Author: Samira Mosalla
Contributor: Jessica Ly
History of the Disease
Alzheimer’s disease has been recognized for over a century now, and affected 5.6 million Americans over the age of 65 in 20191. It is also ranked the sixth leading cause of death in America2. Alzheimer’s disease is an irreversible brain disorder that destroys one’s cognitive abilities. One’s memory begins to slowly fade away and eventually simple daily tasks become a struggle to carry out. This disease is the leading cause of dementia, which may also be caused by other diseases, and comes in different stages ranging from mild to severe, as the cognitive damages progress.
The main characteristics of Alzheimer’s disease that Doctor Alzheimer first witnessed in his patient were abnormal clumps in the brain known as amyloid plaques, a tangled bundle of fibers also known as neurofibrillary tangles, thus there is a loss of connection between neurons. With continuous technological breakthroughs, scientists are able to study the biological features of Alzheimer’s disease in the brain much more thoroughly than ever before. Through scientific research it shows that the brain begins to deteriorate slowly about a decade before symptoms appear. The damage takes place initially in the hippocampus and entorhinal cortex, which is where memories are formed. As healthy neurons stop functioning, they begin to die and the brain begins to shrink.
Researchers are trying to study the biomarkers of Alzheimer’s for an earlier detection of the disease, but more research needs to be done before it can become a part of everyday medical practice. Why is it that this disease targets older adults? This question seems to still remain a mystery3.
There is a gene known as apolipoprotein E that can increase the risk of developing Alzheimer’s disease. Obtaining this gene does not necessarily mean that one will definitely develop the disease, and some people whom do not have the gene can result in having the disease. Sometimes the case may be that an individual will inherit a change in their genes which can result in an early onset of the disease known as FAD; familial Alzheimer’s disease. Individuals with Down syndrome are also more prone to developing this disease because of their extra chromosome that generates amyloid. Many researchers also state that genetics factors are not the only cause of this disease. There are environmental, health, and lifestyle factors. Eating healthy, exercising, and being socially engaged while keeping your brain stimulated can decrease the risk of developing Alzheimer’s disease.
This disease at hand is a very complex one; there is no treatment. There are many medications that can assist in maintaining mental function and reduce symptoms, but will not change the eventual path of the disease process. Researchers are still looking into discovering ways to delay or prevent Alzheimer’s disease.
Many people know that this disease comes with memory loss, but what many don’t pay attention to are the larger social issues that come along as well. More and more people are being diagnosed with this disease, and that leaves these patients to require around the clock care. The symptoms of the disease include anxiety, sleeplessness, and aggression. These symptoms can take a toll on the family and the caregivers of a person with the disease. Not only is it emotionally draining for them, but also financially. The care that these patients require is very demanding, and researchers are also looking into ways to make this process easier for the families and caretakers. Taking care of someone with Alzheimer’s disease can cause stress and burnout. There are two primary caretakers; family and/or a private duty attendant, both of which can be very time consuming and stressful4.
Caretaker as a Family Member
Family members are the primary caretakers of Alzheimer’s patients because hiring someone would result in a financial burden. There are already so many other costs that come into effect when caring for someone with Alzheimer’s that hiring a caretaker is not always ideal. The majority of family caretakers tend to be housewives. As a family member, they have little to no training at all when it comes to taking care of a patient; this may result in burnout emotionally and physically. Most of their time becomes devoted to taking care of this person and they end up losing any social life they ever had. They tend to lose a sense of control of their futures and proceed to isolate themselves from others because they feel obligated to being a 24/7 caregiver, which can disrupt their sleep schedule and result in a weakened immune system. This may further lead to cutting down on spending on themselves to be able to afford the proper care the patient needs. Dealing with an aggressive and irritable patient can be emotionally and physically exhausting, and can be detrimental for the caretakers health. The health effects on a caretaker can range from cardiovascular diseases to arthritis. There seems to be a direct link between chronic diseases and feelings of emotional exhaustion for caretakers4.
Anger and denial are symptoms that a family caretaker can suffer from as well. As an Alzheimer’s patient, remembering how to do everyday tasks becomes hard. Simple things such as dressing oneself is no longer a task that can be carried out by the patient; therefore, this might frustrate the caretaker. The patient may have known how to dress themselves the day before, and will forget the very next day.
Caretaker as a Stranger
Taking care of someone with Alzheimer’s can be just as draining if there is no relationship between the two people. Private caretakers are doing this as their paid job, but family members feel a moral obligation to their relatives. Alzheimer’s patients require a lot of assistance, and round the clock care, which can lead to burn out quickly for the caretaker. Patients can struggle with sleeping; therefore, keeping the caregiver up all night as well. The only upside to a private caretaker is that there is no financial burden on anyone besides the person paying the caretaker for their services. Most caretakers work through private companies that bill the insurance companies that cover some costs of care, but most insurers do not cover this.
Although many caretakers are family members, that does not cut the cost of Alzheimer’s disease by much. Common costs for the disease other than a paid caretaker include, treatment, medical equipment, prescription drugs, and much more. In 2017, according to the PhRMA, the cost of Alzheimer’s disease and other dementias in the U.S. cost $259 billion.5 In 2050, they estimate the cost to medicare and medicaid to be about $758 billion. At the facility I currently work for, residents with Alzheimer’s disease are living in the Assisted Living apartments, paying nearly $9-10K a month for a single occupancy room. The families of these residents are not capable of caring for them; so they move them into these expensive senior care facilities.
There have been drastic increases in Alzheimer’s disease cases, which is only increasing the costs of care and resulting in caregiver stress. The cases will keep increasing with time; therefore, the number of Alzheimer’s cases will reach 7.1 million by 2025, from the current 5.7 million that are present now6. An estimated cost for Americans suffering from Alzheimer’s is $277 billion, not including the unpaid caregivers/ family members mentioned previously6. The only solution for a problem this large is to keep attacking Alzheimers with a multidimensional approach through extensive research and also providing the proper care and support for the patients with the disease along with their caregivers as well. Early recognition and effective medications as well as better understand of pathogenesis are essential.