Study Finds: Having Purpose In Life Helps Fight Alzheimer's

New research suggests that having a purpose in life may help protect people from health issues such as Alzheimer's and other cognitive problems. In this preliminary study, scientists defined "purpose in life" as intentionally engaging in behaviors that one thinks are important.

Research done by Memory and Aging Project at Rush offers hope in fight against disease. 

Charlotte Morrison loves to walk, practice tai chi and paint with watercolors.  Morrison, 83, finds meaning in helping others who live with her in the Bethlehem Woods Retirement Community in LaGrange Park to express themselves. "Every morning, I ask myself, 'How can I help someone today?' My purpose in life is to help people," she said.

Morrison worked with developmentally disabled children and adults for 32 years, then cared for her husband for seven years before he died.

After Alzheimer's disease took his life, she joined the Memory and Aging Project at Rush University Medical Center, about 3 1/2 years ago. "I will do anything to help anyone figure out Alzheimer's. Now research is coming up with real results, finding ways of helping people live better with Alzheimer's. It's an honor to be part of something like this," Morrison said.

Some of this research, including a study published in the Archives of General Psychiatry's May issue, has found that having a purpose in life can help protect individuals from health problems, including Alzheimer's disease and other cognitive disorders. The term "purpose in life" is defined as the tendency to be intentional, to engage in behaviors that one wants to engage in and thinks are important, said lead investigator Patricia A. Boyle, a neuropsychologist with the Rush Alzheimer's Disease Center and associate professor in the Department of Behavioral Sciences.

"(The research) is exciting. It suggests possible behaviors that everyone can strive toward and that promote cognitive health. People are asking what they can do to prevent Alzheimer's, to maintain cognitive function. Find things that are meaningful and that help you feel life is purposeful," Boyle said.

Alzheimer's disease is the sixth-leading cause of death in the United States, with 1 in 8 older adults, and 5.4 million individuals, suffering from it, according to the Alzheimer's Association. Symptoms of Alzheimer's disease include loss of memory and thinking ability and functional changes, including reducing the ability to care for oneself.

Boyle and her colleagues looked at information from 246 of the more than 1,500 older individuals enrolled in the Rush Memory and Aging Project, which began in 1997. It studies chronic aging conditions among those living in the Chicago area. For up to about a decade, participants had yearly clinical evaluations, with neurological and cognitive testing.

Participants tended to be older, with an average age of about 80, and began the study without showing signs of Alzheimer's disease. Once a year, they were asked to rate themselves on the answers to certain questions, including how much meaning they derived from life's activities and whether they were goal-directed or purposeful.

"We found that for two people with a similar amount of Alzheimer's changes, the one with higher purpose in life did much better with cognitive function over time," Boyle said.

After the participants died, brain autopsies were performed on them. The researchers then looked at the plaques and tangles that had formed in their brains. Plaques and tangles are protein deposits associated with Alzheimer's disease. "They prevent brain cells from communicating effectively with each other," Boyle said.

"There is increasing evidence that almost everyone has some amount of plaques and tangles," she said.

With this information in mind, the idea becomes helping people to cope and still do well, perhaps by developing a purpose, Boyle said.

"Purpose in life is something everyone can work toward," she said.

It is part of an overall sense of well-being, including contributing to society, being a productive person, having goals and a knowledge of what's important to you, working toward those goals and contributing to the world, Boyle said.

The daily challenges one faces, including working to pay the bills, can make it difficult to maintain a focus on how people are spending their "most important resource — time," she said.

"I recommend that people think of their priorities. Think of what's important and meaningful to you, and move in that direction," Boyle said.

These activities could include spending time with family, and, perhaps doing a different kind of work. "These bring a sense of wellness that is protective. Studies are showing that this promotes health," she said.

Morrison said her work at Bethlehem Woods as an advocate is consistent both with her earlier work as a teacher for the developmentally disabled and her work with Alzheimer's research.

