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Sunday, May 1, 2016

Alzheimer's -- the slow goodbye

Thursday, June 15, 2006

Clad in a red and navy plaid flannel shirt, a pair of navy Dickie's trousers and a pair of workboots, Samuel Bunch finished tending his garden filled with tomatoes, cucumbers, turnips and cabbage before making his way to the house.

Once inside he sat in his large leather recliner and began talking with his granddaughter, Chrissy, about the first few years after he and her grandmother were married.

"It was hard. We didn't have any money and we were scared when we found out Sue was pregnant, but we couldn't have been more pleased when Rita, our first-born, made her way into our family," he said. "Then just a couple years later you were born, Linda, and we were busting at the seams we were so happy."

He had confused Chrissy with her mother. Her grandfather was having a good day, but this was a sad reminder that he suffered from Alzheimer's disease and he would never be the same.

Alzheimer's disease is a progressive, degenerative disease that alters the brain, causing severe memory loss, impaired thinking and personality changes.

It affects 5 percent of people over age 65 and nearly 50 percent over age 85 and makes up the largest percentage of those suffering with dementia. Roughly 4 million Americans have Alzheimer's. Early onset Alzheimer's can occur in those in their 40s and 50s but is rare.

Support is out there. An Alzheimer's Support Group meets the fourth Wednesday of each month at 2 p.m. at Cherokee Village United Methodist Church at the corner of Otter and Keno drives.

Karen Tews, organizer of the group and a social worker, has been working with the group for six years, but it has been in existence for much longer. It is the only Alzheimer's support group for Fulton, Izard and Sharp counties.

"You are there to give to them and get support," she said. "This is a place where you can talk about things and no one will judge you. Some problems don't have to be as bad as they are if they can get some help and support."

Approximately 15 members attend the group, which is affiliated with Alzheimer's Arkansas of Little Rock.

"They are the support and training system," she said.

The monthly meetings typically last about an hour and a half, she said. During the group sessions, members discuss the stages their loved ones are in and specific issues they are dealing with at home. Other members offer advice and Tews researches other options that might help. Tews also informs members of financial programs that help with equipment, home modifications and other expenses.

"We're a resource for knowing where the resources are," she said.

"It is a progressive, fatal disease; however most people don't die of Alzheimer's," she said. "Eventually all their parts will forget what to do. It's like as a baby grows they learn how to eat, how to talk, how to walk -- with Alzheimer's they lose everything in reverse of the way they learned it."

The ability to be reasonable is the first thing to go. Short term memory soon follows, she said. Symptoms of Alzheimer's also include a different gait and a lack of sensibility, she said.

"Loved ones have to be able to express grief as things go along," she said. "They lose a little bit of their life with that person every day."

It could take as long as 20 years for someone to get through all the stages, she said, but the average time from diagnosis to death is eight years.

The brains of those suffering with Alzheimer's contain neurofibrillary tangles or twisted nerve cell fibers which block the flow of nutrients to the brain and neuritic plaques, patches of a sticky protein which inhibit the processes of memory and learning. While a physician can make a diagnosis, the only way to prove a loved one has the disease is to have an autopsy performed after their death, Tews said.

There is no specific cause of Alzheimer's disease, Tews said. Heredity appears to be a factor but isn't proven, she said. Lifestyle, however, is thought to make a difference. Exercise, a proper diet, active social life and games that keep the mind active are thought to help prevent the disease.

"They say to watch Jeopardy, do crossword puzzles, be involved," she said.

If patients or family members notice unusual things happening with a loved one they should inform their doctor.

There are four stages to Alzheimer's disease. In the first stage symptoms are often rationalized by family members as simply old age. In the moderate stage patients lose the ability to perform complex tasks until they cannot handle finances, plan functions, understand a joke or make decisions. In the advanced stage patients become disoriented and cannot identify familiar people or events and may require help performing basic activities such as dressing, bathing and using the bathroom. In the latter stage patients are marked by a severe cognitive decline and are often unable to find their way around the house and speak clearly. This stage ends in death. The cause of death is often not Alzheimer's but some other disorder.

Tews said it is essential for caregivers to have a sense of humor. "You either laugh or cry, and by golly it's easier to laugh," she said.

There are medications for the early stages of Alzheimer's. The medications will not reverse Alzheimer's but can keep patients in the first stages for a longer period of time.

Sometimes caregivers and other family members need a break, Tews said.

"It's important that they know they cannot wear themselves out," she said. "They've got to keep going. People feel guilty about putting their loves ones in the nursing home. We really push for them to keep them at home as long as they can, but they can't ignore their own needs."

In addition, caregivers are encouraged to take care of themselves and to get outside help when needed to allow them to get away from time to time.

"You need to have your own interests and keep them up," Tews said. "Whether you enjoy golfing, going to church, meeting for lunch with friends ---- you need to continue to do that. This is a 24-hour, 7-day-a-week job. You have to be able to get away now and then."

Approximately 70 percent of those with Alzheimer's disease live at home. About 20 percent of U.S. families are currently caring for an adult with some form of dementia, she said.

Keeping a loved one at home is cheaper than putting them in a nursing home, she said. In fact, Tews encourages family to keep them at home if possible and to take advantage of community programs.

There is financial assistance available. Alzheimer's Arkansas has a family assistance program that can provide $300 a year to families to assist in the purchase of equipment to better suit the patient, legal costs for wills and power of attorney, respite to provide support at home and home modifications. There are other programs available through agencies such as White River Area Agency on Aging.

The Alzheimer's Support Group is open to caregivers and family members of those suffering from all types of dementia, including strokes, Parkinson's disease and Pick's disease, either in the nursing home or at home. Members can also attend even after their loved one dies.

The next meeting will be June 28.

For more information contact Tews at 870-670-4814.

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