Caring Currents

The hottest tool for people with Alzheimer's and dementia is a baby harp seal. A robot baby harp seal, that is. "Paro" is soft and cute as a stuffed animal, but it also coos when its fur is stroked, wiggles on the lap, bats its eyelashes, and makes little noises. Paro reacts to warmth and sound, and remembers previous interactions.  

Six-pound Paro debuted in the U.S. earlier this year. It was designed as a therapeutic robot by Japan's National Institute of Advanced Industrial Science and Technology back in the 1990s and has been used with elderly people with dementia (and youngsters with autism) in Japan and other countries for several years.

What's so good about it? Lifelike Paro stimulates the senses and encourages communication. It relaxes the person with dementia, lowering the risk of depression and behaviors like agitation, especially during transitions, which can get tense...  Read more

People with advanced dementia have "a duty to die." Or so says Baroness Mary Warnock. My first reaction, after the shiver of shock finished running down my spine, was that whoever this woman is, surely as a baroness she can afford decent care for loved ones in the late stage of disease! And then I discovered that in addition to being a British government adviser, Lady Warnock is its "leading moral philosopher."

"If you're demented, you're wasting people's lives -- your family's lives -- and you're wasting the resources of the National Health Service," this philosopher says. With cold morality like that on their side, no wonder people in the UK are in full-scale panic over its dementia explosion. (You can't even get NHS reimbursement for drugs like Aricept over there.)

Of course she has it all backwards. The duty in end-stage Alzheimer's lies not with the afflicted but with the people around them -- and not to kill them but to love them, or at least act as humanely as possible...  Read more

Calling this presidential election "hot" is as much an understatement as saying that watching your parents age is "challenging." As someone who writes a lot about Alzheimer's disease, however, one particular oft-mentioned presumption rankles: the notion that people are unqualified to be president at  72 (or 73, 74, or 75, to run through a full term) because they might get Alzheimer's disease.

Political persuasions aside, the debate is a good opportunity to revisit the facts about who gets Alzheimer's.

Fact: Alzheimer's disease can technically strike anybody, but will not strike everybody. Half a million people in their 30s, 40s, and 50s have "early onset" cases. Classically, Alzheimer's is a disease of aging -- but with emphasis on the word disease. Alzheimer's is not a normal or inevitable consequence of getting older.

Fact: The majority of 72-year-olds do not have the disease...  Read more

The so-called "doughnut hole" coverage gap in Medicare Part D prescription drug coverage snared millions of seniors in 2007 -- and forced many to stop taking prescribed medications they would have had to pay for themselves.

In 2007, 3.4 million people, or 14 percent of all people enrolled in Medicare Part D, fell into the coverage gap, says a Kaiser Family Foundation study released last week.

According to Medicare Part D rules, enrollees pay a monthly premium, a deductible, and a co-payment of 25 percent of the total cost of their medication until they have spent $2,510 on prescription drugs. After that point -- known as the doughnut hole -- they must pay out-of-pocket for prescription drugs until they reach a "catastrophic" level of $4,050 total out-of-pocket spending. Then, Medicare coverage will kick in again. (Seniors can also purchase a private insurance plan to bridge the gap...  Read more

You notice certain lapses in memory or behavior. You worry. You suggest a check-up. You get stonewalled. Sound familiar?

A fascinating new report from the Alzheimer's Association, based on interviews with more than 300 people who have early-stage Alzheimer's, sheds some light on why: A rampant negative stigma about the disease, much of it rooted in myths and misperceptions, especially regarding what the early stage is like.

But what if you do get your parent or family member to have that checkup? How likely is he or she to get an accurate diagnosis? The past decade has finally shed a great deal of light on early-stage Alzheimer's, and the must-read "Voices of Alzheimer's" report brings up many issues deserving deeper attention. But the problem of getting a diagnosis hasn't been widely discussed before.