"I want everybody's grandchildren to not have Alzheimer's," she said. "I think that people in general know people who've had Alzheimer's. We are hoping that it's something that can be cured. I think they are getting on the right track."

(Source:  Alzheimer's Association - Chicago Tribune , 23 May 2012 By Jessica Tobacman)

Smell Tests Don't Predict Alzheimer's, Study Finds - Misleading Reports May Create False Hope -- Or False Alarm

SMELL TESTS should not be used to predict Alzheimer's disease, the most common form of dementia, according to a new study.

Although there is a link between the two, Researchers found other medical problems may cause people to lose their sense of smell, and it may not necessarily mean they will develop the progressive brain disorder later in life.

"A nonspecific association between poor smell function and Alzheimer's dementia is not the same as actually being able to use a smell test to predict Alzheimer's," Dr. Gordon Sun, a General Otolaryngologist at the University of Michigan in Ann Arbor, said in a University News Release.

"Unfortunately, this misinterpretation of the research has led to the promotion of these tests by the media and public figures like Dr. Oz," he added. "This study helps set the record straight about where the evidence currently stands."

In conducting the comprehensive review, the study's authors examined nearly 1,200 articles dating back to 1984. Two studies that tracked patients over time and 30 studies that evaluated patients at one specific point in time met inclusion criteria.

"Understandably, researchers, clinicians and the public are eager for a simple, accurate, and inexpensive way to predict or diagnose Alzheimer's early, but we're not there yet," argued Sun, who is also a Robert Wood Johnson Foundation/U.S. Veterans Affairs Clinical Scholar at the University of Michigan Medical School.

"My concern is that by promoting smell tests at this point, we create false hope or even false alarm among seniors and their families," he said. "Additional research is needed before we can rely on smell tests to predict the later onset of Alzheimer's."

The study, published online on 10 May in the Journal Laryngoscope, concluded that patients visit their primary care physician if they are concerned about their risk for Alzheimer's disease.

(Source:  HealthDayNews, 10 May 2012)

Memory : Six Key Signs That Memory Loss May Be Serious

At least three-fourths of people over age 50 report that their memory is not as good as it was. The reality is that more than 90 percent of those who do complain about memory impairment do not have Alzheimer's or dementia. Many memory complaints reflect changes in ability over time but appear to be relatively minor and due to normal age-related changes in the function of the brain.

So how do you know if your loved one is part of the minority whose changes in memory are more serious and warrant an evaluation by a health professional?

Red flags - Momentarily forgetting someone's name or a specific word is actually normal and does not necessarily worsen with age. The following behaviors, in contrast, may be signs that something more serious is taking place:

1.   Difficulty with routine tasks. Trouble completing tasks that a person has done many times before, like figuring out a tip at a restaurant, filling out tax forms or managing a checkbook, is a real reason for concern.

2.   Getting lost. Another red flag is when a person becomes lost while walking or driving in a familiar place, even the person says the navigational difficulties were due to inclement weather or having to make a big detour. This too is a potential warning sign of early Alzheimer's or dementia that needs to be investigated further.

3.   Loss of recent memory. Forgetting what you had for dinner the day before or what movie you watched a few hours earlier is not always a sign of normal brain aging. Other warnings include forgetting important dates or events or repeatedly asking the same question.

4.   Forgetting simple words. People with Alzheimer's or dementia may also have difficulty following or joining in a conversation. They may stop in the middle of a sentence and be unable to pick up where they left off. This is different from the occasional difficulty coming up with a name or word.

5.   Poor judgment in financial matters. It's not uncommon for people with Alzheimer's or dementia to buy things they don't need, to give away significant sums of money to telemarketers or unscrupulous salespeople, or to repeatedly make donations in response to mailed or telephoned requests to legitimate organizations.

6.   Mood change. People with Alzheimer's or dementia may exhibit confusion, suspicion, fear, depression or anxiety, traits that they never had before.

