Category Archives: Awareness & Activism

Alzheimer’s Society facing criticism over ‘The Long Goodbye’

A short film by the UK-based Alzheimer’s Society has generated a wide range of strong emotions from those with dementia and their families. In addition to the original video campaign embedded above, there is also an extended cut version and a profile of a couple who faced a heartbreaking FTD diagnosis.

The crux of the criticism comes from the film’s fatalistic point of view, framing dementia as a series of deaths that occur when a person loses the ability to do something they loved or remember something fundamental to their life, such as remembering their child’s name. With these series of “deaths”, one will need an organization for support, which is where the Alzheimer’s Society says it will be there for families impacted by dementia again and again.

George Rook, a patient activist living with dementia, has posted his eloquent rebuke of the film on his blog. It’s garnered a lot of support within the dementia community, and he has since written more posts related to the film that I encourage you to read.

Gail Gregory posted a moving response to the film, demonstrating how she has made adjustments in her life to live well with dementia.

The Guardian also wrote a column about the controversy, with the columnist agreeing that the film is uncomfortable to watch and concluding that “the advert went too far, but that one of the many issues with the public discourse about dementia is that it can be overly sanitised.”

Below is the Twitter/X post from the Alzheimer’s Society which I’m including so you can read the replies. As you can see, the video sparked a passionate discussion from those living with dementia who felt personally offended that they were being portrayed as the living dead when in fact they are living with dementia reasonably well.

In the Alzheimer’s Society response to the video’s controversy, it states the need for a societal wake-up call when it comes to dementia. It’s the leading cause of death in the UK and according to the organization, only 10 percent of people are aware of that sobering fact. I know I was not aware of that statistic.

If you’ve read my book, The Reluctant Caregiver, I think you’ll know my take on the film. While I can understand some may find the tone of the film harsh, I do agree with the need for a wake-up call. That’s why I wrote about the difficult moments in my caregiving experience, even if that has led to some reviews that the book is depressing.

In the US in particular, the financial impact of dementia is something many people are woefully unprepared for as they think Medicare will cover expenses. People don’t fully appreciate the challenges of living in place nor are they prepared for the astronomical cost of memory care. As for the “series of deaths” a person with dementia may experience, there is a real sense of loss when the disease takes away people’s abilities and aspects of their personality. As I wrote in my book, it did feel like an imposter had taken over my dad’s body. When he looked my mother straight in the eye and asked where she was by name, the heartbreak I experienced was worse than when I viewed his body in the morgue.

My mother dealt with the brunt of my father’s dementia. From what my mother, the eternal optimist, told me, there were not many good days. I’m sure she didn’t even share all of the horrific moments, though some she couldn’t hide, like when my father punched my mother in the jaw as she tried to get him ready for bed.

Once he was heavily drugged in the memory care center, his aimless shuffling through the hallways with the lost, vacant stare in his eyes did make him seem like a zombie in some ways. I know some people may find that portrayal offensive, but that was my honest reaction at the time.

I’m encouraged by those with dementia who continue to lead rewarding lives, and if I get the dreaded disease one day I hope I will follow their example. Unfortunately, that was not my family’s experience with the disease. It not only had a dire financial impact but I’m also convinced that the toll of caring for my father played some role in my mother ignoring her own health issues and being diagnosed with stage III colon cancer just six months after his death. I live alone and don’t have children, so for those of us without a support network, thriving with dementia may be a challenge.

We live in polarizing times when we refuse to recognize that multiple things can be true at once. There are some people living well with dementia, and maybe that should be the focus of the Alzheimer’s Society’s next awareness campaign. Kudos to these people and we should all be working towards the goal of improved treatments and better support resources so that living well with dementia becomes the norm and not the exception. But there are also those whose lives, and their family’s lives, are devastated by dementia. Those stories should not be buried because they make some people uncomfortable.

Each person with Alzheimer’s or another form of dementia will experience the disease in their own unique way. So will their families. We should encourage those from across the spectrum of dementia experiences to share their stories, the good, the bad, and the ugly.

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2024 Alzheimer’s Disease Facts and Figures

The 2024 Alzheimer’s Disease Facts and Figures has been released by the Alzheimer’s Association. One major fact that jumped out to me was the topline figure. For years, it’s been over 6 million people in America are living with Alzheimer’s. Now we are at the 7 million threshold.

