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Tuesday, December 26, 2006 Webster’s Dictionary defines dementia as: “A usually progressive condition marked by deteriorated cognitive functioning often with emotional apathy.” In older people, Alzheimer’s disease is the most common form of dementia. It robs people of their memory and reason — stealing their lives long before they actually die. More that 4.5 million Americans suffer from the disease; 80,000 of them live in Alabama. There is no cure for Alzheimer’s, and doctors are not even sure what causes it.
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Living with Alzheimer's and dementia
Hoping and coping
What is certain is that, for the victims of dementia and Alzheimer’s, the prognosis is grim. Life is almost as difficult for their loved ones and caregivers.
Over the next few days, The Daily Home will examine what this disease is, what it means for patients and their families, and what is being done to find new treatments and possibly a cure.
Alzheimer's and dementia A working definition
Bob Crisp/The Daily Home
Alzheimer's disease is the most common form of dementia among senior citizens. By Denise Sinclair Home staff writer
What is Alzheimer’s Disease? The question is simple. The answer is far from it. Just ask those who deal with it on a daily basis. Early signs can be forgetfulness, memory loss, depression, confusion, inability to perform daily tasks or even having problems doing simple math. If the person is 55 or older, those symptoms might suggest the beginning of Alzheimer’s Disease, according to experts at UAB Alzheimer’s Disease Center.
It is estimated to affect more than 4.5 million older people in the United States and some 80,000 in Alabama. Alzheimer’s is the most common form of dementia, said Dr. Daniel Marson, a professor of the Department of Neurology and interim director of the UAB Alzheimer’s Disease Center. Dementia is a general term relating to brain disorders that seriously affect ability to carry out daily activities. According to the Alzheimer’s Disease Education and Referral Center (ADEAR), a service of the U.S. National Institutes of Health and the Institute See Dementia, Page 7A
This is your brain on Alzheimer's
These images of what a brain looks like prior to Alzheimer’s, left, and then after an individual gets the disease, right. The images can be seen on the Web site of the National Institute for Aging.
Tuesday
Index Editorial.......................... 9A Lifestyles......................... 4A Sports........................ 1B-3B Community Calendar..... 2A Dear Abby...................... 5A Comic/Television............ 5A Classified................... 4B-6B See Obituaries, Page 2
Pride in print Childersburg highlights heritage, attractions with new magazine By Christa Jennings Home staff writer
Area residents now have another reason to take pride in Childersburg with the publication of the city’s first magazine. The Chamber of Commerce recently announced that publication of its magazine, Childersburg Magazine, was complete. Copies are now available, and Chamber executive director Pete Storey said he would be delivering copies to some advertisers and Chamber members today. The 100-page full-color magazine, sponsored by the Chamber, serves as a guide to living, shopping, playing and working in Childersburg. The Chamber hopes to update the magazine every two to three years as needed. The magazine is free to the public. Individuals who wish to obtain a copy can pick one up at the Chamber office or City Hall. Copies will also be available at some local restaurants, hotels, doctor’s offices and dentist’s offices. It will also be included in relocation packets, Storey said. Childersburg Magazine was published by Rejoice PR & Communications and produced and printed by The Print Shop, both Childersburg businesses. “I’m really proud of the way it turned out,” said Crystal Ricks, volunteer secretary on the Chamber Board and consultant with Rejoice PR & Communications. “I’d like to thank the advertisers and those who contributed to the magazine. The staff did well, and The Print Shop did a great job printing it.” Storey and Ricks began selling ads for the magazine at the end of March. At the same time, Ricks began working on articles for it.
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ting it together. Crystal and her company worked hard on it, as well as the Chamber staff. It’s everything I thought it would be. I look forward to distributing it and hope it accomplishes the goal we’ve set for it.” Storey hopes the magazine will serve as a marketing tool to recruit new businesses and industries to the Childersburg community. The Chamber printed 2,500 copies of the magazine, and it will also be available online in PDF format at www.childersburg.com in the near future. “We thank all the businesses that helped by advertising See Magazine, Page 8A
Christa Jennings/The Daily Home
The Childersburg Chamber of Commerce is proud to announce the publication of Childersburg’s first magazine titled Childersburg Magazine. From left are Chamber Board secretary and Rejoice PR & Communications consultant Crystal Ricks, Chamber President Mort Moody, Chamber executive director Pete Storey and Joe Allen with The Print Shop of Childersburg.
British troops raid police station; Baghdad bombings kill 14 By Christopher Torchia Associated Press writer
BAGHDAD, Iraq — Backed by tanks, British soldiers raided a police station in the southern city of Basra on Monday, killing seven gunmen in an effort to stop renegade Iraqi officers from executing their prisoners, the British military said. Another U.S. soldier died in southern Baghdad, meanwhile, raising the death toll for American troops in Iraq to 2,972 — one less than the number of people killed in the Sept. 11, 2001, attacks. After the British stormed the Basra police station, they removed the prisoners, who showed evidence of torture, then evacuated the building before blowing it up. The operation showed how
‘Hoping and Coping’ aimed at dealing with dementia Tip of the hat: Volunteers restoring community center
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In addition to many photos of the area, the magazine also includes city statistics, business directories, a buyer’s guide, Chamber membership directory and church directory. Numerous articles in Childersburg Magazine highlight the city’s proud heritage and offerings. Some items featured include reflections of the city’s past, the city’s booming industries, tourism, annual events, schools, recreation, quality of life, health, services and highlights on some shops and attractions in Childersburg. The magazine is especially targeted toward newcomers, key business prospects and visitors or tourists, with the unique aspects of living and doing business within the Childersburg community. “I’m thrilled it’s turned out as well as it has,” Storey said. “It’s been a long journey put-
U.S. death toll in Iraq only one less than 9/11 toll
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closely aligned some police units are with militias and death squads — and the challenges coalition forces face as they transfer authority for security to Iraqis. In Baghdad, police found 40 bodies, apparent victims of sectarian violence. A car bomb exploded beside a market and a suicide bomber struck a bus in separate attacks that killed 14 civilians and wounded at least 33. In the Basra raid, the British set out to arrest officers with the station’s serious crimes unit who were suspected of involvement with Shiite death squads. Seven members of the rogue police unit were apprehended three days ago in other raids, said a British spokeswoman, Royal Navy Lt. Jenny Saleh. ‘‘We had intelligence to indi-
cate that the serious crimes unit would execute its prisoners in the coming days, so we decided to intervene,’’ Saleh said. British troops were fired on as they approached the station and their return fire killed seven gunmen, said Maj. Charlie Burbridge, another British military spokesman. British and Iraqi forces transferred all 76 prisoners at the station to another facility in downtown Basra, he said. Some prisoners had ‘‘classic torture injuries’’ such as crushed hands and feet, cigarette and electrical burns and gunshot wounds in the knees, Burbridge said. The British demolished the building in an effort to disband the unit. ‘‘We identified the serious crimes unit as, frankly, too far gone,’’ Burbridge said. ‘‘We just had to get rid of it.’’ The unit’s members, he alleged, were involved in tribal and political feuds in southern Iraq, which is mostly Shiite. See Iraq, Page 8A
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You can help While you are on vacation send your newspaper off to school Call Talladega, 362-1000; Pell City, 884-3400; Sylacauga, 249-4311
6A — THE DAILY HOME, Talladega-Sylacauga-Pell City, Ala., Tuesday, December 26, 2006
hoping and coping
Dementia changed their lives forever Living with Alzheimer's and dementia
One night, Carolyn Booker's Hoping and coping husband could not find their home
By David Atchison Home staff writer
PELL CITY — It was 1984 when Carolyn Booker, now 77, realized her husband was slipping away into a world in which he would eventually forget all that he knew. “He drove past our driveway,” Booker recalled. “I said, ‘Harvey that was our driveway you just passed.’ “He didn’t answer me,” she said. Harvey turned the left turn signal of the car on. “Where are you going,” Booker asked her husband. “Tell me where I’m at,” Harvey replied. “I knew it then,” Booker said. “I was real calm. I said, ‘We’re going to turn around and go back, and we’ll find our house.’” Although doctors suspected Harvey had Alzheimer’s, it was about four years later before he was actually diagnosed with the disease, she said. “He went through all kinds of tests, weeks after weeks,” Booker said. “I understand they can detect it much quicker now.” Even before the incident when Harvey drove past their home, Booker suspected something was wrong with her husband. She believes even her husband knew something was wrong, but neither said anything to the other about it. “He didn’t come out and say, I think I’m getting that disease or anything,” Booker said. But Harvey would forget things, she said. He would open the car door and forget to close it. The same way he would do with closet and cabinet doors. He would open cabinet and closet doors, and then just walk away. “He would turn water on, and I would have to turn it off,” Booker said. “Then I found the notes. He would write notes like, ‘Shave in the morning.’ “They say that’s what he would do at work,” she said. After Harvey’s death, workers from Stockham Valves told Booker her husband, who was a superintendent there for 32 years, would also leave notes for himself, reminders of things he needed to do at work each day. “They were picking up on things at work, but they didn’t share that with me until he passed away,” Booker said. “Everything he needed to do was written down.” Those revelations came after Harvey’s death, not while he was living and struggling to remember things from day to day, from hour to hour and, eventually, from minute to minute. “I guess, in a way, I was cov-
Bob Crisp/The Daily Home
Carolyn Booker, 77, of Pell City looks at an old picture, inset, of her with her husband Harvey, taken during a family reunion in South Alabama. She said at the time of the picture, Alzheimer’s had already taken its toll on her husband.