Finally, when a person regularly complains about poor memory and mentions that it is worsening from the year before, it should be looked into.

(Source:  John Hopkins Health Alert, 14 May 2012) 

Does Namenda Work? Dr. Rabins Addresses a Difficult Question

In this excerpt from a recent issue of the Memory Disorders Bulletin, Medical Editor Dr. Peter V. Rabins confronts the difficult question: What do you do when a caregiver asks, "Dr. Rabins, do you think that Namenda is really working?"

Namenda (memantine) was widely available for about 20 years in Europe before it received approval in 2003 for Alzheimer’s disease therapy from the Food and Drug Administration (FDA). Namenda is approved for people with moderate and severe Alzheimer’s disease, but some doctors, including memory and dementia experts, offer it to all of their patients with Alzheimer's, regardless of the severity of their symptoms.

Many doctors who are specialists in Parkinson's disease and frontotemporal dementia are using Namenda for their patients with dementia symptoms, even though it is not FDA-approved for that. While it is perfectly within their purview to use a medication "off label" for Alzheimer’s disease if they feel it's warranted, I hope studies will be carried out to tell us whether Namenda does have positive benefits.

There is no cure for Alzheimer’s disease, so the goal of drug therapy for Alzheimer’s disease is to help manage the symptoms. Improvement in cognition is an indicator that Namenda might be working. Therefore, when a caregiver asks me if I think that Namenda is working or not for their loved one, I answer "yes" only when I can see an improvement on a scale that measures cognition or thinking.

Should you choose Namenda? The decision to use Namenda depends more on the preferences of the Alzheimer’s disease patient and his or her family than on the science. Many families and caregivers say, "If Namenda might help, even a little bit, I want my loved one to take it."

On the other hand, some families and patients say, "I don't want to take something that will only make a small difference." For these individuals, I work to get them as much information about Alzheimer’s disease as possible to help manage any behavioral or psychiatric symptoms and to address the financial, legal, ethical and social problems they are facing.

There is no "right" or "wrong" when it comes to this issue. It is the patient and family who should make the final decision, not the doctor. I feel the same way about stopping Namenda. It is up to the patient and family to decide once they are given the information in a balanced and fair manner.

However, colleagues whose opinions I value feel that a drug such as Namenda offers false hope and the benefit is so minimal that it should not be used unless family members feel strongly that they want to try it with their loved one.

(Source:  John Hopkins Health Alert, Posted in Memory on 7 November, 2011)

Antipsychotic Medications and Dementia: What Are the Risks?

Most people with dementia or Alzheimer's disease will, at some point in their illness, show signs of aggression, agitation or psychosis. When these symptoms are so severe that individuals present a serious risk to themselves or to others, a class of drugs known as antipsychotics (or neuroleptics) are often used.

However, several recent studies have found that antipsychotics are associated with an increased risk of death when used in older people with dementia and Alzheimer's disease. In fact, the U.S. Food and Drug Administration (FDA) now mandates that drug makers add what is referred to as a "black box" warning to the labels of all antipsychotics, alerting doctors and patients to this increased mortality risk in people with dementia-related psychosis.

Since those warnings were first implemented in 2005, the use of antipsychotics for older people with dementia has declined significantly. Nonetheless, almost 10 percent of antipsychotic use is still attributed to people with dementia. In addition, about one third of nursing home residents with dementia receive antipsychotics.

Typical and Atypical Antipsychotics. Antipsychotic drugs were first developed in the 1950s to treat schizophrenia. 

• The first generation of these drugs is sometimes referred to as "typical" or "conventional" antipsychotics; they include chlorpromazine and haloperidol (Haldol). Typical antipsychotics work by blocking the receptors for the neurotransmitter dopamine and can cause a number of side effects that affect physical movement, such as tremors, rigidity, restlessness and muscle spasms.

