Two excellent Nurse Practitioners who specialize in gerontology, Holly Carter and Chelsa Bringhurst, talked about Alzheimer’s Dementia at Spring Gardens Assisted Living in Mapleton. Like me, Holly and Chelsa are mobile practitioners, which means they see people in their homes. It was the best presentation I’d seen on dementia, so I’m sharing some of the notes here.
1. When it comes to end-of-life measures such as feeding tubes, vents, treating chronic infections: are we trying to maintain quality of life or are we trying to maintain existence?
2. Alzheimer’s Dementia (AD) is like aging backwards. An 80-year-old might remember everything before they were 60 years of age. A year later, they may remember everything before they were 40. A year later, they might remember everything before they were 20, which explains why they may remember their spouse, but not their kids. Sometimes the individual with AD will remember a feeling they have towards someone, they know they are important, but they cannot pinpoint where the feeling comes from.
3. Routine is especially important; Even having the same caregivers at the same times of day is very helpful.
4. Do not try to convince them of things they are not aware of (e.g., If they think their mom is still alive, don’t try to fight it). Their reality is your reality.
5. Medications: there are medications for AD that are good for the first 18 months. After being taken for 18-24 months, the medications start causing side-effects and can be counter-productive.
6. The hardest part for the individual with AD is the early stage, where they realize they aren’t remembering things. The next phase is often much easier for the person with AD, but harder for the family; this is when the individual doesn’t realize that they are forgetting things.
7. As the body ages, it takes more time to chew, swallow, digest, and eliminate, so the brain convinces the body that it’s not hungry because it’s too much work. So weight loss goes along with the disease. Another problem is that the person with AD simply forgets to eat.
8. An assessment called the FAST (Functional Assessment Staging Test) may be administered. When a person scores 7A or 7B, Hospice is considered.
Question and Answer Period
Question: What are some things we can do to prevent AD?
Answer: Sleep is really important. Nurses and shift workers are at greater risk of AD due to disrupted sleep. Also eating well and exercise are shown to reduce the risk.
Question: Can you see AD on an X-Ray?
Answer: No, you cannot see it on an X-Ray, but atrophy of the brain does show up on an MRI and CAT Scan.
Question: Why do falls make AD worse?
Answer: When you’re young, your brain is very close to the skull. As you age, your brain shrinks and the space between the brain and skull widens. So a fall shakes that brain and exacerbates AD.
Question: Is Alzheimer’s the same as dementia?
Answer: Dementia is an umbrella term for 4 different types: Vascular, Frontal-Temporal, Lewy Body, and Alzheimer’s. Alzheimer’s is the most common by far.
Question: Is Alzheimer’s hereditary?
Answer: A person is at greater risk if they have close relatives who had the disease, but there is no definite pattern.
Question: Are men or women more likely to get Alzheimers?
Answer: Women are, and we are not sure why; it may simply be because women live longer.
