We enjoyed seeing so many of our clients and friends, uniting in our efforts to overcome this terrible disease.  The walk was three miles through downtown San Jose with participants in every age range. Participants at the walk were able to to write about the friends and loved ones for whom they were participating on colorful flowers that were placed in a memory garden. It was very emotional to see that garden and realize the number of lives that have been affected in our community.

I recently had a family crisis issue when a family member, who is the primary caretaker for another family member who suffers from Alzheimer’s, was herself admitted to the hospital with Pneumonia.  Her absence triggered all sorts of caregiver related concerns and family realizations as to the care level required.  I was able to utilize our care coordinator here in our office to provide resources to my family relating to specific issues for the care of Alzheimer’s patients, particularly information relating to eating issues and the progression of the disease.  It was so comforting to have a knowledgeable resource specialist who could provide calm advice in the middle of a serious issue for my family.

We were prepared, or so we thought, as the house had been sold, parents were living at a stepped up living facility, care givers were available, and yet when the crisis hit, there was still so much to arrange and worry about.  I was so glad that our care coordinator and resource specialist was here to assist me and realize her services are invaluable not only to help all of us prepare for long term care issues, but also to help us in our moments of crisis.

Dr. Jonathan D. Canick, Ph.D., a clinical psychologist/neuropsychologist at Sutter Health in San Francisco, spoke at the June meeting of the Northern California Chapter of the National Academy of Elder Law Attorneys (NAELA).   Dr. Canick specializes in the study and assessment of mental capacity and shared some startling facts with us.

First, he said that Alzheimer’s disease starts about 16 years before there are any noticeable symptoms.  Further, by the time there are visible signs, 80% of the neurons in the person’s brain are dead, leaving only 20% to do the brain’s work.  Wow!   That it takes a loss of 4/5 of our brain before it is apparent that something is wrong, shows how well the pathways in our brains can adapt.

An even more startling fact is that our mental capacity does not degrade as we age, as long as there are no illnesses, like Alzheimer’s disease, or injuries, like from traumatic brain injury or stroke.   In fact, capacity is graphed as a straight horizontal line from our early adulthood to when we die (again absent illness or injury), in contrast to the downward sloping line that depicts the decline in our physical body due to aging.

Dr. Canick acknowledges that there are some changes in the brain as we age that result in an elder not being able to take in new facts at the rate a younger person can do so.  Makes sense to me!  We all know how fast a young child learns.  But, what Dr. Canick explained is that, while our elders are not able to learn new things as fast, they are much better at analyzing and evaluating new information and situations.  This is why elders have historically been revered as “wise”.

Dr. Canick believes that, in the not too distant future, mental capacity will be part of our annual check-up, leading to early detection of illnesses or injuries to the brain.  Early detection will enable early treatment that can slow the effects of illnesses like Alzheimer’s.

Finally, Dr. Canick revealed that recent studies show that, other than genetics, the two factors most affecting whether a person develops Alzheimer’s disease are lack of  sufficient sleep and cardio exercise.  The recommendation is 8 hours of sleep every night and 30 minutes of cardio exercise at least 5 days a week.     Well, I guess that this last bit of information should have been expected.  It seems that everything works better when we get enough sleep and exercise.

Jacqueline’s presentation was a both humorous and poignant tale of her year-long agonizing effort to cope with her aging parents’ care, while fighting her controlling, strongly independent, and frequently tyrannical and hot tempered father’s determination to take care of his ailing wife himself.   To make matters worse, her father’s uncontrollable rages left Jacqueline believing that he was losing his mind, although he was sweet as pie and apparently completely competent when seen by any of his doctors.   In the end, Jacqueline figures out that her father is suffering from early stage Alzheimer’s disease and had all of the 10 signs of it.  It is, however, unclear what she would have done differently to cope with her father’s bizarre behavior had she known what was wrong with him.

I am currently reading her book, which is an easy and entertaining read (although I could use a bit less of her endless humor), to learn more about the ordeal she endured and exactly how she eventually discovered the cause of her father’s problems.  I recommend her book to anyone dealing with “problem” aging parents as a study of one daughter ‘s struggle to figure out what to do.  A note of caution, I have heard from two people I greatly respect that the advice Jacqueline gives for dealing with aging parents with diminished capacity is too manipulative.  Perhaps so, but you should decide that for yourself.

At the conference, Jacqueline implored my colleagues and I to tell our clients about the 10 Signs of Early Dementia put out by the Alzheimer’s Association.