Medical Panel - Alzheimer's
Wednesday, 14 April 2010
The Alzheimer's society of Ireland will be starting their Tea for Alzheimer's Day in the first week in May.
We are joined by carer Tom Menton, Dr. Frank Marmion and Samantha Taylor from the Alzheimer's Society of Ireland.
About Alzheimers:- What is it?
Alzheimer's disease is the most common form of dementia, accounting for 50-60% of all cases.
It is a progressive neurological condition characterised by the build up of proteins in the brain called 'plaques' and 'tangles'. These proteins gradually damage and eventually destroy the nerve cells.
This can make it more and more difficult to remember, reason and use language. The loss of memory of recent events may be one of the first difficulties noticed. The person may also become disorientated, be at a loss for a word when speaking and have increasing difficulty with simple daily tasks such as using the phone, making meals or managing money.
The risk of developing Alzheimer's Disease increases with age with its prevalence rising from approximately 1% in people under 65 years old to more than 25% for those over 80 years. Although rare and more commonly associated with older age, Alzheimer's disease can also occur in people under 65.
There is currently no known cause for Alzheimer's disease and there is no cure for the condition.
Drugs have been developed that, in some cases, temporarily alleviate some of the symptoms in the early and middle stages. These drugs are Aricept (donepezil hydrochloride) Exelon (rivastigmine) and Reminyl (galantime). There is also a drug for the middle to late stages of the condition called Exiba (memantine). For some people these drugs may stabilise some of the symptoms for a limited period of time.
None of these drugs will cure the condition, although research is continuing into developing treatments, drugs and vaccines.
In Ireland more than 50,000 carers are caring for someone with symptoms of dementia. Our carer survey last year revealed that many carers are caring for more than 14 hours per day without adequate support services, financial supports, training or general understanding of their tremendous contribution. Social isolation and stress have a significant impact on health and wellbeing of carers.
What are the symptoms of Alzheimers?
Unfortunately the symptoms can start off as quite similar to just signs of old age, and can sometimes be overlooked by family members who are in the persons company regularly. It can commonly be picked up by someone who has come back from being away for a while that notices as difference.
These are the symptoms, but only to be worried about as a combination of a repetitive basis:-
Memory loss, particularly for recent events
Difficulty in performing everyday tasks
Changes in mood and behaviour
Changes in personality
Disorientation in familiar surroundings
Problems with language
Poor or decreased judgement
Misplacing things regularly
Difficulty solving problems or doing puzzles
Loss of interest in starting projects or doing things
Any risk factors?
There is nothing proven and in general age is the biggest risk factor. Anyone over 80 has a 25% chance of developing the condition. Also if there is a 1st degree relative that has the condition, there is a slight chance that you are more likely to develop it.
What advice do you give to carers?
1. Keep in regular touch with your GP and the Alzheimer's Association. Depending on where you live there are various community schemes and support groups that will give respite or daily care.
2. Share the care with family members. Its too much for someone to take this all on themselves, so don't expect to be able to do it.
What about in difficult situations where the patient may get distressed in your care?
Reassurance is the best way to deal with an episode of distress, and also people are given medication to help with this, so again be in touch with your GP.
Samantha Taylor - Spokesperson The Alzheimer Society of Ireland
What is the first step for someone who thinks that a member of their family may have Alzheimer's?
They generally go to their GP, who will want to build a picture of what their symptoms were, how long they have been going on for and the extent of the symptoms.
They will also send them for an examination that will rule out other conditions that may have similar symptoms such as thyroid problems, depression and other neurological conditions that are more specific. Alzheimer's and dementia are generally a diagnosis of exclusion, when everything else is ruled out.
How long does the process of diagnosis take and how do families get through it?
This is sometimes the most difficult time because they don't have the facilities or care available to them that people who have been diagnosed have. The process can take a while, especially as the doctor will generally have an examination a few months after the first visit. It can be frustrating and they will find everything much easier when the diagnosis is final.
What happens then?
For some people who have been diagnosed in the early stages of dementia, they can proceed to live a normal life, but may struggle with names, or identifying certain things, but in general will have a good quality of life.
When it gets more advanced there is a home care service where nurses and trained professionals will visit the patient at home, and this not only means that they are getting good quality care, it means a lot for the carer for them to get a break, knowing that their loved one is in safe hands.
Is the aim to stay out of a nursing home?
Well in general the person and the family do better when they stay at home, and this is the way they want it. However some people need 24 hour care and when they are at the moderate late stage of Alzheimer's there is often no choice.
What advice do you have for carers?
To look after themselves. It is so common for carers to end up sicker than the person they are looking after with all the stress and worry. They need help, be it from family or the medical system, and its important that if they are struggling to get the help they need.
What happens in a case where there is a somewhat elderly couple with children that have grown up and moved out, but where one person is too old or incapable of caring for their spouse who may have developed Alzheimer's?
This is a difficult situation and every family is different. There is normally a good support system within families, but realisticially people work full time and are sometimes not able to be there as much as they'd like. The safety of the patient is the most important thing so in these cases a nursing home may be the only option.
What is the situation with visiting a member of the family who may be in a home?
It is extremely important to keep up the contact and communication with someone in a nursing home, even if they may not recognize you. The feeling for them of having someone there who talks and cares for them is extremely positive. There are moments aswell where people do connect even for a short period of time, and have a brief moment of clarity.
So is it frightening for people with Alzheimer's to receive visits from people that they don't recognize?
No not in my experience, that would happen very rarely.