There are many challenges caregivers face when looking after a loved one with dementia in the community. Some of these challenges include sundowning, increased confusion and agitation in the evening, and day-night reversal which leaves the individual with dementia and their caregiver on opposite sleep schedules. A nursing home in New York City runs an innovative program, titled Elderserve at Night, to help. "Many people with dementia are more alert at night than they are all day—just when their caregivers need to sleep. Rather than try to alter this mismatch, Elderserve At Night embraces it. The program is the brainchild of David Pomeranz, the executive director of the Hebrew Home, who opened the program in 1996. He says the idea came to him after hearing heartbreaking stories from struggling families. 'People were sleeping in front of doorways because they were concerned that mom or dad would wander out of the house,' Pomeranz says." To read more about this overnight camp-style respite program check out this article.
The film Still Alice starring Julianne Moore took home an Oscar last week for best actress. It chronicles the experience of Dr. Alice Howland, an accomplished professor at Columbia University, as she is diagnosed with early Alzheimer's disease. How accurately, however, does this critically acclaimed movie portray the onset and progression of this disease? Dr. Kristine Yaffe, a psychiatrist and professor at the University of California reviewed the film and offers her perspective in this interesting article recently appearing in Time Magazine. "Scientifically, the first phase of Alice's symptoms and encounter with her consultant neurologist are very realistic and deeply moving. The movie accurately demonstrates the early word-finding challenges, occasional memory lapses and sense of becoming overwhelmed in once familiar situations."
To read more about Dr. Yaffe's perspective with regard to what the movie got right (and wrong) with regard to Alzheimer's disease visit: http://time.com/3695430/how-accurate-are-health-films/item/still-alice/
A new study has demonstrated a positive correlation between taking high doses of anticholinergic medications for prolonged periods of time and dementia risk. This class of medication includes commonly used diphenhydramine (Benadryl), tricyclic antidepressants, and oxybutynin which is often used to treat bladder incontinence. "The study ... is the first to link higher use of anticholinergic medications to increased risk of dementia. It is also the first to suggest that the dementia risk associated with these drugs may not be reversible even years after people stop taking them." As such, "health care providers should regularly review their older patients' drug regimens -- including over-the-counter medications -- to look for chances to use fewer anticholinergic medications at lower doses."
To read more about this topic, visit http://www.cbsnews.com/news/common-allergy-depression-meds-may-increase-odds-of-dementia/
New research being conducted by Dr. Lili-Naz Hazrati at the University of Toronto is investigating the association between head trauma and future risk of developing Alzheimer's disease. "Trauma is one of the risk factors involved in Alzheimer’s. It’s an area I’m [Dr. Hazrati] especially interested in, and where I’ve been able to make a breakthrough studying how concussions may cause inflammation in the brain. My lab is identifying the inflammatory pathways that, when activated, may eventually lead to the development of age-related brain diseases. Our findings reveal that head injuries trigger a type of chronic swelling in the brain that could be at play in Alzheimer’s. Looking at the disease through the lens of head injuries is a new and hopeful area. I also think it will be interesting to learn why some people don’t suffer any ill effects from head trauma. Those people might hold the key to a future Alzheimer’s treatment." To read more about the work being done in this area by Dr. Hazrati and her research lab, check out this recent article appearing in the Toronto Star.
As a follow-up to last week's blog post about the increasing use of antipsychotics to manage behavioural and psychological symptoms of dementia (BPSD) in long-term care facilities, this week's post highlight's one nursing home's efforts to counteract this trend. Pathstone Living, a nursing home in Mannkato, Minnesota, has successfully altered their approach to managing BPSD from pharmacological to behavioural and environmental interventions. "A few years ago, antipsychotics were used frequently at Pathstone. 'We saw these as medications that were supposed to help the patient and, of course, we gave them to them with the feeling that we were doing good', says Shelley Matthes, a registered nurse who is head of quality assurance for the nonprofit Ecumen, which runs Pathstone and about a dozen other nursing facilities in Minnesota. Our goal, says Matthes, was to reduce our antipsychotic use by 20 percent. And in the first year we reduced it by 97 percent".
To read more about how this facility successfully reduced the need for antipsychotic medications, visit http://www.npr.org/blogs/health/2014/12/09/368539057/this-nursing-home-calms-troubling-behavior-without-risky-drugs.
John Sheehan is a 70 year old with a host of accomplishments, both professionally and personally. He has been living with Alzheimer's disease since 2013 and both he and his wife, Sharon, are determined to not let it become his identity.
“The important thing to remember is that we are not our diagnosis,” says Mr. Sheehan. “We are full people with real relationships and interesting histories. In this community [Peterborough] we have the second largest population of people over 65 in Canada, so we need to be aware of this illness and learn how to treat people who suffer from dementias with respect and empathy.”
To read more about John's experience with early Alzheimer's disease including the early signs that led to his diagnosis, check out: http://www.mykawartha.com/community-story/5250354-dementia-is-a-diagnosis-not-an-identity/
Supporting and enhancing students' and health professionals' knowledge and understanding of mental health and psychiatry