DavidT
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It's great to be here in the chat. I'm the executive director of the Alzheimer's Association here in Santa Barbara. We're part of a nationwide group of Alzheimer's Associations dedicated to helping patients and families. We're just beginning our conference here in Santa Barbara and it's a time of great optimism about treatment and research.
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Beth
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Question directed to David Troxel:
Wow, that's great - I am actually joining on line - I am with the Alzheimer Society in Canada - I am not at the conference
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DavidT
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Greetings Beth. I spoke in Calgary last year and enjoyed my time in Canada.
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DavidT
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We are just beginning our Alzheimer's conference here in Santa Barbara and we have a distinguished group of faculty coming together this weekend. Many are from National Alzheimer's disease Research Centers.
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DavidT
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We've just heard from Dr. Ronald Petersen of Mayo clinic about his important work on something called Mild Cognitive Impairment (MCI). This is a hot new area of interest, wondering if older people who are having mild memory loss eventually convert to full blown Alzheimer's disease. I don't think we'll ever be able to reverse the damage caused to the brain late in the illness, but maybe we'll learn ways to really slow it down or prevent it altogether.
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DavidT
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One of the presenters here is my co-author of a book we wrote called "The Best Friends Approach to Alzheimer's Care". This book is reflective of a new trend in dementia care where we try to be more positive and more solutions-oriented. It's my belief that there are things we can do to bring out the best in the person with dementia and to help ourselves as caregivers.
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DavidT
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One of the concepts from the book is something called Caregiving Knack, which we define in the book as the art of doing difficult things with ease. It's a real valuable concept for caregivers and for staff in long term care facilities. Hopefully we can teach them better and easier ways to do their jobs.
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Beth
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Question directed to David Troxel:
David - How do you feel about prescribing Risperidone for problem behaviors associated with Alzheimers Disease
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DavidT
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Beth, I'm not a physician so I'd rather not specifically answer your question, but let me make a few general comments.
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DavidT
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We used to be so afraid of mood altering medications and I think they still can be terribly abused and over-used, but at times some of these medications can make all the difference in the world to a caregiver trying to keep a loved one at home. One paradox is that these medications may make a problem behavior get better, but at the same time they can increase the very confusion we are concerned about.
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DavidT
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I'd like to welcome the other people in the room and ask if you have any questions.
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DavidT
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We'd also like to know why you are here or where you are from.
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sue
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Question directed to David Troxel:
Hi, I just logged on. Will you please tell me at what age does Alz. usually onset and what is the rate of dementia or quality of life deterioration one can expect?
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DavidT
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Sue, Alzheimer's is primarily a disease of older people well into their 70s, 80s and 90s. But younger people do get the disease. On average, a person with Alzheimer's lives 8 years after the diagnosis. But that statistic is not always helpful since the range can be so great.
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sue
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Question directed to David Troxel:
David, thank you for the information. One more question, what kind of research is going on to identify a genetic predispostion to the disease or is this something that is not being focused on.
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DavidT
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Sue, we are making incredible advances in our understanding of the root causes of Alzheimers. In general, we still think that Alzheimer's in not an inherited disease per se, but it does run in some families. This is why it can be called a familial disease. Researchers believe that your risk is greater if you have parents or relatives who got the disease at a fairly young age. but you could also have lots of relatives who have had the disease and never get it yourself.
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sue
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Question directed to David Troxel:
David, I remember reading something about stem cell research and a possibility that stem cells could reverse the effects of dementia and/or Alz.
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DavidT
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Question directed to David Troxel:
Sue, I know this has been a subject debated even in the US Congress. I think that this work is quite experimental.
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DavidT
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One phrase that I like to remember is that "if you've met one person with Alzheimers, you've just met one person with Alzheimers" Everybody seems to take their own course and the impact and symptoms of the disease vary.
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D
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Question directed to David Troxel:
I'm from the Rochester chapter of the Alzheimer's Association and thought this would be a good forum for any additional insights and information
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DavidT
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Greetings to the Rochester chapter. Feel free to share some of your work.
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sue
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Question directed to David Troxel:
David is there any kind of special diet that one can follow to deter the onset and or rate of Alz. Dementia?
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DavidT
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Great question Sue. Years ago I would have said no, that we can see no link between diet and Alzheimers. But interestingly enough we are beginning to see more linkages between lifestyle and dementia.
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DavidT
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Some people feel that people who are at a high cardiovascular risk for stroke or heart disease, that they might have a greater incidence of Alzheimers.
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DavidT
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If this is true, it's possible that the same healthy diet that we want to prevent heart disease, might in fact prevent or slow the onset of Alzheimers.