Bob Crisp/The Daily Home
“It’s an ugly disease,” Carolyn Booker said of Alzheimer’s. “It affects your entire family.”
ering up for him,” Booker said. “I didn’t want to be an alarmist. I thought it would get better, but it didn’t.” It only got worse, much worse, as Harvey continued to suffer with Alzheimer’s. “It’s an ugly disease,” Booker said. “It affects the entire family.” Booker eventually moved to Pell City from Birmingham to be close to one of her sons as Harvey’s condition worsened. Booker, who was the primary caregiver for her husband, said she received help from the hospital, family, friends, neighbors and church members throughout the long, hard ordeal. She said she kept taking Harvey to the First Baptist Church of Pell City despite his condition. “The church helped me a lot; they were wonderful to me,” she said. “You got your family, your friends, your church, but you still feel alone.” Booker said it was especially tough watching her husband’s mental state deteriorate. “It’s hard seeing the deterioration of not only his mannerisms, but his whole being,” she said. Harvey forgot how to do the simple things, like tie his shoes. “He forgot how to make steps, so he would stretch out on the floor,” Booker said, adding that he was a big man and she
would have to call 911 for help sometimes to get him up off the floor. “At one point, he forgot how to feed himself.” But day in and day out, the devoted wife of more than 50 years took care of her husband. “It got to the point where he couldn’t do anything unless I was right beside him,” Booker said. “You just can’t imagine what goes along with that disease — if they can only find a cure for it.” Booker was constantly worried about her husband. She was afraid he would get up in the middle of the night and hurt himself. Booker could barely get a good night’s rest. “It was like sleeping with one eye open,” she said. For 13 years Booker took care of her husband, but it took its toll on her “I don’t want any sympathy,” she said. “But, I didn’t have any time to take care of myself.” In 1999, Booker had a stroke. She said the couple was fortunate enough to have money set aside so they could have help and sitters for Harvey. “I did everything I could to make life pleasant for me and for him as long as I could,” Booker said. “I tried to be brave, but there were times I had to cry.” She said Harvey was placed in a nursing home during his last four years of life.
He died in 2005. “The last two years, he didn’t know us. That’s when the two boys (their sons) couldn’t handle it. It was tough on them,” Booker said. “I would sit with Harvey, and he would look at me and ask, ‘When is Carolyn coming back?’ If you don’t think that would get to you.” Booker said she feels for families who have a family member afflicted with Alzheimer’s disease. “You can’t prepare yourself for it,” she said. “You just have to take it day by day, really hour by hour.” She believes researchers can eventually find a cure for this horrible disease. “I want people to recognize this disease as what it is and let’s find something to stop it before it gets started,” Booker said. “It’s so, so bad.” She said people just don’t know how bad Alzheimer’s is until they experience the disease up close. “I buried Harvey long before the funeral,” Booker said. “I know this may sound bad, but I was relieved. I thanked the Good Lord when he carried him home.” The personal experience with Alzheimer’s has marked Booker for the rest of her life. “I want a cure, so other people don’t have to go through what I went through,” she said.
THE DAILY HOME, Talladega-Sylacauga-Pell City, Ala., Tuesday, December 26, 2006 — 7A
hoping and coping
Looking for the disease ● While some memory loss is a natural part of aging, Alzheimer’s disease has distinct signs By Will Heath
Home sports editor
It is a generally accepted notion that, as people grow older, memory starts to deteriorate. It’s partially true, according to UAB’s Richard Powers. “It’s an urban legend,” he said. “Everybody is a little forgetful, but it’s not normal to lose your memory that it disrupts your daily life. “I’m 56 years old. I can’t remember people’s names like I used to when I was 40. It doesn’t mean I have dementia; I don’t think it means that, anyway.” Powers should know. A clinician at the Alzheimer’s Disease Research Center in Birmingham, Powers is also the medical director for the Alabama Department of Mental Health and Mental Retardation and manages the Dementia Education and Training Program (DETA), a network of dementia educators for the state. As such, Powers treats a number of patients in the early stages of Alzheimer’s disease. And he admits there is a difference between normal agerelated memory loss and a fullfledged mental illness. “About 70 percent of people over 65 will complain their memory’s not as good as it used to be,” he said. “Most older people who are intellectually intact have difficulty with names. “When they get to the point that it disrupts your daily life, that’s different.” The popular notion is to associate Alzheimer’s disease with simple memory loss, but Clifford Mosley of Talladega, who’s seen his fair share of Alzheimer’s patients, knows it’s something deeper. “Dementia starts with, like, forgetting where you put your car keys,” he said, “forgetting where you parked at the grocery store, forgetting you’ve already paid your light bill and go pay it again. You can’t balance your checkbook like you used to. “That’s one of the things people have to really watch out for, because people will mess up things at home with early stages of dementia. Those are some of the first stages and signs of dementia.” The chairman of the local Alzheimer’s support group for nearly 26 years now as well as someone who has dealt with the disease in his family for most of his adult life, Mosley knows more about the disease than he likely ever cared to. “My mama (who died with Alzheimer’s) had 14 children, but there was only two of us that took care of her, out of the
Living with Alzheimer's and dementia
Hoping and coping
whole 14,” he said. “Of course, I had to move out of my house and move in with my mama to take care of her. That is one of the worst things. Dementia and Alzheimer’s can destroy a family, because your other relatives don’t want to believe that this is happening to their mom or their dad or whomever, they don’t want to believe that.” According to the Alzheimer’s Association, memory loss is only the first symptom of the disease. Also included are problems with determining time and place, decreased judgment, and difficulty performing day-today tasks. And along with these problems comes a great amount of frustration. “They can really be angry and upset,” he said. “One of the things we teach in our class, you can imagine they would be angry and upset. It’s not them; it’s the disease. And they don’t understand what’s going on in their mind, and you’re trying to tell them what’s going on, and they don’t want to accept it, and you don’t really understand what’s going on in their mind yourself. “That’s what really makes them so frustrated.” While no cure exists for the disease, Powers and others at UAB encourage people to get themselves checked out as soon as symptoms become obvious. “Older people are really worried about it,” he said. “We have medicines that will slow the progress of the disease. There are a lot of things people can do to help their brain.” Even though genetics goes a long way in determining exactly who gets the disease, Powers — a member of the board of trustees for the Alzheimer’s Foundation of America — says
there are a number of other risk factors. “In the old days, people would just throw up their hands,” he said. “We need to change the way people think; my genes do determine whether I’m going to get this disease, but there are other things I can do to help. “We know that people with high blood pressure have an increased risk. We know people who are physically inactive have an increased risk. We know people who are obese have an increased risk. We know that people who drink excessively have an increased risk. These are the kinds of things people ought to do to protect their brain. “In aging, one third of it is genetics and two thirds of it is life choices.” Often, in getting treatment, a patient may find that what they’re experiencing isn’t Alzheimer’s at all. He saw “a patient in a clinic a few weeks ago, and he said, ‘I’m so forgetful at work and my memory’s not what it used to be,’” he said. “He was a pretty beefy guy, and I asked him if he snored. His wife said he snored and quit breathing. That patient probably has sleep apnea, and his oxygen saturations are dropping, and because his brain isn’t getting enough oxygen, it doesn’t work properly. “I’ve had some patients come to me and say they’re not thinking like they used to; you fix that problem and everything’s OK. “Just because you have severe memory troubles, doesn’t necessarily mean dementia. We have a memory disorder clinic, and that’s all we do is look at this stuff. “But it needs to be looked into carefully.”
Clifford Mosley of Talladega is the chairman of an Alzheimer's support group. He has dealt with the disease in that capacity and personally with his own family.
