When Kelly Davis Garrett invites family members in to discuss a loved one's diagnosis of Alzheimer's disease, she's often pleased to find she must scrounge extra chairs.
Alzheimer's strikes an individual, but the entire family is stricken. For all their sakes, early intervention must be sought.
The current state-of-the-art treatment is drug therapy that will, it is hoped, stabilize the condition for a while, said Garrett, a neuropsychologist at LDS Hospital. Earlier assessment and treatment mean "more of a chance to stabilize from further decline, preserve quality of life and delay placement in a nursing home," she said. They also provide a chance to take care of paperwork, to talk about the patient's wishes when the time comes he or she can't express them. It reduces the caregiver burden, as well.
Garrett and Dr. Cherie Brunker, acting chief of geriatrics at the hospital, will be featured on today's Deseret Morning News/Intermountain Health Care Hotline, where they'll answer questions about Alzheimer's disease and other dementias.
Garrett looks at the "constellation of strengths and weaknesses" of the person with Alzheimer's, as well as ways to compensate for the weaknesses. Often, the strengths aren't cognitive but include things like a really supportive family network or a good attitude or a willingness to try.
It all ties in to quality of life. Recently, a man complained that he didn't want to just sit around and play bingo and shuffleboard at the assisted living center where he resides, even though that's the planned activity. Because many people in the mild to moderate stages of the disease still can read just fine — though they may not retain what they read — Garrett suggested finding some English as a Second Language kids who would love to have someone read to them. Could he get organized enough to be able to identify that opportunity, drive himself there, remember the teachers name? Probably not. But it is something that adult daughter could do with her dad that would use his cognitive strengths, Garrett said.
Unquestionably, family members pass through stages of grief much like that which accompanies death. Since it's a progressive illness, the process can go on a long time. And grief is exhausting, too. So part of the trick becomes how to mourn the diagnosis, adjust to the reality and keep up enough energy to be there for the shopping and the bathing and other tasks.
Garrett said caregiving is "physically exhausting" and families need to find ways to receive care respite either from other family members or an organization that can provide it.
They can also share the tasks within the family. "The oldest son might not be able to do the lifting and bathing, but he might be up to doing the taxes and covering for a weekend or two," Garrett said.
Studies have shown a physical toll to caring for loved ones with dementia. Blood lab studies looking at the integrity of the immune system found that it was weaker in individuals who are caring for people with dementia than for those that are caring for individuals who may have physical disabilities.
"I keep saying respite, respite, respite," she said, "but not enough people realize that's an option.
They also don't know that hospice can help both the patient and family of someone with Alzheimer's disease.
She encourages caregivers to join the Alzheimer's Association and some of the support groups, not only for helpful information but "the opportunity to vent and talk about your experiences with peers. And there's usually going to be someone in a group that has been dealing with an individual who is further along in the disease, and to start hearing some of those stories can helpful. They can in a relatively benign way become acclimated to what they might anticipate to come."
The hotline deals with a different health topic each month. All calls are confidential.
E-mail: lois@desnews.com