Here are other major takeaways from the report:

  • 1 in 3 seniors dies with Alzheimer’s or another dementia.
  • Alzheimer’s kills more people than breast cancer and prostate cancer combined.
  • Between 2000 and 2021, deaths from Alzheimer’s have increased by 141 percent.
  • In 2024, Alzheimer’s and other dementias will cost the US $360 billion.
  • That cost would have been even higher if it hadn’t been for the over 11 million Americans who provided unpaid care to people with Alzheimer’s and other dementias.

You can review the entire report at https://www.alz.org/alzheimers-dementia/facts-figures.

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New study sheds new light on cognitive decline’s impact on speech functions

Changes in speech and word recall can be among the earlier signs of cognitive decline. We’ve all experienced this, no matter what the age: “It’s on the tip of my tongue!” While not always a precursor to Alzheimer’s or other forms of dementia, it’s important to recognize changes and talk to your doctor about them.

A recent study, albeit with a small sample size of 125 people, shed new light on what is a frustrating yet common complaint among older adults: difficulty in finding words. Among the findings: “Overall reaction time for word retrieval (controlling for psychomotor slowing) was the best predictor of spontaneous WFD (word finding difficulty) and executive function decline, suggesting processing speed as the key factor, and that verbal reaction time may be an important clinical measure.”

AI software was used to extract data such as speech speed, word variety and pauses in speech, according to The Conversation report. The study participants also completed a series of tasks designed to gauge executive function ability, and the results found a link between age-related decline in executive task ability and speech pace.

The findings are interesting but of course more research will be needed with a larger study group. If confirmed, the findings could help in forming more accurate tests for cognitive decline.

Image created by Microsoft Copilot.

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Wendy Williams diagnosed with FTD, aphasia

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Former talk show host Wendy Williams recently revealed that she has been diagnosed with primary progressive aphasia and frontotemporal dementia (FTD). The update on her medical condition was provided as a new documentary about Williams and her whereabouts since leaving her talk show aired and generated a great deal of controversy.

I watched the documentary, “Where is Wendy Williams?” and while it was difficult to watch her cognitive struggles, a lot of people got an eye-opening education on the varied forms of dementia. While Alzheimer’s has moved more into the public awareness in recent years, dementia variants like FTD are less known and understood. For those who think dementia is just “memory loss” witnessing the symptoms Williams displayed, combined with the aphasia, should raise awareness of the distinct symptoms that dementia variants can present.

FTD can trigger personality-driven changes, with erratic behavior and mood swings. For the former radio personality and talk show host, aphasia is a particularly cruel diagnosis, as it impacts speech and language skills. All of these symptoms are on display in the documentary, further aggravated because of Williams self-medicating with alcohol. Williams was previously diagnosed with Graves’ disease and lymphedema.

The documentary also puts a spotlight on court-appointed guardianships, and how a system supposedly designed to protect the vulnerable can isolate the person and cause further harm. The Williams family feels cut off from providing care for their struggling family member, while those in Williams orbit approved by the guardian seem not equipped to handle such a complex case. There is also the challenge of convincing a loved one that they need help, which is something many families dealing with dementia are all too familiar with.

Actor Bruce Willis has also been diagnosed with FTD and aphasia. I’m grateful that both celebrities have chosen to go public with their dual diagnosis, as it will help raise awareness and hopefully funding for these conditions.

I’m participating in the Smashwords  2024 Read an Ebook Week promotion that runs from March 3-9. During this time, get my award-winning personal essay collection, The Reluctant Caregiver, as well as CBD for Caregivers, for half off.

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Remembering Wendy Mitchell, who shared her dementia experience with candor, compassion

I was saddened to learn that Wendy Mitchell, who so generously and insightfully shared her experience living with dementia through her blog and books, died this week. However, I take solace in knowing that Mitchell left this world in a way that honored the agency she still had over her own life.

I mostly knew Mitchell through her blog, Which me am I today? The blog’s title captures the dementia experience so well. I enjoyed the photos she shared from her sunrise walks, which included gorgeous skies as well as a variety of birds and other animals. Mitchell was dedicated to her nature walks, writing that the “miracle of nature would thin the glue in my head and bring me alive again.” Mitchell shared the full spectrum of the dementia experience, demonstrating that memory impairment does not prevent those with dementia from continuing to feel a wide range of emotions, maintaining a sense of humor, and achieving new milestones.

At the same time, Mitchell was clear-eyed about what the end of the dementia journey looks like for many people, and she was determined to not have her life end that way. She had been making her end of life plans for awhile, consulting with family and getting their blessing. Because assisted dying isn’t a legal option in the UK, Mitchell planned to travel to Switzerland and utilize the services available at Dignitas. But a recent fall in which she spent a week in the hospital derailed those plans. With her mobility limited, Mitchell chose to stop eating and drinking. You can read Mitchell’s final blog post which goes into detail about her decision process. I encourage you to read it, even if you disagree with her choice.