•  In the 1990s, a second generation of antipsychotics known as atypical was introduced. These also block dopamine receptors but have fewer of the movement-related side effects that plagued users of the older, typical antipsychotics. Still, atypical antipsychotics have potentially serious side effects, including drowsiness, dizziness, blurred vision, rapid heartbeat, sexual dysfunction and skin rashes. They can also cause significant weight gain, and if left unchecked, people taking them may risk developing diabetes or high cholesterol levels. Examples of atypical antipsychotics include risperidone (Risperdal), olanzapine (Zyprexa) and quetiapine (Seroquel). 

(Source:  John Hopkins Health Alert, 13 February, 2012)

Memory : Advanced Dementia: Why Do Some Skills Remain?

A subscriber to the Johns Hopkins Memory Disorders Bulletin asked: “I recently read a newspaper interview with a famous neurologist who described the case of a musician who had completely lost his memory to dementia, yet was capable of playing piano concertos -- from memory at a professional level. Having cared for my mother, who died from Alzheimer's, I do not see how this is humanly possible. Can you please explain?”
Dr. Peter Rabins answers:  “I have also observed individuals who have advanced Alzheimer's disease but can still play bridge or music. There are several plausible explanations. Most likely, the retained ability is "highly developed," that is, something the person was especially good at. Usually, there is some deterioration from the very high level at which the person could once perform, but the remaining skills are still far above average. Often, what is retained is something learned a long time ago.

In Alzheimer's disease and most dementias, new information is lost first and information that was learned long ago is retained for a much longer period. As a result, the person with dementia can play a piece of music learned many years ago, but not learn a new piece of music. In vascular dementia, the deficits are described as "patchy" because some abilities are intact and others are impaired -- the difference depends on whether a particular area of the brain has been injured or not.”


(Source: John Hopkins Health Alert, 2 April 2012)

Memory : A New Take on What Causes Alzheimer’s

More than a century after German psychiatrist Alois Alzheimer first lectured about the gooey mass of plaques and tangles he noted in a postmortem brain tissue sample, scientists are still debating what causes Alzheimer's disease.

The majority of scientists have agreed that plaques result from overproduction of beta-amyloid -- a protein found in the cell membrane of neurons. In people with Alzheimer's, this protein accumulates in clumps between brain cells.

But recently, researchers from Washington University in St. Louis arrived at a new theory: that rising brain levels of beta-amyloid do not mean that patients are making more of it but that they can no longer clear it from their brains as effectively.

The study - As reported in the journal Science, the investigators tested 24 people, average age 74, and separated them into a group composed of people with minor Alzheimer's disease and another whose members were cognitively normal. Special testing revealed that both groups produced beta-amyloid at the same average rate within the brain.

The study subjects were then tested to see how the beta-amyloid was cleared from their brains. One of the ways the brain does this is by moving it to the spinal fluid for disposal. The researchers took samples of cerebrospinal fluid by inserting a needle into the subjects' backs and drawing off the fluid that normally surrounds the spinal cord. They found that those with Alzheimer's had decreased clearance of beta-amyloid from the brain to the cerebrospinal fluid -- about 30 percent less than those who were cognitively normal. This suggests that Alzheimer's is associated with disruption of the brain's ability to normally handle the beta-amyloid.

What it means - Early diagnosis of Alzheimer's has been elusive. But because researchers have uncovered a possible mechanism of early disease development, it is possible that this discovery could lead to both a test for early detection and the development of effective therapies to stop or reverse Alzheimer's memory disruption. They calculate that it would take an adult 10 years to build up enough amyloid in his or her brain to reach the amount typically present in someone with Alzheimer's.

This knowledge could offer doctors a window of opportunity to diagnose someone long before dementia symptoms develop. Once they learn they are at risk for dementia, people could make more concerted efforts to reduce their personal risk factors for Alzheimer’s. At the same time, pharmaceutical companies could work on targeted medications to halt brain damage before symptoms become irrevocable.

