic home nursing by the family may reduce the adverse impact."
When the additional layer of the flu enters the picture for caregivers of people with Alzheimer's disease, issues like fluid intake, fever, medication side effects, potential behavioral problems and back-up support systems need to be top of mind. This is the time when "you can't do it alone" takes on extra significance.
Like everything else having to do with Alzheimer's disease, it's empowering to be educated about what to do should either flu strike caregivers or their loved ones. As always, "be prepared" is the motto of the day.