Jerry Martin/The Daily Home
Warning signs 10 warning signs of Alzheimer’s:
1. Memory loss. Forgetting recently learned information is one of the most common early signs of dementia. A person begins to forget more often and is unable to recall the information later. What’s normal? Forgetting names or appointments occasionally. 2. Difficulty performing familiar tasks. People with dementia often find it hard to plan or complete everyday tasks. Individuals may lose track of the steps involved in preparing a meal, placing a telephone call or playing a game. What’s normal? Occasionally forgetting why you came into a room or what you planned to say. 3. Problems with language. People with Alzheimer’s disease often forget simple words or substitute unusual words, making their speech or writing hard to understand. They may be unable to find the toothbrush, for example, and instead ask for “that thing for my mouth.” What’s normal? Sometimes having trouble finding the right word. 4. Disorientation to time and place. People with Alzheimer’s disease can become lost in their own neighborhood, forget where they are and how they got there, and not know how to get back home. What’s normal? Forgetting the day of the week or where you were going. 5. Poor or decreased judgment. Those with Alzheimer’s may dress inappropriately, wearing several layers on a warm day or little clothing in the cold. They may show poor judgment, like giving away large sums of money to telemarketers. What’s normal? Making a questionable or debatable decision from time to time. 6. Problems with abstract thinking. Someone with Alzheimer’s disease may have unusual difficulty performing complex mental tasks, like forgetting what numbers are for and how they should be used. What’s normal? Finding it challenging to balance a checkbook. 7. Misplacing things. A person with Alzheimer’s disease may put things in unusual places: an iron in the freezer or a wristwatch in the sugar bowl. What’s normal? Misplacing keys or a wallet temporarily. 8. Changes in mood or behavior. Someone with Alzheimer’s disease may show rapid mood swings – from calm to tears to anger – for no apparent reason. What’s normal? Occasionally feeling sad or moody. 9. Changes in personality. The personalities of people with dementia can change dramatically. They may become extremely confused, suspicious, fearful or dependent on a family member. What’s normal? People’s personalities do change somewhat with age. 10. Loss of initiative. A person with Alzheimer’s disease may become very passive, sitting in front of the TV for hours, sleeping more than usual or not wanting to do usual activities. What’s normal? Sometimes feeling weary of work or social obligations.
Dementia From Page 1A on Aging, Alzheimer’s disease is not a normal part of the aging process and initially involves the parts of the brain that control thought, memory and language. Although researchers are learning more every day, right now they still do not know what causes the disease — and they still don’t have a cure, Marson said. Defining an illness Alzheimer’s disease may lead to complete loss of memory and usual judgment of right or wrong. In the late stages, the person may no longer be able to recognize previously familiar people, including their relatives, say medical officials at the Alzheimer’s Disease Center. And though treatment may improve signs and symptoms, Alzheimer’s disease will continue to progress. Marson said the disease can begin as early as 55, but usually shows up after age 60, and the risk of getting Alzheimer’s goes up with age. Some younger people do get the disease, but that is far less common. Statistically, ADEAR said, about 5 percent of men and women ages 65 to 74 have Alzheimer’s disease, and nearly half of those age 85 and older may have the disease. Alzheimer’s Disease is named after German doctor Alois Alzheimer. In 1906, Alzheimer noticed changes in the brain tissue of a woman who had died of an
unusual mental illness. He found abnormal clumps, called amyloid plaques, and tangled bundles of fibers, now called neurofibrillary tangles. Today, these plaques and tangles in the brain are considered signs of Alzheimer’s. Marson said these changes can be seen under a microscope and there is also a loss between connections of brain cells. “There will be decline in everyday functions, and the driving force behind this is the loss of connectivity in the brain. Other diseases that cause dementia are strokes and Parkinson’s disease, yet Alzheimer’s is the most prevalent in older people,” he said. According to the National Institute on Aging, scientists have found other brain changes in people with Alzheimer’s in addition to those found by Dr. Alzheimer. Studies have shown that in some people with Alzheimer’s, nerve cells die in areas of the brain vital to memory and other mental abilities. Alzheimer’s victims also have lower levels of some neurotransmitters — chemicals in the brain that carry messages back and forth between nerve cells. Alzheimer’s disease may impair thinking and memory by disrupting these messages. Risk factors Age is the greatest single risk factor, Marson explained, followed by genetics and even education levels. “People who are better edu-
cated seem to have a protective effect and are less likely to get the disease. More than likely, this is because the more educated you are, the more focused cognitively you are. “There is also the genetic risk factor for the disease. We have located some of the genes that carry the risk factor. There are selective genes that affect a few people,” Marson said. The UAB Alzheimer’s Disease Center is one of 30 funded nationally to study how the disease develops over time using patients. The center at UAB was established in 1991 through a grant funded by the National Institute of Health and the National Institute on Aging. The center is an interdisciplinary program of scientists working in diverse areas, including neurology, psychiatry, genetics and psychology. Through this effort to gain more knowledge about Alzheimer’s, the center is dedicated to improving the quality of life for those with the disease and other related disorders. A growing problem Marson said that by 2050 at least 14 million people in the United States will have the disease. He said it is more prevalent in women because they live longer than men. Dr. Andrew Duxbury, an associate professor in the division of geriatrics, gerontology and palliative medicine at UAB, said there is a cure for Alzheimer’s out there, but it hasn’t been found yet.
He predicted the number of cases of the disease will double in the next 35 years because people are living longer, which makes them susceptible to the disease, and because the large population of Baby Boomers is growing older. He said no two patients are alike. Each may experience different rates of decline and symptoms. The disease, he said, robs people of active, productive lives. Searching for a cause A fact sheet put out by ADEAR says scientists do not yet fully understand what causes Alzheimer’s. There probably is not one single cause, but several factors that affect each person differently. Age is the most important known risk factor, while family history is another. The only risk factor gene identified so far for late-onset Alzheimer’s is a gene that makes one form of a protein called apolipoprotein E (ApoE). Everyone has ApoE, which helps carry cholesterol in the blood, but only about 15 percent of people have the form that increases the risk of the disease. It is likely that other genes also may increase the risk of the disease or protect against it, but they have yet to be discovered. Scientists have also not ruled out environmental factors as contributing to Alzheimer’s disease. For more information on the disease, contact:
Jerry Martin/The Daily Home
Dr. Daniel Marson, professor of the Department of Neurology and interim director of the UAB Alzheimer’s Disease Center, says dementia is a brain disorder that seriously affects a person’s ability to carry out daily activities. o Alzheimer’s of Central Alabama – www.alzca.org or 205-871-7970; o Alzheimer’s Disease Education and Referral Center (ADEAR) – www.alzheimers.
nia.nih.gov or 1-800-438-4380; o Alzheimer’s Association - www.alz.org or 1-800-2723900; o UAB Alzheimer’s Disease Center – www.uab.edu/adc.
THE DAILY HOME, Talladega-Sylacauga-Pell City, Ala., Tuesday, December 26, 2006 — 9A
Our voice ‘Hoping and Coping’ aimed at dealing with dementia
Across the country, 4.5 million people suffer from dementia, often referred to as Alzheimer’s, even though that disease is but one form. Here in Alabama, 80,000 people have been diagnosed with it. And by 2050, it is estimated that 14 million people in the United States will be afflicted with the disease. Multiply those staggering statistics by the families and facilities that care for them, and it is easy to see that its impact reaches well beyond a single victim. For the next five days, The Daily Home staff will examine dementia and Alzheimer’s in a comprehensive series that puts a human face on this debilitating illness, tells what to look for in the early stages, where to go to for help in the local area as the disease advances and what is on the horizon. Called “Hoping and Coping, Dealing with Dementia,” the series should be a resource guide for the thousands of families throughout the area who are doing just as the name says — hoping for a cure; coping until then. It is meant as a helping hand in understanding the disease and its prognosis for the future. There is still no cure, no pinpointed cause, but the numbers are growing. And so many who once were strangers are finding they are in this maze together, looking for answers on survival — one day at a time. It is a health crisis that crosses all lines, and a cure must be found. Until then, all who are touched in some way by the disease will simply have to hope and cope.
Tip of the hat
Volunteers, Wallace restoring community center
Nation’s schools need radical change What the Iraq Study Group said about the Iraq War situation — “grim and deteriorating” — has been echoed by another bipartisan commission, this one studying the state of American education. It didn’t use those exact words, but the New Commission on the Skills of the American Workforce warned that unless U.S. schools are improved radically, the country’s standard of living will plunge over the next 20 years. The commission, whose members included four former Cabinet officers, proposed a series of radical and most likely controversial changes designed to keep the United States from falling behind foreign competitors. The reforms mainly require action at the state level, and one gutsy governor will be needed to start the process and serve as a model for the rest of the nation. As this study and numerous other reports on competitiveness have warned, other countries — led by India and China — increasingly are offering the world’s employers highly skilled work forces at lower costs than American labor, causing jobs and investment to move offshore. The only reason that employers would depend on Americans, the panel said, is “if we could offer something that the Chinese and Indians, and others, cannot.”