(Source: John Hopkins Health Alert, 23 April 2012)

Memory : Is Your Loved One Overmedicated?

Behavioral and neuropsychiatric symptoms of dementia can be extremely challenging and distressing for patients and their caregivers. Antipsychotic medications may be the only option if the patient's behavior is potentially harmful to him- or herself or to others.

Antipsychotic medications are often prescribed "off-label" for dementia patients in nursing homes to alleviate the agitation, aggression or psychotic behavior that is either distressing to the patient or else makes them a danger, but the Food and Drug Administration (FDA) has not approved any drugs for the treatment of behavioral symptoms of dementia. What's more, antipsychotics carry an FDA black box warning that older patients with dementia-related psychosis treated with atypical antipsychotic drugs are at an increased risk of death.

Drugs Versus Alternatives

There are ways to deal with difficult dementia patients that don't involve the use of drugs. Once a medical cause has been ruled out, the nursing and medical staff should look for environmental triggers that can be avoided or minimized.

• Changes in the environment might include increasing contact with caregivers, switching roommates, adjusting the temperature in the room or providing stimulating activities.

• Simply paying attention to a patient can often ease disruptive symptoms.

• In some cases, difficult behavior can be safely managed by reducing boredom, providing intellectual and physical stimulation, exercise, calming music and pet therapy.

However, if someone is in psychological agony and nondrug approaches have failed, medication might help. The risks and benefits of prescribing antipsychotics to people with dementia need to be carefully considered. While dementia patients are difficult to care for, even when drugs are administered, the practice of overmedication to make patients "manageable" is certainly not acceptable.

Advocating for your loved one with dementia

When someone with dementia is cared for in a nursing home, the support of family and friends is still critical, since the person can't adequately advocate on his or her own part. Family members must learn about the medications that are being dispensed, the reasons for their use, proper dosages and possible side effects.

If you notice that your loved one seems to be showing greater confusion after starting a drug, say something. Bring this to the attention of the doctor who prescribed the medication and discuss what steps can be taken to improve his or her quality of life. By maintaining this dialogue, you will be doing everything you can to ensure the best care for your loved one.

(Source:  John Hopkins Health Alert, 9 May 2012)

Reminder To Filial Son Moves Others To Care For Their Aged Parents

(Source, The Sunday Star, By Yvonne Lim, yvonnelim@thestar.com.my, 12 May 2012)
 Nobody visits the Leong car air-conditioning service shop here without learning a thing or two about filial piety.

And not many leave without shedding a tear or two after reading a framed “Letter from Mom” with its reminder of a child's duty to his aged parents.

The letter taking pride of place in the shop of 60-year-old Leong Swee Kee reads in part:

“My Child, when I get old, I hope you understand and have patience with me."

Cherished possession: Leong showing a family photo which includes his late mother (middle, in grey)-RONNIE CHIN/The Star
“When my knees get weaker I hope you have the patience to help me get up."

“Like how I used to help while you were little."

“Do you remember learning how to walk?”

Leong said the “letter” was put together by his sister-in-law in memory of his mother, Chung Thye, who died last year at age 103.

“She had a stroke in 1997 which left her barely able to function on her own. My five brothers and I took care of her until she died in May last year,” he said, nodding towards pictures of his mother which adorn the wall.He added: “Those who have cared for a stroke patient understand the challenges. Many times, people came up to me and asked why I did not put my mother in an old folks' home since caring for her at home was so troublesome?

“I told them that my mother had worked hard and sacrificed so much to raise my four brothers and me single-handedly after our father passed away when I was seven. It was an honour for us to take care of her in her old age.”

Leong described his mother as “generous and giving”, and said that many of his customers remembered her as the old lady who would serve them boiled sugarcane juice while they waited for their car to be serviced.

“She cared more about what she could do for others than what they could do for her,” he said.

