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Published September 28, 2009, 12:00 AM

Alzheimer’s ‘burden’ likely to grow

Q & A with Dr. John Thomas
There’s a “train coming down the track” in North Dakota and Minnesota as baby boomers age, says Dr. John Thomas.

By: Sherri Richards, INFORUM

There’s a “train coming down the track” in North Dakota and Minnesota as baby boomers age, says Dr. John Thomas.

“We know the incidence of Alzheimer’s disease increases with age, so that there’s going to be a huge burden in the state of Minnesota, but the same is also true in North Dakota,” says Thomas, medical director of Hospice of the Red River Valley. “The other half of the equation … there’s less caretakers, less people in the age group to take care of an increased number of patients with dementia.”

Thomas was recently named to the 20-member Minnesota Alzheimer’s Disease Working Group, which will examine trends, needs of individuals with Alzheimer’s and the services available. It will report findings and recommendations to the governor and state Legislature by Jan. 15, 2011.

Thomas talked to The Forum about the neurological disorder, the challenges for rural residents and ideas for families dealing with dementia.

Q: What are the early signs and symptoms of Alzheimer’s disease?

A: Dementia is a loss of functioning in two or more cognitive areas. The most common area is memory.

Many of us forget to attach a name to a face or get to the store and forget bread, milk or toilet paper. Memory loss alone does not classify as dementia. You need another area of cognitive loss. The ability to plan and do things in sequence. The ability to have social interactions. But early memory loss can be early stages of dementia.

Probably the most common test is a mini mental-status exam, which is a common test that can be done in an office setting. The exam can be followed up by more sophisticated testing called neuropsychological testing.

How can end-of-life care, like hospice, benefit people with Alzheimer’s?

Taking care of a patient with advanced dementia is a huge job. In many cases, it takes three shifts of people to do that. So for patients with end-stage dementia who are being cared for by their families, any assistance that you can bring to help those families is badly needed and greatly appreciated.

So, nursing visits, social workers to help families negotiate the thing they mistakenly call a health care system, clergy, assistance with medications, equipment supplies, hospital beds. Oftentimes just help in terms of end-of-life health care planning. Many of these patients, the last thing they would want would be to die in a hospital ICU with tubes and monitors.

We also take care of a number of patients in long-term care settings.

What challenges do residents of a rural state face when it comes to living with Alzheimer’s?

Time and distance in rural areas is a significant barrier, and then you throw in an occasional blizzard. These patients become less and less portable. It gets more and more difficult to bring the patient to the clinic for an evaluation. So having services that can be available and trained nurses that can visit in the home makes a real difference.

The other piece we’re seeing particularly in North Dakota, are significant population shifts. I don’t think it’s a secret that many of the rural areas are decreasing in population. But the older residents tend to be staying to great extent. So the younger age group who are potential caregivers may no longer be in the community.

What suggestions do you give to families dealing with Alzheimer’s?

The Alzheimer’s Association is a great source of knowledge and wisdom. In terms of planning, in terms of learning what to expect, in terms of what resources are out there that families can tap into.

It’s important for patients and families to understand the nature and progression of the disease, to know what to expect. There are medications and treatments to help slow the progression of the disease. There are also significant interventions in terms of symptom management. Patients with Alzheimer’s disease often have disturbing behaviors. There are approaches in terms of dealing with those behaviors that can be extremely helpful. There’s support groups that let families know they’re not alone.

Can I plug a book? There’s a book called “My Mother, Your Mother” (by Dennis McCullough). It’s not a book about hospice care. It’s not a book about dementia. … It’s a book I recommend highly, and I think it’s helpful for families, not just with dementia.


Readers can reach Forum reporter Sherri Richards at (701) 241-5556

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