Morton Kondracke
MORTON KONDRACKE That has to be superior skills, know-how, technology and innovation, yet U.S. schools — the second costliest in the world per pupil — badly lag behind in performance on international tests. Moreover, the panel said, while spending on U.S. schools has increased by 240 percent over the past 30 years (adjusting for inflation), national test scores in reading and math have improved only marginally. Unlike the Iraq Study Group, which tended to split differences between Republicans and Democrats in order to achieve consensus on what to do in Iraq, the 26-member skills panel agreed unanimously on what its executive director called “a complete shakeup” in U.S. education. The recommendations include ending high school for most students at age 16, after 10th grade. Students passing a state-run exam that meets national standards would move on to community colleges or job training. Others who pass would
stay in high school for Advance Placement or International Baccalaureate work leading to admission to four-year colleges. Those who failed the test would return to high school until they passed. The money saved by lopping off the last two years of high school — $60 billion a year — would be used to double teacher salaries and fund preschool for all 4-year-olds and all low-income 3-year-olds. In order to attract teachers from the top third of college graduates, starting pay would average $45,000 a year — a level that is currently the midcareer national average — and then rise to $95,000, with possible increases up to $110,000 for teachers who work year-round or in demanding situations. Commissioners emphasized that cutting out 11th and 12th grade for most students was more than just a money-saving measure — it also was based on findings that most students who drop out do so because they find school “boring.” Also, some European countries end formal school at 16. The benefit of pre-school education for getting children prepared for academic work — and to narrow income inequalities — has been demonstrated in study after study. Possibly the most radical change would be a takeover by states of supervision and funding of schools, thus eliminating reliance on local property taxes,
With the financial help of pro-basketball star Gerald Wallace, volunteers in Childersburg are restoring the Phyllis Wheatley Community Center, hoping to once again provide a center that will have a positive impact on the city’s children. Wallace is giving back to his hometown because he wants to reciprocate the community’s support of him over the years and to ensure that kids and families have a center that is safe and provides a nurturing recreational and learning environment. Marquis “Bird” Marbury, spokesman for an impressive band of volunteers shouldering the work and fundraising effort, sees the project as a foundation on which to build a future. “It takes a community to build a future,” Marbury said, and the Wheatley facility will be at the heart of that building program. We commend Wallace, Marbury and all the volunteers involved in restoring the center. Their mission is a noble one, and it certainly deserves support from all corners of the city.
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Let your legislator or congressman know how you feel about issues important to your community. Talladega County State Sen. Jim Preuitt — (334) 242-7898 or (256) 362-6900 State Rep. Ron Johnson — (334) 242-7777 State Rep. Steve Hurst — (334) 353-9215 State Rep. Barbara Boyd — (334) 242-7692 St. Clair County State Sen. Jack Biddle — (334) 242-7846 or (205) 945-6557 State Sen. Del Marsh — (334) 242-7877 or (256) 237-8647 State Rep. Blaine Galliher — (256) 543-6196 State Rep. Jim McClendon — (334) 242-7750 State Rep. Randy Wood — (334) 242-7749 U.S. Congress Sen. Jeff Sessions — (202) 224-4124 or (334) 244-7017 Sen. Richard Shelby — (202) 224-5744 or (205) 731-1384 Rep. Mike Rogers — (202) 225-3261 or (256) 236-5655 Rep. Spencer Bachus — (202) 225-4921 or (205) 969-2296
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although community school boards would retain some management functions. The commission, which included New York Schools Chancellor Joel Klein, former Cabinet Secretaries William Brock, Richard Riley, Ray Marshall and Rod Paige, and union and corporate representatives, also advocated creation of teacher-organized “contract schools” that would be run independently and judged on their ability to meet state standards. Another proposal would create “personal competitiveness accounts” of $500 for every child that could be added to by the federal government or individuals to fund training and retraining throughout a worker’s lifetime. The panel also recommended a significant upgrading of testing standards at the state level so that 16-year-olds would have to possess world-class skills in order to graduate from high school. Various groups, including the conservative Thomas B. Fordham Foundation, advocate national testing standards to replace inadequate state standards established under the 2001 No Child Left Behind Act. The foundation’s president, Chester Finn, said at an all-day conference sponsored by the skills panel last week that it succeeded in “making practically every interest group unhappy.” Indeed, the National School Boards Association attacked the report, entitled “Tough Choices for Tough Times,” because it de-emphasized local control. The American Federation of Teachers objected to the call for “front-loading” teacher compensation — that is, raising pay — in return for conversion of guaranteed pensions to investment accounts. Probably the most difficult group to convince about the need for change is the American citizenry, which has repeatedly told pollsters that American education in general is deficient but that the school system in their jurisdiction is successful. On the other hand, there is widespread agreement that middle-class incomes are being squeezed by foreign competition. One answer to the problem — a bad one that won’t work — is an isolationist attempt to protect the United States from foreign competition. The better answer, and the only one that will work, is for the United States to lead the world in innovation and skills. That would require that U.S. schools be the best in the world, which they aren’t. One state has to lead the way toward excellence. Which one will it be? Morton Kondracke is executive editor of Roll Call, the newspaper of Capitol Hill.
The abandoned Abu Ghraib whistleblower By Nat Hentoff In his farewell address at the Pentagon, Donald Rumsfeld said that the worst day of his nearly six years as Secretary of Defense was the disclosure to the world of the photographs of the abuses at Abu Ghraib. Those pictures might never have been known were it not for Joseph Darby, then a specialist with the Army’s 372nd Military Police Company at Guantanamo Bay. Because his moral code told him “it had to stop,” Darby may never be able to return home to Maryland. In the Dec. 10 interview with Darby on CBS’ “60 Minutes,” he told how the photos had been given to him by one of the perpetrators of the abuse, his friend, Charles Graner, now in prison. Knowing, as he says, the difference between right and wrong, Darby, anonymously, turned the pictures over to the Army’s Criminal Investigation Division. But they knew where he worked, and the investigation began on who gave him the pictures. Darby told “60 Minutes” interviewer Anderson Cooper that he had no idea the photos would go around the world; “but you can’t stand by and let this happen.” Several months later, “60 Minutes II” obtained the pictures from another source; a New Yorker magazine article revealed Darby’s name; and Defense Secretary Rumsfeld
said, at the time, in testimony before Congress that among those “who did their duty professionally” when the story broke was “First Specialist Joseph Darby, who alerted the appropriate authorities that abuses were occurring.” While still at Guantanamo, Darby, in fear of retaliation, slept with a gun under his pillow. The Army decided to bring him back to the United States, ahead of his unit. Back home in Cumberland, Md., the whistleblower was a pariah. The commander of the local Veterans of Foreign Wars post, Colin Engelbach, told “60 Minutes” Darby “was a rat. He was a traitor. He let his unit down, he let his fellow soldiers down.” Darby heard that in Cumberland, people who had known him since he was born — “my parents’ friends, my grandparents’ friends turned against me.” And his wife, Bernadette, heard people there say that her husband was “a dead man ... walking around with a bull’seye on his head.” When he arrived at Dover Air Force base, with his wife there to meet him, the Army told Darby it wasn’t safe for him to go back to Cumberland, adding: “You can probably never go home.” And, indeed, reported Anderson Cooper, “the Army’s security assessment had concluded: “The overall threat of criminal activity to the Darbys is imminent. A person could
fire into the residence from the roadway.” Darby, who left the Army recently, misses his home, as does his wife. Their current residence is secret. “It’s not fair,” Bernadette Darby told the New York Daily News (Dec. 8). “We’re being punished for (him) doing the right thing.” Does Darby regret that he turned over the pictures? “No, because if they’d been given to somebody else, it might not have been reported. We’re Americans,” he told Anderson Cooper. “We’re not Saddam. ... We hold ourselves to a higher standard. Our soldiers hold themselves to a higher standard.” He would do it again: “They broke the law, and they had to be punished. It’s that simple.” This American felt he had no choice. “The abuse had to stop.” Left out of the otherwise admirable and necessary “60 Minutes” report, “Exposing the Truth” — and its subsequent press coverage — was any mention of who was ultimately responsible for the abuses at Abu Ghraib and at other prisons in Afghanistan and Guantanamo. Charles Graner, Lynndie England and some of the other low-level guards in those photos have been punished, but not those much higher in the chain of command. In early 2002, when the Defense Department asked for instructions on how far they could go in extracting intelli-
gence information from hardto-crack detainees, a cadre of high-level lawyers at the Justice Department and Pentagon — orchestrated by Alberto Gonzales, then Counsel to the President — set the grim climate for what happened at Abu Ghraib and elsewhere. In a series of memos — a story first broken by Jess Bravin on the front page of the June 7, 2003, Wall Street Journal — he disclosed: “Bush administration lawyers contended last year that the president wasn’t bounded by laws prohibiting torture and that government agents who might torture prisoners at his direction couldn’t be prosecuted by the Justice Department.” Among these lawyers: the most influential, John Yoo, is back teaching law at the University of California; Jay Bybee sits on the Ninth Circuit Court of Appeals; and the presidential nomination of William Haynes II to a federal appellate court is still pending in Congress. And Alberto Gonzales is now Attorney General of the United States. “Also not held accountable, above them, are the president, the vice president and Donald Rumsfeld. But Joe Darby can’t go home. Nat Hentoff is a nationally renowned authority on the First Amendment and the Bill of Rights and author of many books.