For the record, I support assisted dying and would consider that option for myself. I think it’s a decision for an individual, in consultation with family members, medical providers and spiritual advisers to make, NOT government officials.

Mitchell shared on her blog what she hoped to accomplish by sharing her dementia journey: “What I want is not sympathy. What I want is simply to raise awareness.” Mission accomplished.

Mitchell was a cherished member of AlzAuthors, read their lovely tribute.

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How creating GenAI prompts reminds me of dementia communication

For the past year, I’ve immersed myself in the emerging generative AI technologies. Mostly for my job, but also for my personal curiosity. Every industry is being impacted by AI, including caregiving. If you’ve followed any of the AI discussion, you’ll know that while the technology offers great potential in certain areas, it also can produce errors, which are referred to as “hallucinations.”

Users of these gen AI models are given the responsibility of creating suitable prompts for whatever tasks they are asking the model to complete. There are now people being hired as “prompt engineers” solely for that purpose. The reasoning goes that the better the prompt, the better the execution.

Instead of just typing in a few keywords into a search engine bar, one has to think about a variety of details. There’s a lot of trial and error in the process, with the accompanying frustration and wonder when you get it just right.

This made me think about communicating with someone in the earlier stages of dementia. The person’s communication skills are typically not that impaired early on, but some aspects may be slightly off. The misuse of a word. The incorrect memory recall. The out of left field response. Not understanding a routine request the person’s done many times before.

I remember having conversations with my father during those early stages of the disease and it was disconcerting because our discussion was mostly normal, until it suddenly wasn’t. And that’s how it feels to me working with generative AI technology. It’s accurate a good deal of the time but there’s still something just a bit askew.

If gen AI is characterized as being almost human, we sometimes feel our loved ones with dementia are not the people they once were. Creating AI prompts reminds me to be thoughtful when assembling the building blocks of communication, and how we may be required to reconstruct our typical communication style with our loved ones with dementia, by reframing questions and devising ingenious ways to keep the conversation, and the connection, alive.

The prompt used for the blog post image: “A digital illustration of an adult daughter and her 80-year-old mother with dementia setting at the dining room table, having a conversation with each other, with hearts floating around them.”

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Study explores link between vision issues and Alzheimer’s disease

A recent study published in The Lancet takes a closer look at a specific vision issue that previous research suggests has a link to Alzheimer’s disease.

The new meta analysis reviewed previous research studies on posterior cortical atrophy. The rare condition causes damage to an area of the brain that results in visual impairment. According to the Alzheimer’s Association, symptoms can include difficulty in “judging distances, distinguishing between moving objects and stationary objects, inability to perceive more than one object at a time, disorientation, and difficulty maneuvering, identifying, and using tools or common objects.” Other symptoms can include hallucinations, and difficulty in performing tasks like spelling and math problems. In the latter stages, memory can be impacted.

Because of the overlapping symptoms of posterior cortical atrophy and Alzheimer’s, there’s ongoing clinical debate as to whether it should be considered a form of Alzheimer’s disease or a distinct disease, according to the Alzheimer’s Association.

The new study “found a strong association between posterior cortical atrophy syndrome and Alzheimer’s disease neuropathology” and “emphasize the importance of Alzheimer’s disease biomarker testing
as part of the diagnostic assessment of individuals with posterior cortical atrophy.” Medical News Today reported that among the study findings, “94% of study participants with posterior cortical atrophy also had Alzheimer’s disease pathology.”

It’s important to note that according to the Alzheimer’s Association, misdiagnosis of posterior cortical atrophy is common as most people would first go to their ophthalmologist if concerned about changes in vision. Those who are experiencing vision issues that persist and who are concerned about their risk of Alzheimer’s disease should seek further testing.

While there’s no specific treatment for posterior cortical atrophy, understanding its potential connection to Alzheimer’s could lead to an earlier diagnosis of the latter. Most of the newer Alzheimer’s drugs on the market are designed for those in the early stages of the disease, so diagnosis timing is critical.

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Controversial Alzheimer’s drug Aduhelm to be discontinued by Biogen

The rocky road that the Alzheimer’s drug Aduhelm experienced on its way to FDA approval was considered a hard-fought victory by proponents, but skeptics and critics may feel redeemed as Biogen announced Jan. 31 that it will discontinue production and research of the controversial drug.

