Well I’ve been spending a lot of time with Dr. Google lately, digging into the drug trials and drug assessments. Seems like the most thorough ones are the ones where government bodies in countries with public health are trying to figure out if the enormous cost of these drugs is worth the money in terms of patient and carer quality of life. (I’m paraphrasing an awful lot of statistics and probabilities and assorted test scales here, most of which I don’t understand very well.)
However, the bottom line (and they mean it!) seems to be that the drugs like donepezil (Aricept) work in terms of improving life for patient and caregiver, at least until the severe stage, but that the deterioration continues underneath the drug treatment of symptoms, so that stopping the drug leads to almost immediate huge setbacks.
Memantine (Trade name Ebixa here in Canada) works to improve mood and maybe function a little tiny bit, (in several studies not even statistically significant) and is considered cost effective. However, the delay to care home placement is measured in weeks or a couple of months. And here I thought we were talking years of stabilization! No miracles here, folks (move along).
Nonetheless these incredibly expensive — and profitable — drugs are cost effective for government systems because even a few months of delay in placement saves thousands of dollars to the health care system.
I THINK, if I read it right, the assessment for the UK also indicated that although these drugs do help somewhat with functionality, they do not affect life expectancy — they slow down the deterioration but do not stop the progression of the disease, which is going on underneath the drug treatment. Most of the trials continue to be of such short term though – 6 months, 24 months – that there really isn’t a lot of info. Also the government assessment is most concerned with delay of placement in care homes, not long term outcome.
Very confusing and of great interest to those of us like me who wonder how long WE can survive our loved ones’ illness.
Another Mayo Clinic Alzheimer’s blog this morning and I found myself lingering over two earlier posts, both of which are enormously helpful to caregivers’ relations.
They deal with the different kinds of memory what is affected how.
One was on procedural memory (brushing teeth, finding “your” chair) which remains intact for a very long time.
The other was on emotional memory and how emotions linger long after the cause is forgotten and thus “blow ups” are triggered.
I figure that’s why it is so important to paste a smile on your face and be calm and non-argumentative, no matter what you really think – the not-so-“patient” has no recall of what events ACTUALLY triggered their emotions.
I just realised that has become my new morning discipline — some of us meditate, I practise smiling.
This is a pretty amazing demonstration of the ability to communicate long after the words have gone….music and early memories remain to be used as a bridge. The video says to check out memorybridge.com for more information, and I sure will. I am pretty sure that such techniques modified to each person’s level of disability (not so extreme) will also work with our dear ones who are not so far lost in this path. I guess we will find out 🙂
A day to be thankful for what we have, because it always could be so much worse, and because we have friends like our Tuesday group to help us along this long and lonely way.
Here’s what that workshop said worked liked like magic (there was more but I had to go pay attention to the hurricane brewing in my living room…you know!)
Don’t deny, don’t defend, don’t counter attack, and don’t withdraw.
Maybe it’s a mantra for those in horrid spaces with their beloved.
Hard to do – requires being absolutely centred – not self-centred – just centred, – breathing from the diaphragm and knowing all is dust and ashes and joy and tears of laughter ….
I think this has something to do with it all (although I couldn’t say exactly precisely what!) … but all the wisdom ties together https://careingcv.wordpress.com/2013/10/09/looking-forward-to-more-self-care/#comment-14
Does anyone know what the effects of memantine are — they tell me it will (or MIGHT) stabilize my love at his current level of ability (which is better than him getting worse naturally) but I am wondering how it affects the overall course of the disease. (as if we know what that is!) What I am wondering (and I suppose it is wicked) is whether this drug means he will be “stabilised” like this for another decade? Or if the typical disease profile still applies?
As this long journey goes on (and on and on and on) I find myself being forced to spend more time thinking about me and how I am doing. Not so well, some days, for sure. I can feel that I am developing the same “pain in the neck” that I had for two years before my mother died, and now I am facing a long drawn-out similar situation with my love. Yikes. I need to learn how to put the joy back in my days, because I could die with this situation still continuing. Can’t “wait it out” because it could be another decade or even two. Unreal. I have to learn to be joyous in the midst of this, and I need to stop thinking of it as a prison (although it is — one with no hope of parole!)
All this whinging started out as a simple note to my Tuesday group friends about the next tele workshop I hope to listen to: ” Strengthening Your Caregiver Backbone: Assertiveness Skills for Family Caregivers: In this session you will learn some simple yet effective communication tools that will benefit any interactions you have with others. Learn how to be more assertive with the person for whom you are caring, other family members and people in the healthcare system. Assertiveness involves actively expressing yourself, while also listening to and respecting the rights of others. Whenever there are differences, both minor and major, becoming assertive can help to minimize the ongoing confrontations that can rapidly develop due to the stress and demands of caregiving. This webinar is facilitated by Allison Reeves, Registered Clinical Counsellor and runs from 6:30 – 8:00 PM. We gratefully acknowledge the United Way of Greater Victoria and the Province of British Columbia for partial funding of this event.”
You can register through http://www.careringvoice.com/for-caregivers.php
Here’s a course at NIC that might be of use to some of us — I am planning to take it if I can get a caregiver for the day!
Activity Programming for Residents with Dementia
If you have an interest in developing activities for seniors who have cognitive challenges this workshop will be of value to you. Activities are planned to meet emotional, physical, cognitive and social needs. You will be introduced to the basics of how to plan activities to enhance a client’s skills and abilities in the areas of daily living and leisure. Topics covered will be brain function and how it affects programming, problem solving strategies, and implementing practical solutions. Please wear comfortable clothes for active participation.