Pair from memorable Ragland squad named to All-State Team
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Wednesday, December 27 , 2006
Webster’s Dictionary defines dementia as: “A usually progressive condition marked by deteriorated cognitive functioning often with emotional apathy.” In older people, Alzheimer’s disease is the most common form of dementia. It robs people of their memory and reason — stealing their lives long before they actually die. More that 4.5 million Americans suffer from the disease; 80,000 of them live in Alabama. There is no cure for Alzheimer’s, and doctors are not even sure what causes it.
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Retailers report Hoping strong and coping sales
Living with Alzheimer's and dementia
What is certain is that, for the victims of dementia and Alzheimer’s, the prognosis is grim. Life is almost as difficult for their loved ones and caregivers.
Over the next few days, The Daily Home will examine what this disease is, what it means for patients and their families, and what is being done to find new treatments and possibly a cure.
Help is out there
Finding resources for caregivers important
Bob Crisp/The Daily Home
Nurse Mickey Green with American Hospice-Sylacauga enjoys some laughs with patient Era Stevens during one of his many visits. By Katie Brumbeloe Home staff writer
Keeping a loved one with Alzheimer’s or dementia at home can be difficult, not only for the family member with the disease, but also for the caregiver. Fortunately, there are many organizations and agencies throughout the state and in Talladega and St. Clair counties that can help. Local Area Agencies on Aging offer many resources to caregivers, ranging from education about Alzheimer’s and dementia to assistance in the home. Through a program called Alabama Cares, a nonprofit organization which has been aiding caregivers through education and assistance in the state since 2001, three tiers of support are available to help caregivers through respite, supplemental supplies and an inhome system called Lifeline, said Ashley Pittman, an information and referral coordinator in St. Clair County for the Middle Alabama Agency on Aging. “Alabama Cares is designed to help loved ones who they (the caregivers) are caring for,” Pittman said. “Being a caregiver can be stressful, so we do what we can to help.” The respite program brings
Wednesday
Index Editorial.............................7 Lifestyles......................... 1D Sports.......................... 1-3B Community Calendar..... 5C Dear Abby...................... 2C Comic/Television............ 2C Classified................. 2D, 3D See Obituaries, Page 2
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By Chris Norwood Home staff writer
The 2006 holiday season was a healthy one for area retailers across a broad range of products, in spite of some early misgivings. “We heard a lot of gloom and doom coming into this year,” said Michelle Sims, manager of the Factory Connection in Pell City. “But we had an excellent year, pretty much as we expected. I don’t know if it’s because we’re an off-price retailer or if it’s just because we’ve got all the brands the kids want this year, but we did very well.” Factory Connection’s big sellers were logo sweatshirts, coats and jeans, “but there wasn’t really a leader for us this year,” Sims said. Grady Spillman, manager of the Radio Shack in Talladega, agreed with Sims’ assessment. “We did about what we expected. It was better than what we feared, but of course we wanted to do even better,” Spillman said. “Still, I can’t complain, we did pretty well overall.” Wireless phones, which were on sale before the holiday, were among the hot items, along with digital cameras, camcorders, printers and various combinations of the above. “And, of course, toys, that goes without saying,” Spillman said. “Remote-controlled vehicles are always popular this time of year.” “We had good sales throughout the season,” said Brian Murphree, operations manager for Foote Brothers Furniture in Sylacauga. “I actually noticed an increase in the last few days before Christmas, but we’re still doing business this week, so I can’t really compare it to last year yet.” Recliners, jewelry armoires See Retailers, Page 4
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Rachel Stevens heads a ministry at Eden Westside Baptist Church that supports U.S. troops serving in the Middle East and other locations throughout the world, as well as their families who are left behind.
Ministry touches lives of soldiers around the world By David Atchison Home staff writer
PELL CITY — Thanks to a local ministry and the work of one woman, military personnel serving in the Middle East know they aren’t alone. “I e-mail soldiers once a week to let them know that there are people here who care and pray for them,” said Rachel Stevens, 39, of Riverside. Three years ago, Stevens started Operation Westside Ministry at Eden Westside Baptist Church. The ministry has since touched the lives of service people around the world. “I started the ministry with our minister Jacky Connell in 2003,” she said. Stevens, who is the education secretary for Eden Westside Baptist Church, said the ministry was able to reach out to more than 100 service members, who were or are currently stationed in the Middle East. Stevens, whose husband,
Tracy, is in the military, said this was a special way to support the troops who are away from family and friends. “Our motto is, ‘Always remember your faith in God will get you over the hill when nothing else will,’” she said. Stevens said through the years, the ministry has reached more than 100 soldiers serving in the Middle East. “The soldiers change from time to time,” she said. “Right now, we e-mail about 25.” Stevens, who has two sons, Elliott, a third-grader at Walter M. Kennedy Elementary School, and Morgan, a Pell City High School senior who is also in the ROTC program, said she just wants to let service members know they are thought about and prayed for. Connell, minister of Eden Westside Baptist Church, said the ministry Stevens started three years ago continues to serve service members in a time See Ministry, Page 4
Bombings kill at least 54; 7 more U.S. soldiers killed Latest U.S. deaths bring number of military killed to at least 2,978 Gary Hanner/The Daily Home
The Project Lifesaver bracelet is a simple, lightweight unit that is worn 24 hours a day. The battery-operated device emits a frequency, which can be used to track clients if they wander away from home. a trained assistant a few times a month into the home when the caregiver is away to perform any chores and offer assistance where it is needed. “They do whatever needs to be done — cooking, cleaning, changing linens,” Pittman said. “Some of them go above and beyond to help.” Supplemental supplies are available based on need and income. Supplies range from
incontinence items to cases of Ensure, a supplemental drink to help with nutrition. Pittman said each county has different providers, so caregivers need to contact their local agencies to find out what is available in their area. The third option, which Pittman highly recommends, is Lifeline, an in-home system See Help, Page 7C
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Associated Press writer
BAGHDAD, Iraq — A string of car bombs and other blasts killed at least 54 Iraqis on Tuesday, including 17 outside Baghdad’s most venerated Sunni mosque, while U.S. troops battled Shiite militiamen in Baghdad. Seven more American soldiers died, the U.S. military said, pushing the December death toll to 90 in one of the bloodiest months for the American troops in Iraq this year. Some 105 troops were killed in October. President Bush is weighing whether to send thousands more troops to Iraq, but a senior Democratic senator, Joseph Biden, said Tuesday he would
fight such a move. In the most lethal incident Tuesday, three parked cars exploded one after another in western Baghdad, police and Iraqi media reported. The blasts killed 25 people and wounded 55, one physician said by telephone, as he watched the victims being carried into Yarmouk hospital. The doctor, who has provided information in the past, spoke on condition of anonymity because of security concerns. Perhaps the most politically significant attack came in Azamiyah, a Sunni enclave of Iraq’s capital, where a car bomb exploded near the Abu Hanifa mosque, according to Iraqi media. That blast killed 17 and
wounded 35, said a physician at the nearby Nuaman Hospital, who has provided information to the Associated Press in the past. He also asked to remain anonymous out of concern for his safety. The explosion tore through a busy square at the start of the evening rush hour, when merchants were selling clothing and kebabs. The mosque itself was not damaged, witnesses said. The mosque is Sunni Islam’s holiest shrine in Baghdad, and a regular target of Shiite mortar teams. One person was killed in shelling there last month. Abu Hanifa, who lived in the 8th century, was one of Islam’s most important scholars and founded the Hanafi school of Islamic law, embraced by many Muslim cultures. The mosque has long been associated with Sunni activism. U.S. Marines fought a fierce See Iraq, Page 4
6C — THE DAILY HOME, Talladega-Sylacauga-Pell City, Ala., Wednesday, December 27, 2006
hoping and coping
When it's time to turn to hospice Living with Alzheimer's and dementia
Hoping and coping
By Christa Jennings Home staff writer
