Jane Austen's Guide to Alzheimer's

Image from the Times article

Carol Adams writes in her essay in the Sunday, December 20, 2015 New York Times:

I came to Jane Austen’s “Emma” in my 50s.  During a caregiving crisis in my life, I lost count of how many times I read or listened to Austen’s novel. I turned her words over in my mind like a piece of slowly melting hard candy.

“Emma,” which was first published 200 years ago this month, is one huge paean to caregiving, depicting its hardships, demands and frustrations. Recognizing the challenges in Emma’s everyday life, I was no longer bothered by Emma; I felt my heart break for her.

It is amazing how much one can learn from a really great novel.  According to Ms. Adams, “Emma” is a textbook for care givers.  It is now on my list…

See: Jane Austen's Guide to Alzheimer's.

Escape From the Land of the Pink Bibs

This is the story of Narcy Houle’s father, a highly respected orthopedic surgeon, developed Alzheimer’s.  During the course of the disease, he broke his hip. One day when we visited him at the nursing center, about six months after his accident, we found him sitting in a row of patients all wearing pink bibs, left on after they had finished eating. Like the others, his head was bent toward his lap; though his eyes were open, they were not focused on anything. His shoulders slouched, like a rag doll’s, and his mouth hung slightly ajar.

What he needed was a geriatrician.  Most health care professionals have had little to no training in the care of older adults. Currently, 97 percent of all medical students in the United States do not take a single course in geriatrics.

Recent studies show that good geriatric care can make an enormous difference.  Older adults whose health is monitored by a geriatrician enjoy more years of independent living, greater social and physical functioning and lower presence of disease. In addition, these patients show increased satisfaction, spend less time in the hospital, exhibit markedly decreased rates of depression and spend less time in nursing homes.

See:  An Aging Population, Without the Doctors to Match by Marcy Cottrell Houle (NY Times, September 23, 2015)

The Last Days of Her Life

When Sandy Bem found out she had Alzheimer’s, she resolved that before the disease stole her mind, she would kill herself. The question was, when?

"Sandy Bem, a Cornell psychology professor one month shy of her 65th birthday, was alone in her bedroom one night in May 2009, watching an HBO documentary called “The Alzheimer’s Project.” For two years, she had been experiencing what she called “cognitive oddities.”

NYTimes article Sunday Magazine, May 17, 2015

Sandy Bem and her daughter

A Lion in Winter

“Fierce-eyed, 88 year-old Jerome Medalie has seen people close to him die lingering deaths from dementia and has already decided. His pithy motto is: ‘If I’m not me, I don’t want to be.’”

Mr. Medalie’s advanced directive also specifies something more unusual: If he develops Alzheimer’s disease or another form of dementia, he refuses “ordinary means of nutrition and hydration.”

“Some wonder if a directive to hasten death by withholding “ordinary means of nutrition and hydration” should apply to persons who can’t remember it.”

Paula Span’s article in the NY Times, Complexities of Choosing an End Game for Dementia, is worthy of thought and discussion.

"Had we both world enough and time" to discuss this...

How A Woman's Plan To Kill Herself Helped Her Family Grieve

Five years ago, after doctors told her that she had Alzheimer's disease that would eventually steal her ability to read, write and recognize people, Sandy Bem decided to kill herself.

Sandy was 65 years old, an unsentimental woman and strong willed. For her, a life without books and the ability to recognize the people she loved wasn't a life she wanted.

And so she decided there was only one thing to do. Sandy's plan was to wait until the last conceivable moment that it was physically possible for her to commit suicide alone, then go off and kill herself.

Dr. Bem wasn't a stranger to suicide. She and her husband, , were both psychologists, professors emeritus at Cornell University in Ithaca, N.Y. Both had volunteered at a suicide hotline, and so had an intimate appreciation of just how destructive the act of suicide could be.

This NPR piece is worth listening to. (June 2014)  8 minutes.

About Sandra Bem.

Alzheimer's Epidemic

According to a 2014 study from Rush University Medical Center, the number of deaths attributable to the Alzheimer’s disease had been vastly undercalculated. The research showed that Alzheimer’s was the underlying cause in 500,000 deaths in the United States in 2010, a figure close to six times the estimate from the Centers for Disease Control. This means that in a single year, Alzheimer’s claimed nearly as many lives as AIDS — responsible for 636,000 deaths in this country — had taken in more than three decades.

See NY Times article: Alzheimer's:  A Neglected Epidemic.

My Mother's Keepers

Photo from NY Times article

My Mother's Keepers is a touching essay written by Janet Steen about the care given her mother by a Caribbean family living in the Boston area.
It could be a template that would help elderly patients while also assisting poor families.  Instead of paying exorbitant fees to a nursing home care can be provided in the community.