Watch Video ->  Letter from Mom

The father of two grown-up children said he put up the “letter” in his shop to remind customers, especially young people, the importance of caring for their parents.

“Some customers cry after reading it. One man came up to me weeping. He said he was taking care of his own father who suffered a stroke recently and the letter had encouraged him greatly,” he said.

Leong believed that he and his brothers had by example taught their children the meaning of filial piety.

“It is a good feeling to know that I was a good son to my mother. It has been a year since she passed away, and I still miss her a lot,” he said.

“But I am happy to know that she lived a rich, long life with the people she loved and who loved her in return.”

MALACCA ALZHEIMER’S DISEASE SUPPORT GROUP 

MALACCA Alzheimer’s Disease Support Group is organizing a Public Talk on ”DEMENTIA  …...   WHO CARES !!!” by Speaker, Mr Willie Kwa, a professionally trained UK Mental Health Practitioner.  Join us at the talk for a time of learning, encouragement and bonding with those who care.

DETAILS:

TITLE OF TALK  :  " DEMENTIA ...........WHO CARES!!! "

SPEAKER  :   MR WILLIE KWA

DAY/DATE  :  SUNDAY, 20 MAY 2012

TIME  :  2:00pm - 5:00PM

VENUE  :  ACE Centre, 115 - I, Lorong Mayang 3, Taman Peringgit Jaya, 75400 Melaka

PROGRAMME

2.00pm :   Registration of Attendance
2.20pm :   Welcome Address by Chairman, MADSG Commtittee
2.30pm :   " DEMENTIA .......WHO CARES!!! "
3.30pm :   Q & A Session
4.00pm :   Light Refreshments

SYPNOSIS:  'People with dementia have a past/present/future and continues to be a person of worth and dignity and deserving the same respect as any other human being. Carers deserve to be given the same status.'

SPEAKER’S PROFILE:
Willie Kwa from UK is Malaysian born and bred. Willie is the Advisor on Caregiving from ADFM Panel of Medical Specialists. A Distance Carer for his loving late Mom who had Vascular Dementia. Wiillie who is a qualified Mental Health Practitioner has been professionally delivering care within the National Health Services (NHS) for over 40 years and retired in 2007.  Since retirement, he has been working as locum for care agency delivering care at various private Dementia Care Home.  35 years of his professional working life were spent with people who have Dementia.  

REGISTER HERE (compulsory first come first served basis) OR
 
SMS to:  016 - 902 0757 with full name/s & Tel/mobile contacts

For further information, please contact Alice  016 - 902 0757 / 06 - 284 7886      

Please click at “ MAP “ for directions to ACE Centre, Malacca
                                          
 

ANNOUNCEMENT:

ADFM 3RD NATIONAL CAREGIVERS WORKSHOP 2012 ON 12 - 13 OCTOBER 2012, FIRST WORLD HOTEL, GENTING (Program details will be announced soon)

JOIN YOUR STATE SUPPORT GROUP AND ADFM NATIONAL CAREGIVERS NETWORK
SIGN UP at:  http://admalaysia.ning.com/main/authorization/signUp
Email:  caregivers.adfm@gmail.com
TEL:  03-7956 2008 / 016 608 2513 (Jenny)
Website:  www.adfm.org.my

Who Is Worse Off: People With Alzheimer’s OR Their Caregivers?

Though they look through the prism of the future from different angles, people with Alzheimer's disease and their loved ones will likely find their lives dramatically altered after the onset and diagnosis of AD.

Certainly, the person who develops the disease is facing a life-altering and ultimately terminal disease. However, because of the intensive care needed by people with advanced Alzheimer's, and the pain involved in watching a loved one gradually lose their cognitive abilities, some people wonder if the caregivers endure more than the person with the disease.

Every case of Alzheimer's disease is as unique as the individual with the disease, and every caregiver brings unique traits to their caregiving journey. Each configuration, also, has different resources, different support systems and different coping skills. Thus, there is no one answer, and if there were the answer would likely change, depending on the challenges of any particular day.