Many families that have a loved one diagnosed with Alzheimer’s or dementia find it difficult, if not impossible, to care for their relative by themselves. Families in those situations can seek help from home health or hospice services as another alternative to nursing home care. Mid South, a Gentiva company, is a home health provider with area offices in Sylacauga, Pell City, Birmingham and Montgomery. According to Mid South Home Health account executive Scott Grissett, the company treats patients with a broad range of diseases and disorders if they qualify. This range includes Alzheimer’s disease and dementia. Grissett said a nurse will perform an initial assessment of the patient. If the patient does have Alzheimer’s or dementia, the staff determines the patient’s level of functionality and will offer treatment based on the findings. The staff also educates the family to help prepare them for the progress of the disease and help them better understand what to expect. Grissett said the staff, as home health care providers, follow the doctor’s orders concerning the exact services offered to each patient. Care varies from one patient to the next based on what the doctor requests. Gentiva companies offer a variety of homecare services that include nursing; cardiac care; disease and pain management; physical, occupational and speech therapy; infusion nursing; and wound care. Grissett said Gentiva also offers innovative specialties that include cardiopulmonary, orthopedics and Safe Strides. Mid South personnel are educated on Alzheimer’s and dementia and remain informed of any updates or new information that is made available. “We send in great caregivers,” Grissett said. He said the initial admission can take one to two hours or
longer in order for the nurse to learn more about the patients, figure out their medications and become familiar with the situation. Following the initial assessment, Grissett said, visits can last anywhere from 30 minutes to an hour and a half as needed in order to treat the patient and educate the family. Education is key to keeping them together as long as they can. The company also has contracted social workers and speech therapists to assist with patients. “The branch staff is caring and dedicated,” Grissett said. “It’s emotionally exhausting for a family to take care of a patient.” Doctors are pleased with their services, the nurse turnover rate is almost zero, and the caregivers stay with the company for five to seven years or more, he said. “We’re not a typical home health provider,” Grissett said. As the largest home health service provider in the nation, Gentiva offers its services 365 days a year, whenever a patient needs them. “Our job is to bring ‘em home and keep ‘em home,” Grissett said. He said Alzheimer’s and dementia not only affect the elderly, but can also strike the young, with younger individuals also being diagnosed with the disease today. “It (Alzheimer’s) has no criteria really,” Grissett said. “It has no mercy on anybody. It’s a sad disease. It’s heartbreaking, and it’s emotionally, physically and spiritually exhausting to see somebody have so much quality of life left, but not be able to function.” Once a patient can no longer be cared for with home health services, then it may be necessary to move on to hospice care or admission to a nursing home. However, that is not as bleak of an option as many might think. “Hospice is not one foot in the grave anymore,” Grissett said. Hospice care With illnesses so prevalent
Hospice organizations Pell City: Alacare Home Health and Hospice – 205-338-3250 Talladega: Comfort Care – 256-761-1250 Sylacauga: American Home Care – 256-245-9212 New Beacon Inc. – 256-207-2055 Gentiva Health Services – 256-249-4363
One family finds peace with help from hospice By Christa Jennings Home staff writer
Those who walk through the doors of Era Stevens’ home in the Talladega Springs community would be surprised to find it unlike the home of most Alzheimer’s patients. Upon entering the house, guests can hear joyful laughter and see delightful smiles from Stevens and her family. Then again, for those who have known Stevens a long time, it may not come as such a surprise. “She’s always been a happy personality,” daughter Glenda Kelley said. “If you come in in a good mood, she’s in a good mood,” granddaughter Wendy Chandler said. Stevens was diagnosed with Alzheimer’s about six years ago, although she began having some problems before that, according to Kelley. She said that in the last couple of years it has been a downhill slide, with her mother gradually stopping performing tasks she once did regularly. Stevens has now been on various hospices for about a year. “We would have a hard, hard time without family support and hospice,” Kelley said. Stevens is one of Mickey Green’s patients with American HospiceSylacauga. “It takes a lot of family support,” Green said. Stevens is fortunate enough to have many family members living close-by who check on her and her husband, Vernon, regularly. Kelley said she is lucky in the region and more individuals being diagnosed with Alzheimer’s and dementia, many family members feel fortunate to have a variety of hospices offered in their area. American Hospice-Sylacauga is one such care provider that offers services to patients with Alzheimer’s and dementia. Nurse Mickey Green, an American Hospice-Sylacauga case manager, said that in order to qualify for hospice services for Alzheimer’s, a patient must meet all of the following criteria: be unable to bathe without assistance, unable to dress without assistance, unable to walk, must be unable to speak or communicate six words tangibly, and must be incontinent of bowel and bladder. Green said that in many cases
Bob Crisp/The Daily Home
Family members stick together and help offer support for a relative with Alzheimer’s disease. Standing are Kathy Carpenter and Jerry Stevens. Sitting from left are Wendy Chandler, Era Stevens, Glenda Kelley and Vernon Stevens. to have three sons-in-law who don’t mind their wives taking time away from their homes to help and be with Stevens. She also considers it a blessing that her mother is typically jolly, something that Green also enjoys about visiting her. “She’s the exact opposite of how Alzheimer’s patients usually are,” Green said. “She laughs and is jolly. She’s at the opposite end of the spectrum.” “I wanna laugh,” Stevens smiled and said. Kelley said her parents had retired to Destin, Fla., for about six years before having to move back home in about 1994 as her mother’s health began to decline. Kelley said her mom never forgot birthday cards or other holiday cards to send to the family. “I can tell exactly when it started, because her birthday cards stopped; Christmas cards stopped,” Kelley said. Family members reminisced about some of the things they missed Stevens doing, or special items of hers they missed, such as having her bring them extra food when she had an Alzheimer’s patients can speak, but can’t form a full sentence. Dementia patients must also meet the same criteria. “Alzheimer’s and dementia run hand-in-hand with hospice,” Green said. For these patients, American Hospice’s services include nurse visits as often as requested, at a minimum of one per week; optional home health aides to assist with bathing and other projects, who visit three to five times a week, depending on the case; social worker visits; optional chaplain visits; optional home maker to perform light cleaning service 45 minutes each week; and volunteers, who call the patients, make them crafts and do other services for them. The hospice nurse assesses the patient weekly and commu-
abundance, seeing her weedeating her yard, her special biscuits, wrestling with the grandchildren, or even simply seeing her coming across the yard. Stevens has a doll that she often holds close to her and cherishes. “She always loved children and babies,” Kelley said. She said Vernon and Era kept many foster children for several years. The family now relies on each other, along with hospice care, to help take care of Stevens. The Stevens’ granddaughters, Wendy Chandler, Gwen Chandler, Kathy Carpenter and Amanda Stevens, perform a variety of tasks for their grandparents, including cleaning house, getting groceries, getting Era up and dressed and then ready for bed at night, cooking, giving her medications, and other such tasks. Hospice care helps handle the other tasks and items for the family. “We just go day by day,” Kelley said. “We don’t really know what’s wrong with her because she can’t tell us.”
Kelley and Stevens’ son, Jerry, both said how much they appreciate the assistance the family gets from hospice. Thanks in part to hospice, Talladega Springs Senior Center now brings lunch out to the Stevenses. Kelley said hospice brought out papers and information about many things the family was unaware of and didn’t know they could apply for, such as the lunches. She knows the toll her mother’s illness has also had on her dad and is grateful for the family and hospice support provided to him. He and Era have been married since September 1944 — for 62 years. “He went from having a wife and partner to almost having to take care of a child,” Kelley said. The family is grateful for both Mickey Green and Joe Jones, who visit every day, with American Hospice-Sylacauga. Hospice has been a comforting help to the family in their time of need. “Any time we’ve needed anything,” Kelley said, “they have been great and easy to reach.”
nicates with the patient’s physician, as well as calling in refills on medications and other small tasks. American Hospice-Sylacauga also pays for medications and equipment related to the diagnosis and any supplies needed, such as diapers, most common over-the-counter medicines, wipes, gloves and other disposable supplies. Green said every 60 to 90 days a nurse has to recertify a patient to be certain he or she needs to remain on hospice care. If an Alzheimer’s or dementia patient begins to not meet the qualifications specified, then services may be stopped. To qualify for hospice, it typically has to be in the doctor’s medical opinion the patient has a life expectancy of six months
or less. However, Green said, this varies with Alzheimer’s because the patients lose functions so slowly. “They’re on hospice a lot longer than other diseases are,” Green said. “They lose one function at a time.” Currently, about seven out of American Hospice’s 25 patients have Alzheimer’s disease. “It’s not very necessary to think your loved one is immediately dying to receive hospice, but they do have to be showing signs of decline.” American Hospice offers services to 10 counties, which include Calhoun, Clay, Cleburne, Chilton, Coosa, Jefferson, Shelby, St. Clair, Talladega and Tallapoosa.
