What do you do when someone you love starts to confuse who you are and how to perform day-to-day activities? Could it be Alzheimer’s disease?
What is Alzheimer’s?
Alzheimer’s is the most common form of dementia. It’s increasing rapidly nationwide, taking a heavy toll on those who have it and their families.
“More than 5 million Americans are living with Alzheimer’s, by 2050 this could rise as high as 16 million,” reports the Alzheimer’s Association. They also note the prevalence among many people over age 65, women and African-American and Hispanic people.
Juan Escobales, MD is the chief medical director at Suncoast PACE (Program of All-Inclusive Care for the Elderly), part of the Empath Health network. He and the PACE team provide a wide scope of medical care, adult day care and support services to help keep Pinellas County seniors with chronic illnesses as healthy and independent as possible. One common disease they help manage is Alzheimer’s.
“Alzheimer’s is a decline in cognitive skills. People can have difficulty paying bills, losing keys, driving, cooking, cleaning house, personal hygiene, getting lost or identifying people they need to connect with. The immediate recall is affected more than the past recall. They tend to recollect what happened years ago and not what happened in the last few days. Alzheimer’s is probably 60 to 70% of cases of dementia. Other dementia includes alcoholic-induced, vascular, frontal temporal and more,” Dr. Escobales explained.
Alzheimer’s and Hispanics
In light of National Minority Health Month in April, Dr. Escobales addresses how Alzheimer’s is diagnosed, its impact on Hispanic populations and PACE and other community services that help support patients and families.
Research shows that Hispanic people are more likely be diagnosed with Alzheimer’s.
“Hispanics are Spanish-speaking people from the Caribbean, Spain, Mexico, Central America, South America and other areas. There are differences in one population to the other. I’m from Puerto Rico and have been here 40 years. Once we come and live here we become acculturated. It increases the likelihood of getting Alzheimer’s,” he said.
He added that several Alzheimer’s risk factors and barriers to treatment affect Hispanics.
“Factors to developing dementia are having diabetes and vascular (hypertension and stroke) conditions. There are characteristics that cause barriers to getting treatment for dementia. One is lack of connection to the healthcare system because of economic, transportation or language barriers. There is a wide class of Hispanic people, but many Hispanic people in the U.S. are not educated and are doing industrial, heavy work with low incomes and high stress. Nowadays if people don’t have a legal status, they’re afraid to seek care for fear of being taken out of this country.”
Some people may not recognize the signs of Alzheimer’s with their loved ones, Dr. Escobales says.
“One of the big barriers with Alzheimer’s is the stigma. We’re getting used to the idea that this is as common as diabetes. Like diabetes, once you have it you can’t stop it but you can control it. Because of the language barrier and lack of regular care, Hispanic families tend to deny the problem. They tend to say that it’s just old age.”
Many families take on responsibilities and sacrifices caring for their loved ones, he added.
“Hispanic families tend to be more into personally caring for their loved ones, so they don’t necessarily want to put them in institutions. Most females, including daughters and daughter in-laws, are caregivers and give up their jobs for their loved ones’ care. It’s very expensive.”
He says testing can be done by providers when they notice signs of dementia.
“We do basic testing to exclude B12 deficiency, cerebral abnormality, hydrocephalus (fluid in the brain) or infection (e.g. syphilis). We look for reversible conditions that can be corrected, such as infections, neoplasms (abnormal tissue growth that can become tumors), stroke or metastasis of cancer. Many times we find cancer if we do an MRI (magnetic resonance imaging). Hydrocephalus is also common with older people.”
One elderly Hispanic woman recently turned to Suncoast PACE for care after her dementia diagnosis.
“This one lady was from Puerto Rico. The family realized she had difficulty driving and became confused and unable to care for herself. She came to live with her daughter in St. Pete. Her daughter took her to a neurologist, who did a mini mental status examination with a series of questions asked regarding her name, date of birth, location, objects, drawing a clock and more. She failed the test. And she continued to decline with confusion, falling and agitation. Eventually she joined PACE because she needed support. She continues to enjoy PACE and have excellent support,” he shared.
Getting Help Needed
Many local programs are available to help those impacted by Alzheimer’s.
“The Alzheimer’s Association is a good place to check with. Most of the hospitals have educational materials and referral sources. The Area Agency on Aging and Empath Health are other good resources,” he noted.
At PACE, the team focuses on treating a person’s whole well-being.
He shared, “We help our participants with a team approach with all levels of professionals, including nurse practitioners, home health aides, dieticians, physical therapists, pharmacists, activities director and others. We have all that you need.”
They also help educate families about care and decision making.
“We can’t stop the disease (Alzheimer’s). We try to control it like any other condition people may have, such as diabetes, heart disease or arthritis. It’s important to pay attention to early symptoms before they get out of hand. It’s also important to educate the caregivers so they can help their loved ones do early healthcare and end-of-life care planning while they can decide for themselves,” he said.
We are here for you
Find out more about Suncoast PACE online or contact us at (727) 289-0062 or (800) 458-2933.
Fill out living will and dementia living will extension forms online or call us for assistance at (727) 536-7364.
Come to our next Alzheimer’s caregiver support group on May 8 from 9:30 a.m. to 10:30 a.m. at Largo Public Library. Call to register with Maria Pepe at (727) 479-7071 or Tracy Christner at (727) 536-7364.