A Quick Look At The Alzheimer's Journey From Inside

At this time, Alzheimer's disease is considered incurable. People who develop AD tend to die from seven to 10 years after diagnosis, though some can live as long as 20 years. Still, upon diagnosis, the person diagnosed knows instantly that his or her life is going to change dramatically.

Though testimonies from people with AD illustrate that many people with dementia continue to enjoy life for a number of years, there is no denying that their life will change dramatically, over time.
   
The person with AD must come to terms with the fact that as time moves forward, he or she is likely to lose the ability to live independently. Worse for many people, is the realization that one's memories and ability to reason will likely be stripped away. Their feeling of dignity as a human being is subject to being altered, as well.

Most people like feeling as though they have some control over their lives. The person with Alzheimer's lives in a world that is increasingly confusing, and often frightening, as the stages of the disease move forward. Making sense of one's surroundings becomes nearly impossible.
   
Paranoia is an understandable development in many people with Alzheimer's. When the brain tells a person one thing and everyone around this person is saying the opposite, it would be natural to wonder if people are playing tricks on them, lying to them or even stealing from them. Paranoid behavior in AD is quite common and causes great pain to both the person with the disease and the caregiver.

People with the disease generally become completely dependent on others, which is hard enough for most people. However, with AD, the person will likely lose the ability to remember who their caregivers are from moment to moment. Spouse, child, grandchild? Eventually, only the feeling of being dependent on a complete stranger may remain.

The Caregiver's Journey

Caring for a person with Alzheimer's is intensive and stressful, and it can be all-encompassing. After a loved one is diagnosed with Alzheimer's disease people generally suffer through an agonizing period of grief. It seems impossible to accept the fact that their spouse or parent has a disease that will rob him or her of personality, memories and the ability for self care. Yet, there is no alternative but to accept the diagnosis and move forward.

One of the first things most people do after the diagnosis is to plan for the inevitable changes Alzheimer's brings. However, with Alzheimer's there are many variables. Some people do quite well for months or even years. Others will decline quickly. Yet, the family must try to look ahead at the changes that will most likely occur, and plan with their loved one how best to manage the disease and future care.
   
With AD, people can change moods in an instant. The caregiver may be constantly on edge, worrying about mood swings, incontinence issues or the person wandering away and getting lost. Some people with AD have significant personality changes, which is distressing to loved ones.
  
Watching the slow process of Alzheimer's rob a loved one of memories and abilities can be excruciating. People who love and care for someone with Alzheimer's disease face the daily task of accepting the losses their spouse or parent must endure, all the while knowing that at the end of this journey they will suffer the second loss of their loved one through death.
   
The paranoia that often accompanies Alzheimer's can turn the diagnosed person against his or her caregiver, leaving the caregiver feeling helpless and ineffective.

 Alzheimer's disease is progressive and there is a downward spiral through recognized stages, however that doesn't mean the disease leads down a straight path. This uncertainty can contribute to the caregiver feeling uniquely alone and isolated, even when support services are offered.

Considering the challenges that people with Alzheimer's disease and their caregivers face, is there any joy at all in the journey? For many, yes. Caregivers can and do find joy in caring for someone they love, even if exhaustion and occasional impatience can make them wonder how long they can continue this intensive care. Most people eventually need to include paid outside help.

As for the person with Alzheimer's, many find a new determination after the diagnosis to live each day as fully as possible. They are aware of the changes that loom in their future, which makes the present more precious.

Who has a more difficult time? I believe that question is like most other quality of life questions. The attitude of the people involved, as well as their resilience, their flexibility and ability to accept what life hands them, will make the answer to this question unique for every Alzheimer's family.

(Source:  By Author, Columnist and Speaker, Carol Bradley Bursack, Agingcare.com, April 2012)