enough caregivers in the area to go around. More people need to hear the call and answer it, she said. “There’s a bad need for people who have the passion to help people and the will to do it,” Horne said. “I think a lot of people shun that type of person because they don’t know about it unless they’ve had that experience already. It’s not your everyday run of patients. Patti Kulovitz, a social worker with Baptist Citizens Home Health Care, facilitates a support group for families of Alzheimer’s patients. One of the many problems they discuss is a lack of people to watch their family members when their primary caregivers can’t be around. “A lot of these folks do not have people to stay with the patients,” Kulovitz said. “A lot of people can’t afford sitters.” Most of the time, the task falls to patients’ children and other relatives. The burden can become overwhelming, Kulovitz said, and it’s important for everyone to pitch in. “Families are the ones who do most of the sitting,” she said. “So often we see one family member, even in a large family, who’s kind of put upon to handle all this.” Horne said that’s not uncommon in her experience. “It’s also important for family members to help with the work and financially, if nec-
essary, and also to visit very often,” Horne said. The most successful families of patients are those in which everyone participates in the caregiving process, she said. Family members who don’t see the patient on a regular basis might not be aware of the extent of the problem, Kulovitz said. One may visit for the holidays, find the patient on a “good day” and fail to realize the need for a sitter. Often, those who put the most into caring for a patient can find their own health or lifestyle suffering from the burden, she said. “One of my main concerns is the health of the caregivers,” Kulovitz said. “It often suffers when they’re trying to care for someone like this. I’ve known people who’ve had to quit their jobs to take care of people. … There needs to be so many more services — affordable services.” The Alzheimer’s support group meets from 10 a.m. to 11 a.m. on the second Saturday of each month at Citizens Baptist Medical Center in Dining Room One on the ground floor. Horne said she hopes more people will hear the call to service and answer it. “I think the love of God first is what a person needs; God will give you the love for people,” she said. “You have to love the people and have patience — a lot of patience at times.”
Sitters can help both the patients and their families By David Mackey Home staff writer
Shirley Horne of Talladega didn’t set out to become a sitter. She found herself doing the job when her mother was diagnosed with Alzheimer’s disease about 10 years before she died. “We didn’t realize what was happening” at first, Horne said. After the death of Horne’s father and several falls, including a blow to the head at the bottom of a staircase, her mother began exhibiting troubling symptoms — forgetfulness, strange utterances. “I was worried about her being by herself, so I talked her into living with me,” Horne said. Her sister, Julia Smith, came back to Talladega from Birmingham to help, and they cared for their mother until her death in 2002. With that experience, Horne and her sister began taking in other family members and related people with Alzheimer’s and dementia. Now, Horne said, she’s cared for about 15 people. She found the experience “very rewarding,” and now sits five days a week with a local elderly Alzheimer’s patient. The calling also found her sister, who became licensed and started TLC Assisted Living. Horne’s daughter, LaJean Horne, also cares for Alzheimer’s patients. “To me, it’s very rewarding to look after someone who can’t look after themselves,” Horne
said. Horne’s current patient receives 24-hour care from four different sitters during the week, with Horne taking a five-and-ahalf-hour afternoon shift, except on Fridays, when she works eight-and-a-half hours. Her duties are mainly to occupy the patient, keep her active and ensure her safety. “It takes being there and being efficient to make sure you see their every move,” she said. Every day, they chat, watch TV and exercise. Horne watches to make sure she takes her medicine, since patients often forget what it is and why they need it. Horne, who retired in 1997 from a career spent mostly with financial institutions, said keeping patients’ minds working can help slow the progress of the disease. “As long as they can, they need to be kept active,” she said. “It keeps their mind thinking and occupied. A lot of people just let them sit.” To that end, Horne takes her patient on car trips, to enjoy a restaurant meal or run errands. A recent drive to view Christmas lights around town “thrilled her to death,” she said. Dealing with the deteriorating mental state of a person with Alzheimer’s disease can be stressful to those who don’t have a passion to help, she said. “One minute they might know something, the next min-
Jerry Martin/The Daily Home
Shirley Horne of Talladega found a new calling after retirement, sitting with local Alzheimer’s patients when their families can’t be around. As dementia and Alzheimer’s disease progress, patients become unable to care for themselves and require a watchful eye 24 hours a day. ute they don’t,” Horne said. “Some of them are like “They sometimes ask the same angels,” she said. “Some, I question 10 or 15 times in would say, can be dangerous at five minutes. That’s where the times. You never know what’s patience comes in.” going to happen when you go in Some experience drastic each day.” changes in their personality and Horne gets calls from other can become aggressive or defi- families looking for assistance, ant. Horne said she has been and tries to help when she can threatened and struck by patients or refer them to a few others she before. knows, but there’s simply not
THE DAILY HOME, Talladega-Sylacauga-Pell City, Ala., Wednesday, December 27, 2006 — 7C
hoping and coping
Support groups critical to coping process By Laura Nation Home features editor
On Thursday mornings, Carol Karrasch is one of four volunteers taking a Bible program and music ministry to Alzheimer’s patients at two care providers in St. Clair County. And the second Thursday of the the month, Karrasch offers an Alzheimer’s Support Group meeting in Moody at First United Methodist Church for anyone who wants to participate. Since starting the group in September, she only had a few people respond, but Karrasch is still making plans to connect with programs and others who need help handling the disease. She and her brother, who both have serious health issues, are facing Alzheimer’s with their mother, and soon after Christmas, Karrasch said there is a decision they will have to make. It’s one she knows other families with Alzheimer’s face and something most people need help with deciding. In her mother’s case, Karrasch said, she and her brother noticed their mother was having trouble keeping track of time and doing simple things like turning on the stove. Her appetite was diminishing, too. After an appointment with her eye doctor, Karrasch’s mother’s doctor called wanting the family to meet with him. They later met with a psychiatrist to find out what was going on. Karrasch and her brother have been collecting information, preparing to find the right place for their mother. “We need to know she’s
Living with Alzheimer's and dementia
Hoping and coping
being cared for and that she has three good meals a day, things like that that are so important,” Karrasch said. She worries that she and her brother’s health won’t allow them to do the same for their mother. Having a support group to turn to with people who are having the same concerns is better than wearing out your friends, Karrasch said. “My friends are great, but they don’t want to hear this every time we get together,” Karrasch said. The exchange of information between families with Alzheimer’s could be of help, one family perhaps having experiences that would benefit another, she said. Having speakers from hospice care, medical professionals and social workers would bring the information people need to them, instead of having to get out and track it down alone. Starting the group “was a tug that wouldn’t let me alone,” Karrasch said. “It was just something that needed to be done.” Karrasch minored in psychology in college and said she had some background that should be
helpful as a group leader. It was firsthand experience that made Clifford Mosley of Talladega become an Alzheimer’s Support Group leader more than 10 years ago. Mosley lost both parents to the disease, and several other family members have suffered from it as well. Mosley is a former licensed practical nurse, which also helps in his role as a support group leader. His group meets at Citizens Hospital in Talladega on the second Saturday of the month at 10 a.m. People can exchange information and resources, but also feel they have an understanding ear ready to listen. Mosely has been known for his willingness to go to people’s homes who have family members with Alzheimer’s, helping them find ways to deal with the terrors the disease can dish out. One of the ways he’s learned to keep patients more content is by keeping them busy. “Just try giving them something to do,” Mosley offers. Usually, something repetitious is a good practice, something as simple as giving them a box filled with objects like
Laura Nation-Atchisson/The Daily Home
Carol Karrasch, left, travels to two St. Clair County care facilities for Alzheimer’s patients with other church volunteers to offer a ministry. She’s started a support group for families with Alzheimer’s at First United Methodist Church in Moody. With Karrasch, from left, are the Rev. Gary Howard from Odenville United Methodist Church, Linda O’Shaughnessy of First United Methodist Church and Neva Hestley of Eden United Methodist in Pell City. buttons or even pennies and the person can take the objects out and put them back over and over. Mosley stresses to those who are involved with Alzheimer’s patients to remember it’s important to avoid agitation for patients and that their erratic behavior isn’t directed at their loved ones purposely. It’s the disease, he says, it’s just what it does to people.
Alzheimer's support groups The Village at Cook Springs: The first Monday of each month, from 5:30 p.m. until 7 p.m. Public invited. First United Methodist Church in Moody: The second Thursday of each month, 7 p.m. Group leader is Carol Karrasch. Citizens BMC in Talladega: The second Saturday of each month, 10 a.m. Group leader is Clifford Mosley.
