Progress in Dementia Care as Treatments and Prevention Lag Behind

Chair exercise class at the Louis and Anne Green Memory and Wellness Center at Florida Atlantic University, Boca Raton. Photo courtesy of the Louis and Anne Green Memory and Wellness Center.

Dementia has long been a diagnosis dreaded by patients and families, as there is no cure. Despite decades of effort, scientists have had little success in developing effective treatments or methods to prevent or slow down the characteristic brain deterioration.

Nearly 6 million people in the United States, including about 14% of the population ages 71 years and older, are afflicted. Dementias, including Alzheimer disease, are among the most common causes of disability and dependency in older adults and projections of the actual number of Americans with dementia—as much as 13.8 million by 2060—suggest rapid growth as the population ages.

Some progress, however, has been made in understanding symptoms and progression of dementias. Recent studies have also shed light on potentially modifiable risk factors, identified new methods of diagnosis, and explored ways to slow disease progression and improve patients’ quality of life. Among […]

2022-06-15T10:13:05-04:00June 15th, 2022|family caregiving, Nursing|0 Comments
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Distinguishing Between Delirium and Dementia in a Mother’s Rapid Decline

We now know just how vulnerable older adults in long-term care have been during the pandemic. COVID-19, especially in the pandemic’s early months, cost many their lives far too early. Even today we are seeing the disease bring premature death to the elderly, especially at facilities with lower staff vaccination rates. Just two days ago, NBC news reported the following disheartening NEJM study results:

“People in nursing homes are much more likely to die of Covid-19 if the staff caring for them remains largely unvaccinated, a study published Wednesday in the New England Journal of Medicine found.”

Other forms of decline accelerated by the lockdown.

But the isolation from family members and other external contacts imposed by the many months of lockdown had other less easy to measure costs. This month’s Reflections essay, “Again in a Heartbeat,” by Jeanne Kessler, MSN, RN-BC, details her own dawning awareness that something had begun to change in her mother as time went by during the lockdown at her assisted living facility.

Suddenly her mother couldn’t talk on the phone any longer. This wasn’t like her at all. Her attention span had shortened drastically. There were other worrisome indications. While […]

2021-12-10T07:55:02-05:00December 10th, 2021|Nursing|0 Comments
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The Unsung Heroes of Hospice Are Family Caregivers

Nurses who find their vocation in hospice may be among the most understanding people on earth. As a nurse who has helped many, perhaps hundreds of patients transition into palliative care and hospice, I thought that I would be prepared to handle placing my father into home hospice after a stroke. At 90, my father had vascular dementia due to chronic infarctions. The call from his provider informing me that he had had an embolic stroke with a hemorrhagic component was not completely unexpected. After his anticoagulation was reversed, I knew that he was likely to have another stroke soon.

Walking the tightrope: daughter, nurse, caregiver.

I guess that’s the curse of the nurse. No false hope for me. As the nurse in the family, I walked the tightrope of caregiver, support person, and grieving daughter. The help from the hospice team was extraordinary, but the overall care and responsibility was placed on the family. It was a bit of a shock to me. I can’t imagine how families without members in health care manage.

My father did not pass his swallow test, and he had left-sided paralysis; however, he was initially able to communicate, with some effort. In fact, the priest who saw him on the first day was obviously curious as to […]

2021-01-14T11:15:10-05:00January 14th, 2021|family caregiving, family caregiving, Nursing|2 Comments
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Polypharmacy in the Elderly: The Risks Often Outweigh the Benefits

“…the single greatest adverse drug event risk factor is the number of medications a patient takes.”

Lessons from speaking to elders about their medications.

Early in my career, I taught groups of seniors about common medications as part of a hospital-based community health program. I traveled around the Chicago area, speaking to groups at senior centers, apartment buildings, and places of worship about their health and medications.

As part of our program’s mandate to educate physicians and nurses as well, we interviewed many elders on film, asking them to tell us about their medications. I will always remember one lady, relating a friend’s problems with adverse drug effects. “He’s dead now,” she stated with finality. She made it clear that she blamed his demise on the drugs his doctor had prescribed.

My experience in the Chicago medication education program influenced my pharmacology lectures to nursing students. Students may remember me most for the many times I repeated this statement: “The first sign of an adverse drug reaction in an older person is often a change in mental function.” This is a central reality of drug effects on the elderly.

Paying attention to unexplained cognitive changes.

Yet even today, the default response of many […]

2020-02-03T08:54:32-05:00February 3rd, 2020|Nursing|0 Comments
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Becoming a Family Caregiver

Photo by Judith E. Bell, via Flickr.

For me, the saga began six years ago, when I offered to help a family member with some spring cleaning. I knew his place was a mess, but attributed this, stereotypically, to a single man’s lack of interest in housekeeping.

When I dove into the work, I was first puzzled and then fearful at what I found: hundreds of pieces of unopened mail, years old, randomly stacked around the apartment; threatening letters from the Internal Revenue Service; correspondence from the city about a tax lien on his condominium. This, in the home of a man who, as an actor and writer, memorized scripts in two languages, had served on the national board of his union, and could solve complicated math problems without using a calculator. Clearly, something was wrong well beyond the state of his apartment.

In AJN’s September original research article, “The Experience of Transitioning to a Caregiving Role for a Family Member with Alzheimer’s Disease or Related Dementia,” Kathleen Czekanski notes that “caregivers often assume the role of caregiving before they quite realize they are doing so.” In this qualitative study, Czekanski set out […]

2017-09-01T08:54:00-04:00September 1st, 2017|nursing research|0 Comments
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Views expressed on the blog are solely those of the authors or persons quoted. They do not necessarily reflect AJN’s views or those of Wolters Kluwer Health/Lippincott Williams and Wilkins.
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