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DavidT
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There's also good research that vitamin E may slow the progress of early Alzheimer's Disease.
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rodger
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Question directed to David Troxel:
I would like to know if any special form of exercise may help prevent of deter dementia and Alzheimers. For example, yoga, meditation, etc...
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DavidT
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Rodger, I don't think we really have any evidence that exercise is linked to Alzheimer's disease.
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DavidT
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But certainly, we talk to families all the time and encourage them to keep their loved ones physically active.
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DavidT
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I really believe that the "game" so to speak we are playing as caregivers is to bring out the best in the person with Alzheimers. Keeping someone active physically has got to be good for them, improving sleep patterns. And probably using up a lot of excess energy.
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sandra
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Question directed to David Troxel:
Hi , I'm Sandra from the Alzheimer's Assoc Alaska Chapter in Anchorage. 17 degrees above today!
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prohealth911
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Wow, That sounds cold!!!!!!!!!!
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DavidT
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Hello Alaska!
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DavidT
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A lot of my work is also aimed at helping caregivers. I'm often asked what activities are appropriate or what might work. I believe that the caregiver should still work hard to pursue their own interests.
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DavidT
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One family here in California, a husband and wife, decided to walk every wooden pier in the state. Walking outdoors along the piers, the husband and wife could hear birds, the waves crash, smell the salt air, even feel the boards creaking under their feet. The husband said it was a wonderful activity for him and he thought this was very beneficial for his wife with Alzheimer's as well. She could also tell that he was happy and happiness was contagious.
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rodger
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Question directed to David Troxel:
How important is it for a potential caregiver to educate themselves on ways to treat their family member themselves or rater prepare themselves for the possible aspects of a person suffering form this disease, for example getting lost, forgetting their names, etc...
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DavidT
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Rodger, we always encourage caregivers to do their very best to plan ahead. This includes legal and financial planning, home safety, and wandering protection. There is a wonderful program called Safe Return that is in the US and helps find individuals with Alzheimer's who have wandered off. I highly recommend it.
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MeJe
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Question directed to David Troxel:
When will your new staff training book be available?
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DavidT
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MeJe, thanks for asking about the book. The book will be available in December and it focuses on how to create a caring community in long term care programs.
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D
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Question directed to David Troxel:
Does the book have a title yet?
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DavidT
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D, The book's title is "The Best Friends Staff: Changing the Culture of Care in Alzheimer's Programs"
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DavidT
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We argue in the book that our staffing crisis is so severe today in long term care that if we are ever going to make some major changes, now is the time.
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MeJe
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Question directed to David Troxel:
Is the book appropriate for adult day care and community based programs as well as residential settings?
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DavidT
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MeJe, the book is written for any long term care program, from in home to day center to skilled care.
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MeJe
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Question directed to David Troxel:
I'm "chatting" from South Carolina - it's 80 degrees here -
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DavidT
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It's between Alaska weather and South Carolina weather here in Santa Barbara. We've had lots of rain which has created havoc on our roads. In fact we're worried that some of our speakers for this afternoon might not show up!
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sandra
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Question directed to David Troxel:
Ok enough about the weather you're making me jealous. I am working on a training program to certify assisted living homes in Alzheimer's care here in Alaska. Do you know of other similar efforts?
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DavidT
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SAndra, you can contact Sam Fazio at the national Alzheimer's Assoc and he can give you some leads for your question.
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DavidT
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Today's newspaper in Santa Barbara, on the front page, says that one of our local skilled facilities will close due in large part to quality of care issues and staffing shortages.
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DavidT
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I really worry about the future of skilled nursing care and whether the whole system might collapse.
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D
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Question directed to David Troxel:
Besides Alzheimer's, what other topics are being covered and experts are attending the conference?
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DavidT
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D, our afternoon conference here in SB is aimed at research and medical practice, but we have many exciting topics ranging from ethics, training issues, diagnosis, medications and more.
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MeJe
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Question directed to David Troxel:
How do you feel about Dr. Thomas's proposed "Greenhouse" approach to long term care?
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DavidT
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MeJe, this is called the Eden Approach and I think it's a good one. I don't think it's the total answer to our problems but it's a valuable tool.
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prohealth911
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AlzheimerSupport.com would like to thank David Troxel and you for joining us for this chat. Unfortunately our time is up. Please join us for our next chat at 1:30 with Dr. Tiffany Chow.
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DavidT
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Thank you all for participating. Your local Alzheimer's Association is always an excellent resource and we would welcome you to visit Santa Barbara anytime.
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