To be sure, fairly accurate screenings are available...  Read more

The curious connection between diabetes and Alzheimer's just got a little more mysterious.

As fellow blogger Paula Spencer noted in her recent Alzheimer's disease conference round-up, researchers have discovered that people with diabetes who take insulin in combination with an oral diabetes drug have a lower risk of developing Alzheimer's disease than those who only inject insulin.

It's not clear why popping a diabetes pill -- like metformin (brand name: Glucophage) or glyburide (Micronase, Diabeta, Glynase) -- along with injecting insulin dramatically drops a person's risk of this kind of dementia, but because several studies have found people with diabetes at much higher risk of getting Alzheimer's than the general population, this is a welcome finding.

In the investigation, people with diabetes treated with both insulin and an oral agent had 80 percent fewer sticky substances called amyloid plaques in the brain -- a hallmark of the brain disease -- than people who didn't...  Read more

"Okay, dolly! Drink up all that water!" I used to cringe when my grandmother's aide would talk down to her like that. (No, Gram's name wasn't Dolly.) So at first, the news that people with Alzheimer's dislike being patronized seemed to fall into the "duh!" category. Then I realized it's a big wake-up call in two ways:

1. It reminds us that those with Alzheimer's deserve as much respect as anyone else.
2. It reminds us that conversations go two ways, even among those with impaired speech or no speech.

In a nutshell: When University of Kansas School of Nursing researchers analyzed videotapes of aides caring for people with Alzheimer's, they found that certain communication patterns by aides led to spikes in resistance and agitation.

What not to use, according to the researchers: Inappropriate terms of endearment (good girl, dear), a caring but controlling tone, and the royal "...  Read more

Worried about a loved one's (or your own) memory slips -- but not that worried, considering he can still manage to drive, make everyday decisions, and carry on a normal conversation?

Maybe you should worry after all. Or at least keep a really watchful eye.

Mild cognitive impairment (MCI) is a relatively recently-identified category of cognitive trouble that falls between normal memory loss and Alzheimer's disease. Mayo Clinic scientists have just issued the first estimate of its prevalence -- nearly one million new cases a year in people over 70, more than double previous predictions. They had expected an increase of MCI cases of maybe 1 to 2 percent a year. Instead MCI is growing by 5 percent, and by 7 percent a year in people over 80.

That's on top of the 5 million people who already have Alzheimer's. And It's troubling because people with MCI are much more likely to develop Alzheimer's over time...  Read more

Three reasons to watch this Sunday, August 3 (9 p.m. ET), when most PBS stations air a rebroadcast of the Emmy-award-winning 2004 program, "The Forgetting: A Portrait of Alzheimer's":

1. The program includes a new discussion on "The Future of Alzheimer's," moderated by activist-actor David Hyde Pierce, whose father and grandfather had the disease.
2. It's a chance to share support with others. The Alzheimer's Association has been encouraging caregivers to host Viewing Parties around the TV event, for which it's providing viewer's guides, activities, and other tips. If you haven't already been invited to a viewing, why not host one for a few friends and relatives?
3. You can get a flavor of what it's like to have the disease. PBS has just this week updated some Alzheimer's resources on "The Forgetting" section of its website. The most interesting page features famous first...  Read more

A friend e-mailed recently with a mini update on her mom, who has dementia. Her latest challenge, she said, was her mom being absolutely unable to sit still for a dentist. She’d fight the dentist off screaming. Fear of being touched is common with those who have dementia, including Alzheimer’s. What’s merely annoying for us -- teeth being poked and prodded -- can be hellish for them.

But my friend's e-mail wasn’t a total downer. Turns out there are special Alzheimer's dentists trained in treating people with dementia. My friend’s mom already had an appointment.

It’s not hard finding these dentists online, especially if you live in a larger town. Do an internet search with the terms dental care, Alzheimer’s, and your parents’ town. Also ask your parents’ current dentist for a referral. (This is how my friend got a name...  Read more