Biogen’s announcement to abandon Aduhelm comes just two and a half years after the drug received accelerated approval from the FDA in 2021. The Alzheimer’s Association and other advocacy groups had urged the FDA to approve Aduhelm despite underwhelming benefits demonstrated in trials and concerning side effects such as brain bleeds and swelling associated with a condition known as ARIA. A congressional investigation found that the FDA’s approval process of Aduhelm was “rife with irregularities.”

While a disappointing outcome, there will be minimal impact, as Aduhelm was only being used by approximately 2,500 patients worldwide, according to NBC News. Why such a low number? The high cost (initially set at $56,000 annually by Biogen), Medicare’s hesitancy to cover treatment, and the intravenous delivery requirement were significant roadblocks.

In its response to the news, the Alzheimer’s Association said that Aduhelm gave hope to millions and helped pave the way for new medications to treat the disease, such as Leqembi, which has been approved by the FDA and remains on the market.

The frustrating and disappointing journey of Aduhelm should be viewed as a cautionary tale for all of us who yearn for a legitimate, effective treatment for Alzheimer’s and other dementias. The pharmaceutical industry responsible for developing innovative treatments are driven by profit and the demands of investors. The FDA’s questionable approval process of Aduhelm also didn’t appear to put patient safety first. At least four deaths were reported among those taking Aduhelm, though it was unclear if the drug played any role.

As I wrote at the time of the FDA’s accelerated approval of Aduhelm “It has been a long wait, and that is why the drug’s approval has been met with a mixture of hope and skepticism.” When it comes to future treatments for Alzheimer’s, take time to do your own research, talk to your doctor, and take a realistic look at the pros and cons to make an informed decision.

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Accessible writing for those with dementia can benefit us all

Dementia can make many daily tasks difficult, if not impossible. One of those tasks is reading. My father was an avid reader throughout his life so as his dementia progressed, his one true hobby and passion in life was rudely stolen from him.

Reading skills are necessary to navigate daily life beyond reading for pleasure. Being able to interpret signs, recipes, instruction manuals, etc. all take various levels of reading comprehension. Is there a way to write that can make it easier for those with dementia to comprehend?

Innovations in Dementia has released new guidelines on accessible writing for people with dementia. It’s an insightful and useful manual offering real world examples and explaining the whys behind the recommendations. It’s written with a good dose of humor, which is hard to do with a style guide! Everything from font choice and size to page layout and navigation and word choice are covered in the manual.

Researchers found through surveys that many of the recommendations on how to make writing clearer for those with dementia were also useful for those without dementia. The guide points out some similarities in reading challenges for those with dementia and those with dyslexia. Many of us find ourselves increasingly distracted and overwhelmed by the information flooding our minds on a daily basis. If you are familiar with the concept of “smart brevity” that powers the concise writing style used by Axios, you may see some similarities with the clear and direct writing style recommended in the writing for those with dementia guide.

Recently I read a book, Writing for Busy Readers, that I found insightful in how we can all improve our written communication to express ourselves more clearly and be understood by others. From corporate boardrooms to schools, there are opportunities each day to express ourselves more effectively.

Communicating in a way that is more accessible to those with dementia could benefit us all.

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Can robots help those with dementia engage with past and present?

Social robots have been met with an understandable level of skepticism by elder care advocates. Can generative AI take such technology to the next level? A recent Wired article highlighted interesting developments in this field. Instead of focusing on robots substituting for human companionship or serving as a virtual caretaker, a group of researchers are developing robots “for the soul.”

One group that is being targeted for this technology designed to spark sensations and experiences are those with dementia, with technology meeting them where they are, whether that is surreal or relived memories. One example cited in the article is a robot playing birdsong that prompts an introverted woman with dementia to mimic a bird and speak about her love of birds. Another product that has been created is a pillow with panels that can be personalized to one’s life experience. When a panel is touched, a familiar sound is played. For example, if I was programming this for my father I would include a rendition of Danny Boy, my father’s favorite song. I might include the sounds of a ship, because my father loved ships.

Most of the article focuses on the development of QT, a chatty robot being tested at a memory care center. The technology has a ways to go, but one of the interesting developments is how the robot can spark conversations between residents and visitors. Encouraging such interactions can have a positive impact on all involved.

While I don’t envision a flood of robots caring for the elder population anytime soon, assistive technology is rapidly developing. Fall detection products are commonplace now, and proved to be an essential tool when caring for my mother. Smart, connected devices like the Amazon Echo Show and the Alexa Emergency Assist service keep busy caregivers connected to their elder loved ones, allowing them to monitor virtually. These products provide long-distance caregivers like I was with some peace of mind.

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