We are all familiar with the medical term "Alzheimer's Disease." We hear it on the television when occasional reports of either biological findings or medical advances occur. We see it written about in our newspapers and magazines, especially when featuring celebrities such as former presidents. But could YOU give a definition of the disease state that is more comprehensive than merely stating: "A loss of memory"?

  Here are some quick facts:

• Currently approximately 4 million Americans have Alzheimer's Disease. As the largest growing segment of our population is 65 years and older, that number is expected to rise in just a few short years to 10 million.
• The Federal government estimates spending approximately $349.2 million for Alzheimer's Disease research in 1998. This represents $1 for every $287 the disease now costs society.
• The U.S. society currently spends more than $100 billion a year on Alzheimer's Disease. Neither Medicare nor most private health insurance policies cover the long term care that most patients need.
• A person with Alzheimer's Disease lives 8 - 13 years after the diagnosis. The average lifetime cost per patient is $174,000!
• Most Alzheimer's Disease patients live at home until late into the course of the disease and are cared for by either the spouse, or an adult child. The stress of care giving is difficult as care providers typically spend 70 - 100 hours a week directly care giving for the Alzheimer's Disease patient who has lost the ability to care for himself.

     The intent is not meant to be a scholarly review of scientific findings or to present the biological process of the disease. Much research is currently being conducted and yet Alzheimer's Disease is not fully understood and currently, there is no cure. Instead, this article will bring to light the growing prevalence of this progressive, degenerative disease, the impact this disease state will have upon the patient as well as the care giver and how the Slidell community, especially Aldersgate, is preparing to reach out to help those in need.

     Alzheimer's Disease develops slowly over years. At first, the symptoms are so mild only the patient is aware of mild memory loss and is often able to creatively cover up and compensate for this emerging problem. Symptoms may include difficulty to recall recent events or information. Later, the patient may forget names of familiar persons or how to find their way familiar. Patients may repeat themselves frequently and become confused about things such as surroundings and time. These are some of the first signs which family members notice. As the disease progresses, personality changes may be evident such as irritability, anxiety, depression, aggressiveness and restlessness.

     An important feature of Alzheimer's Disease is its progressive nature. While initial symptoms appear mild, the patient eventually loses the ability to perform normal activities of daily living. The patient finally becomes completely dependant upon others and often requires institutionalization. But it is more than just the identified, or diagnosed patient who suffers. The care giver, typically the spouse of the patient or an adult child, is the silent sufferer during these many years as the disease slowly robs the family of a loved one. It is often said that there are two deaths experienced with an Alzheimer's Disease patient. The first is a mental "death" (or loss) of a personality. This is the "death" or loss of the person (or more appropriately the personality) the family knows, and who knows them. This is a long and slow process. The second death is, of course, the physical death of the diseased body. For these and other reasons, care givers suffer tremendous stress.

     The actual issues that care givers face vary as the stages of the disease progress according to the patient's current symptoms, rate of disease progression, and other medical conditions of the patient. The burdens for the care giver are emotional, physical and financial. Care giving often includes:

• lost days at work (while the patient needs to seek medical care),
• a reduction in income (up to 50% of care givers report making financial sacrifices to better care for a loved one), and
• extreme exhaustion (most care givers report "on-task" care time to take about 70 to 100 hours a week.)

Some of the specific issues that care givers report include:

• difficulty adjusting to the patients' inconsistent sleep patterns (insomnia is common with Alzheimer's Disease patients),
• coping with wandering behavior,
• changes in family roles,
• fewer visits from friends,
• fewer planned vacations,
• increased depression and anxiety,
• difficulty with medical costs,
• dealing with incontinence,
• conflicts in extended family over sharing care, and
• lack of support and personal time.

     This last burden is critically important and it is where communities are able to help care givers through providing senior day care centers.

     Studies have been conducted nationally to assess appropriate intervention for care giver depression and stress. Several strategies were shown to be effective, therefore allowing the care giver to care for the Alzheimer's Disease patient at home for a longer period of time before having to finally institutionalize the patient. The findings of the studies include:

• the need to communicate with others who are experiencing the same struggles. Support groups are beneficial to enhance coping skills and provide emotional support.
• Families also have a desire to read about the disease state and the latest findings, but sometimes it is difficult to initiate research on their own merit. A resource library is a tremendous tool in giving families additional support and information beyond the small support group.
• And finally, everyone needs a rest. Community service interventions such as senior day care facilities provide hours of respite for the care giver and family. This is typically several hours during which the care giver can do things that they otherwise would not have time to do. Many care givers report they use the respite hours to spend quality time with their own children, to go grocery shopping, or even to go home and take a nap without feeling the need to worry that the patient might wander out of the house and get lost. This is a great fear due to the fact that often the Alzheimer's Disease patient will not be able to tell anyone who they are or where they live.

Day care centers are becoming more and more popular around the country and are a tremendous tool in allowing care givers to revitalize and keep their loved one at home longer. Prolonging long term care could mean substantial financial savings for the family as day care costs anywhere from $25 to $50 a day and nursing homes cost $150 (conservative estimates) a day. A day care center provides

• specially designed environments to promote maximum autonomy and independence,
• recreation such as art, music and other structured sensory activities help the patient experience more of his world,
• educational counseling and support groups for patients and families, and importantly
• a nutritional meal.

It is often hard to get an Alzheimer's patient to eat because their medications often cause a loss of appetite. This can be a frustrating experience for the care giver and studies have shown a high rate of "involvement" in activities during a structured group setting.

Currently, there are only a handful of such day care centers in the New Orleans metro area. Aldersgate has long been known for reaching out to the Slidell community through programs serving various causes. Alzheimer's Disease is a growing concern as we face a new millennium and an aging population. In the Christian spirit, we here at AUMC decided to provide service to those in need of respite care due to Alzheimer's disease and to open the first senior Alzheimer's Disease day care center in Slidell. Please give prayerful consideration to this ministry as it might be an avenue for you to serve God. The center is now open 5 days/week from 10am to 3pm. there are opportunities to be part of this ministry in a number of ways. volunteers are needed to help with the individuals with AD, help prepare meals and snacks and help with clerical duties.