Archive for March, 2012

Society and Dementia

So much is written about Alzheimer’s Disease; what to eat, what not to eat, how much to exercise, how to challenge your brain as well as the statistics predicting how many American’s will suffer from its devastating effects in the next 20 years. The other issue most talked about is the cost of Alzheimer’s Disease, predicted to reach $200 billion in 2012.  I recently read an article on a whole different perspective, a very human perspective: how many people live alone with their Alzheimer’s Disease.  The 2012 annual report released by the Alzheimer’s Association estimates that it is approximately 800,000 people with one half of them without any caregivers.

The cognitive deterioration is not noticed as many become isolated, lose a spouse or just choose to live at home.  Treatment begins late, if at all and the risk of injury from falls, wandering, and neglect is high.  Looking at the Alzheimer’s dilemma from this perspective elevates it to a crisis.  With our aging population more intent on aging in place and maintaining independence, action must be taken.  Education on healthy lifestyle, caring for community, and good medical care should be an ongoing state of mind.  Early diagnosis of dementia brings treatment, health care and caregiving issues to the table for discussion and the opportunity for all parties to participate in a plan of care and plans for aging.

Society needs to recognize the significance of dementia, how it affects the individual and their family.  South Korea has a mandatory high school course on the care of people with dementia.  Too often health care courses teach the physiology of dementia and neglect the social, financial, and psychological effects of all involved.

Understanding the effects of dementia makes everyone a better friend, boss, employee, neighbor and family member.  Staying alert as an educated caring community will mean those living alone are not forgotten.

National Healthcare Decision Day

April 16th is the 6th annual National Healthcare Decision Day.  It is a day set aside to encourage adults of all ages to take the time to put into writing their wishes for end of life care prior to a health crisis.  It is also a day to encourage healthcare providers to discuss these issues with their clients.

The fact that a national day of recognition has been set aside to initiate end of life discussions highlights the significance of this important topic.  Too often the imminent death of a loved one catches people unaware and unprepared, with difficult decisions having to be made amidst an time of emotional crisis.  Family members are all trying to cope with the impending loss in their own way, yet have to come together to make immediate an difficult decisions.

One of the things most people fight the hardest for all their lives is independence.  I remember my youngest saying “me do”  when insisting on doing her own thing. Teenagers fight to define themselves.  Adults resist assistance, fighting to keep their independence, sometimes beyond what can be safely executed. Why would you let others make your decisions on your last journey of life?

These discussions on end of life may not easy, but are much easier when conducted as part of life, just as wills, organ donation or estate planning.  My dad had decided to forego beginning a potentially life extending medication as his overall health began to decline as he approached his 90th birthday.  He discussed his decision with his family and reinforced his wishes for end of life at the same time.  A few months later  I received a phone call from his physician while I was with a client, telling me that the result of a recent cardiac test indicated that my dad had about 3 weeks to live. I do not remember leaving her home, or getting in the car, but do remember the long drive across town and delivering this message to him and my mom as though it was yesterday.  The next 3 months were difficult at times, but full of blessings and fond memories.  They were not encumbered with discussions and decision making concerning end of life issues.   Friends recently lost a son from a tragic motor vehicle accident.  After struggling with his funeral arrangements and death they realized the importance of and end of life plan and now  have formalized their wishes so their family will not have to cope with these decisions while dealing with grief.  What a gift they have given their entire family.

When approaching end of life some people want to be surrounded by the best of medical professionals until the last beat of their heart.  Others want their end of life to be at home, surrounded by family.  Sit with your family and friends and talk about your wishes for your end of life journey; what treatments you want, what you want people to know, what and who you want to be surrounded by etc.  There are several forms for recording your requests.  One that is easy to use and provides a guided discussion is The Five Wishes document which can be found at What ever your choices are, they should be documented and made known to your physician and family.  Take these decisions as your own and give one more gift to those you love.