Dr. Jacqueline Gerhart: How Much Does Parent With Alzheimer's Remember?
Madison, Wisconsin - UW Health Family Medicine physician Jacqueline Gerhart writes a column that appears Tuesdays on madison.com and in the Wisconsin State Journal. Columns are re-published here with permission.
Dear Dr. Gerhart: My dad has Alzheimer's disease, and every time I go to the nursing home I feel like he doesn't even know I'm there. Can he actually remember me visiting him? Alzheimer's seems so common. Why haven't we found a cure?
Dear Reader: I see many families who are affected by the confusion and uncertainty of a loved one with Alzheimer's. It's often hard for families to bear. It's common for family members to wish their loved one could do more, remember more and experience more. As they see Alzheimer's take a larger grip on their family member, they often feel helpless and hopeless.
It may be difficult to know exactly what your father remembers, as it can change from day to day. There are usually three stages of Alzheimer's:
- The early preclinical stage, with no symptoms but with brain matter changes,
- The "mild cognitive impairment" stage, where he or she has more difficulty with memory and thoughts than his or her peers
- And the final stage - dementia - where memory, thought and, often, personality are altered. They may start to forget names of people they know. They may forget routine tasks such as combing their hair. Later, they may have lapses in language or thought processing. At this point they may become anxious or even angry.
Eventually, most people with severe Alzheimer's need total care, either from family members, skilled nursing facilities, or hospice (if their expected life span is less than six to 12 months).
If your father is in the first stage, he likely will remember and appreciate you and your efforts. As he progresses into the final dementia stage, it is difficult to say what he will remember. Many caregivers describe "good days" and "bad days." It is important to maintain a positive attitude and to find joy in the successes and memories that are still apparent.
Alzheimer's disease was first described in 1906, when Dr. Alois Alzheimer noticed that the brain tissue of a patient with memory loss, language problems and unpredictable behavior seemed different than "normal" brain tissue.
These differences are called "amyloid plaques" and "neurofibrillary tangles," which develop from abnormal deposits of proteins in the brain. This causes the nerve cells in the brain to function more slowly, and to not communicate with each other.
When this happens, the cells start to die, and eventually the brain itself begins to lose size. The time from diagnosis to death varies, but can be as little as three years up to 10 or more years.
Given that there are 5 million Americans with Alzheimer's, there is a significant amount of research dedicated to the topic. In fact, it is a hot topic for federal funding.
President Obama has proposed a fiscal year 2013 budget increase of $100 million for efforts to combat Alzheimer's. This includes $80 million for research, $10.5 million for caregiver support, $4.2 million for improved public awareness efforts and $4 million for clinician education.
As yet, there isn't a cure for Alzheimer's, but there are treatments that can help to slow its progression and increase quality of life. If you are interested in community resources, further care options or medication management, contact your primary care physician.
This column provides general health information and is not specific advice intended for any particular individual(s). It is not a professional medical opinion or a diagnosis. Always consult your personal health care provider about your concerns. No ongoing relationship of any sort (including but not limited to any form of professional relationship) is implied or offered by Dr. Gerhart to people submitting questions.
Date Published: 07/10/2012