THE SANDWICH GENERATION
When a person cannot take care of personal tasks it may be too late for medical treatment of Alzheimer’s.
Alzheimer’s Disease (AD) is THE most dehumanizing disease there is. More than 5 million Americans have now been scientifically identified as having AD, and 10 million baby boomers are in the wings to develop it.
I started this recent series because the spouses of two long-time friends have been tested to have AD. The spouses have been struggling with this disease for several years. The husband of one friend was a brilliant physicist, with a Ph.D. and played a key role in the development of new communications products. He no longer knows who I am. The wife of another friend also was a very bright person. She has retreated to behaving like a mentally challenged seven year old. The wife has recently been placed in an assisted living residence that has a special Alzheimer’s section and program.
Alzheimer’s is so devastating because it takes away all of the characteristics of a mature adult human being and returns that person to an infant, who can do nothing for self. This is particularly hard to handle by family members, especially spouses who remember the good times. It is particularly disheartening because to date there has been no cure. But various drugs now in the clinical trials stage show great promise for a breakthrough in the treatment of AD, provided the testing proves the protocols are effective and provided the disease is confirmed in the early stages. (See the last two weeks of The Sandwich Generation columns.)
Years ago Barry Reisberg, M.D. developed the Functional Assessment Staging of Alzheimer’s Disease. He divided the disease’s progression into seven stages.
Stage 1: There are no difficulties either subjectively or objectively.
Stage 2: Person complains of forgetting location of objects and has some difficulty in using appropriate words.
Stage 3: This a key beginning stage and is identifiable from family members or co-workers, for early unset AD. The person has decreased job function and organization abilities and has difficulty traveling to new locations.
Stage 4: Decreased ability to perform complex tasks, to handle finances and to do grocery shopping.
Stage 5: Requires assistance in choosing proper clothing to wear, depending on the time of year.
Stage 6: This is a critical stage and begins a fast downward progression. The person has difficulty dressing,and bathing without assistance. Incontinence becomes frequent. The person may forget the names of family members and friends, and even does not know who the person is. (Years ago I visited the mother of a friend of mine while my friend was on vacation. I knew the mother well. She was in an assisted living residence, and we chatted awhile as she told me what she had done the day before. I finally said to her “Hannah, do you know who I am?” “Not really,” she said, “I do know I know you.”
Stage 7: This is the last stage. Speech ability dramatically decreases and often only single words are intelligible. Repetition of the same idea or thing becomes more pronounced. Walking and even sitting up becomes problematic and complete help is needed. Most become bedridden.
Dr. Joel Ross, M.D., FACP, AGSF, CMD CPI, of Eatontown, New Jersey, is in the forefront of research in Alzheimer’s and Mild Cognitive Impairment. (See last week’s article.) He is founder and CEO of the Memory Enhancement Centers of America and now heads several clinical trials of drugs to treat Alzheimer’s.
Ross says people should seek medical evaluation in Stages 2 and 3. If identified in these early stages, there may be hope for future effective treatment. By Stage 6, he says, it is too late for help.