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Helping those we love: Family, caregivers key to diagnosing Alzheimer’s, dementia

Posted 9/21/19

In a county ranked among the fastest growing nationally with a fast-growing elderly population, the incidence of Alzheimer’s and other memory loss conditions …

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Helping those we love: Family, caregivers key to diagnosing Alzheimer’s, dementia

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In a county ranked among the fastest growing nationally with a fast-growing elderly population, the incidence of Alzheimer’s and other memory loss conditions rapidly rises as well.

Lori Nisson, family and community services director at Banner Sun Health Research Institute and Banner Alzheimer’s Institute confirmed the condition is a growing problem for patients, families and health care providers alike.

“I think this is a common problem and, unfortunately, we’re seeing an increased number of people suffering from memory loss,” Ms. Nisson said. “Arizona is projected to have the greatest growth rate in cases of Alzheimer’s and related dementias than any other state. We have about 150,000 people in Arizona that we know of that have the disease and most people never get a diagnosis, so we think that’s an underestimate.”

According to the U.S. Census Bureau, those 65 and older comprised 15.2% of the county’s 4.4 million residents, based on 2018 data.

By 2025, the number of Alzheimer’s and dementia sufferers projected to increase 42.9%, Ms. Nisson said.

“Unfortunately, this is a growing problem among people and families who are becoming more aware of concern that they may have with family members, neighbors, friends and coworkers,” she said.

However, a number of challenges complicate the condition and, as with many diseases, early diagnosis is key to successful outcomes and patients’ family members are usually the first to spot a problem.

“A short-term memory loss is typically one of the first things that we see. Other things that we notice are people who have done the same kind of work activities and household chores and are now having trouble with those day-to-day tasks,” Ms. Nisson said. “They also see disorientation of time and place, where someone is getting lost in their normal routes or forgetting the time of day or day of the week.”

Those with memory loss also sometimes show changes in behavior, which may indicate a need for screening.

“Another thing that kind of sneaks up is a change in that person’s awareness and judgment. It’s usually a family member who notices, because often the person with memory loss is the least aware of it, it’s family and friends who are noticing these changes,” Ms. Nisson said.

She explained lack of good judgment and insight can create stress in family relationships as someone begins to take actions and make decisions, which might seem out of character.

In one case she recounted, a long-married couple attended a typical time share presentation at a resort, something they’d done on numerous occasions, though they agreed they would not make a purchase.

But while one left to meet friends following the presentation, the salesperson was able to convince the other to sign a long-term contract – something he never would have done, especially not without consulting his wife about it.

This may have been an early sign of the onset of Alzheimer’s or a related dementia, Ms. Nisson suggested.

“People with very early memory loss often become victims to scams and financial exploitation, because their ability to have good judgment is impaired,” she said. “Sometimes that means they’re buying things they really don’t need, giving away money to random people, or just making poor decisions that are really inconsistent with past behavior.”

Because the disease affects the mind of those afflicted, they are usually completely unaware – though not merely in denial in the traditional sense – and will resist efforts to get diagnosis or treatment. Some are even indignant or hostile to any discussion they may have a problem, Ms. Nisson warned.

“In some peoples’ cases, they’re like, yeah, OK, I’ll go see the doctor,” she said. “But some are like, there’s nothing wrong with me. You’re acting like I’m crazy! You’re the one who’s crazy! Because they really don’t have awareness and the reason it occurs is because there are changes in the brain with dementia and it affects the frontal lobe,” she said.

That part of the brain is, part, responsible for good judgment and insight and early onset dementia often affects that part of the brain. But it’s not all bad news, she explained.

“What’s great about the West Valley is there are a lot of incredible resources there,” Ms. Nisson offered.

She explained the Banner Sun Health Research Center in Sun City provides free programs geared toward family members experience just these concerns, who want to be sure their loved ones are healthy or get them needed treatment but are not ready to make a formal appointment.

The Brain Health Check-In Program is offered 10 a.m.-2 p.m. Tuesday-Thursday, where staffers from their neurology and aging health departments meet with participants to provide screening for dementia symptoms.

Appointments and walk-ins are both welcome at the Sun City location based on availability.

While not a formal diagnosis, the screening program can be an easy, less-stressful way to get more information and decide if a potential patient should seek consultation with their primary physician or a specialist, Ms. Nisson said.

Another program offered through the Sun Health, the Memory Care Navigator program, provides in-home screening and a variety of services to families and patients.

The free, confidential program is available to those who qualify within the Sun Health catchment area, which includes the Sun Cities, Surprise, Youngtown and parts of Glendale and Peoria.

Based on the results of research studies, it is likely that thousands of West Valley residents could use the help, Sun Health officials said.

Raising awareness

Public perceptions and stigma present other challenges to proper diagnosis and care for those with dementia and Alzheimer’s, Ms. Nisson suggested.

“I think there’s a lot of stigma in any brain disease, whether it’s mental health or it's Alzheimer’s and related dementia, or whether it’s Parkinson’s or related movement disorders. There certainly are barriers to people wanting to accept help,” Ms. Nisson said.

Tools some advocates employ to combat stigma, especially in health care, include education efforts and public awareness campaigns.

To that end, the Banner Sun Health Research Institute has partnered with local municipalities on a campaign called the Dementia Friends initiative.

Just this week, Surprise Mayor Skip Hall issued a proclamation declaring Surprise a “Dementia Friendly City.”

“Surprise takes great pride in providing programs and services that give every member of our community the opportunity to thrive and feel supported,” Mr. Hall said at the Tuesday Surprise City Council meeting.

Campaign partners include Banner along with Benevilla, Sun Health Wellness and the Alzheimer’s Association.

As part of the new initiative, the Salvation Army hosts a free Memory Café at its Surprise location, 17420 N. Avenue of the Arts.

From 9:30 to 11:30 a.m. on the second and fourth Tuesday monthly starting Oct. 8, the café will provide a place for those suffering from memory loss and their caregivers to come hang out, learn and access resources and support services.

In 2016, city of Tempe officials also designated theirs a Dementia Friendly community, launching a number of programs, including a Memory Café, which is open 9:30 a.m.-noon on Mondays at the Tempe Public Library, 3500 S. Rural Road, Tempe.