Help From Page 1A that can access emergency providers at the touch of a button. Lifeline is a push-button telephone communication system that can be worn around the neck or on the wrist. Once the button is pressed, local authorities are contacted and will come to the home to assist seniors in the event of a fall or any emergency. The programs available through Alabama Cares are available at no cost but only to seniors 60 and older who have a caregiver. “Alabama Cares is a nonprofit organization,” Pittman said. “We receive money through the program and offer it on a needs basis.” There is a waiting list for the program, but the agency prioritizes who receives aid based on income and needs. Currently there are more than 100 caregivers who receive help through the program. Because there is a wait for some, Pittman said, the agency has other resources to find help for those who cannot wait. For caregivers and seniors dealing with Alzheimer’s or dementia who are struggling to cope financially, Pittman said, there are scholarships available through Alzheimer’s of Central Alabama, which can be applied for through the Area Agency on Aging. The first is an incontinence scholarship that provides diapers or Pull-Ups for the rest of the senior’s life, as long as he or she remains at home. The second is an adult daycare scholarship, which provides $224 per month to the caregiver to spend on daycare services for their loved one. For families and caregivers that can afford to take care of their loved one without the aid of Alabama Cares or the Area Agency on Aging, Pittman said, there are a few businesses that provide services to the Alzheimer’s and dementia patients. She often recommends Comfort Keepers, which offers transport, respite and nurses to care for such patients. However, at a cost of $14.50 an hour or more, many caregivers simply cannot afford the cost of private help. Ellen Vincent, a coordinator for Alabama Cares who works for the East Alabama Area Agency on Aging, said the same options provided by St. Clair County’s Area Agency on Aging are available to caregivers and seniors dealing with Alzheimer’s and dementia in Talladega County. In addition to providing respite programs and connecting caregivers to outside sources that care for loved ones with Alzheimer’s and dementia, she said she has plenty of material to educate caregivers and those who are unfamiliar with the disease from videos to brochures.
She applauds the Alabama Cares program, but says that it is only a start to helping those with Alzheimer’s and dementia. “This program is growing, but right now we don’t have the means to keep everyone on the program and provide respite as often as needed,” Vincent said. “Contact your legislators and tell them how important it is to keep them (Alzheimer’s and dementia patients) at home.” If more help can come from the state level, more help can be provided to caregivers and loved ones in need, she said. Until then, she recommends working within communities to establish support groups and other aid. Project Lifesaver can help One program Vincent recommends that is only available in seven counties in Alabama is Project Lifesaver, which is coordinated through local law enforcement to keep records and provide personal tracking devices for Alzheimer’s and dementia patients, among others. Though the program is not available in Talladega County, it is available in St. Clair and Calhoun counties. “I think each county should have (Project Lifesaver),” Vincent said. “It can save a lot of lives.” Project Lifesaver was first established in Chesapeake, Va., by local law enforcement. Those who use the program are provided a lightweight tracking device that can be worn on the wrist or ankle and is monitored by local police and sheriff’s offices. The device is recommended for those with Alzheimer’s and dementia. “In Alzheimer’s, in the early stages, they begin to wander,” said Sgt. John McWaters, Project Lifesaver coordinator for St. Clair County. “This device provides some security during those stages.” St. Clair County has provided the service since 2001. The battery-operated device weighs only 1 ounce and is worn like a wristwatch. The device is durable and waterproof, so it can be worn 24 hours a day. Inside the device is a small chip that emits a frequency. Each client is on a different frequency, and McWaters and other St. Clair Sheriff’s deputies keep track of each client’s frequency and other information through a computer database. McWaters also keeps written documents and photographs of each client in his office. If a loved one wanders away from home or is missing, all a caregiver has to do is call the Sheriff’s Department. “We tell caregivers if you can’t find them in 15 minutes, then give us a call,” McWaters said. As soon as the department is notified, deputies begin the search “We have three tracking
Gary Hanner/The Daily Home
Sgt. John McWaters (far right), Project Lifesaver coordinator for St. Clair County, sets up a mobile locator tracking device, a key tool used by the sheriff’s department for performing searches. If a Project Lifesaver client goes missing, the tracking device is set to a client’s individual frequency and deputies are able listen to the signal for a more accurate search. devices. We’ll put two deputies in each car and triangulate the signals,” McWaters said. Deputies use a mobile locator tracking system to search for clients. Honing in on the client’s individual frequency through the locator, deputies listen to a series of blips to tell how close or far away they are to a client. By triangulating the signal, McWaters said there is a better chance of locating the person. He said that the St. Clair department has not had to use the equipment to perform what he calls a live search. So far, clients that have gone missing or wandered away from home have been found before the department has had to begin a search. However, deputies are certified on an annual basis within the department by performing two searches a year that are coordinated by the department so they will be prepared if a client does go missing. The wristwatch-like device isn’t the only thing McWaters and his deputies use to locate the client. Each client information sheet contains physical characteristics to descriptive details about the person – things that they always have with them, like candy or gum. McWaters knows specific information about each client. One woman, he said, always has lipstick with her, another always carries hard candy and another carries a bunch of tissues in her purse. “These details may sound strange, but they help when you are tracking the person,” he said.
“It may provide more clues.” Deputies also keep a book in their vehicles with all the client’s information on file. There are copies kept at both dispatches in Ashville and Pell City. Files are also accessible through the Internet at alasafe.gov, so agencies in other counties and states can access the file if necessary. “Say someone gets lost on vacation – I call the county or nearest agency that’s a member. They can go to the Web site and get that person’s information,” McWaters said. In addition to knowing specifics, McWaters and his deputies are familiar with each client on a personal level. Each month, a deputy will come to the home of every client to change the battery on the device and make sure it is still in working condition. Clients are also asked to test their battery daily with a device provided through the department and are given a sheet to record when it was tested. Each bracelet costs the department $300, and each battery costs the department $18.50, but the program is available for as little as $8 month, or no cost at all. “If a client cannot afford it, we will absorb the cost,” McWaters said. “We won’t turn anyone away.” The mobile locator tracking devices cost the county $5,000, but McWaters said the Sheriff’s Department received help from the St. Clair Health Authority to cover the cost. Currently the project serves 18 clients, but there have been
as many as 23. Most of the clients are senior citizens with Alzheimer’s and dementia, but the program also provides service to others with special needs. From the youngest client who is 7-years-old to the oldest at 88, McWaters said they provide the service to whoever is in need. The only criteria to utilize project Lifesaver is to have a caregiver. Even if someone is not diagnosed with Alzheimer’s, dementia or other medical problem, the department will provide the service. “If they call with a concern, we’re going to get them on the program,” he said. New programs add to aids for caregivers In addition to programs like Project Lifesaver and Alabama Cares, Vincent with Alabama Cares said there are many things caregivers can do in the home to help their loved one who is struggling with Alzheimer’s or dementia. It is important to prevent potential problems in the home, she said, likening preparing the home for a loved one to childproofing a home. Avoid clutter and clear walkways by removing throw rugs and items that may block paths. If there are hardwood floors, placing strips to prevent slipping can also help prevent falls. Extension cords should be used sparingly, or taped down to avoid tripping. Covers should also be placed on unused electrical outlets. Provide adequate lighting throughout the home and light
switches in every room. If there are stairs in the home, there should be railings, and it can be helpful to place bright, reflective tape on stairs so they can be better seen in the dark. Vincent said placing red tape around hot surfaces like vents and radiators can also serve as warning signs for loved ones so they won’t touch them. Stoves should have automatic shutoffs, and removing knobs on stoves can help prevent fires or other accidents. Smoke detectors should also be installed in every room, she said. If the person is a smoker, he or she should be monitored carefully. She recommends using caution with electric blankets or to avoid using them at all. It is also important to adjust water heaters to prevent scalding, setting them to 120 degrees or below. Foam-rubber faucet covers can also be useful in the event of falls in the tub or shower. It is not a good idea to leave an Alzheimer’s or dementia patient alone in the bathroom, but it is still important to give them some dignity. She suggests keeping an intercom system nearby, similar to ones used for children. Vincent said sometimes those with Alzheimer’s and dementia can forget if they’ve taken their medication, so it is important that medications be locked up except when needed. Plastic bags, poisonous plants and power tools should be removed from the home or kept out of reach, as well. She also said it is a good idea to secure locks throughout the home and to place a spare key outside the home in case the caregiver is locked out. Though she does not recommend leaving a loved one with Alzheimer’s or dementia at home alone, she said it is important to understand their individual needs. “You can’t judge Alzheimer’s patients by just one person,” Vincent said. “You have to use judgment. … Independence is a big thing to lose, and it’s important to give them a sense of dignity.” For more information about services available to caregivers trying to keep an Alzheimer’s or dementia patient at home, contact the local Area Agency on Aging in St. Clair County at 205-670-5770 or in Talladega County at 256-237-6741. Also, caregivers can be put in touch with local agencies by simply calling 1-800-AGELINE (1800-243-5463) or visiting www. ageline.net on the Web. For more information about Project Lifesaver in St. Clair County, contact the St. Clair County Sheriff’s Office in Pell City at 205-884-6140 or in Ashville at 205-594-2140 or visit www.stclairco.com. To learn more about the nationwide program on the Internet, visit www.projectlefesaver.org.
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Thursday, December 28, 2006 Webster’s Dictionary defines dementia as: “A usually progressive condition marked by deteriorated cognitive functioning often with emotional apathy.” In older people, Alzheimer’s disease is the most common form of dementia. It robs people of their memory and reason — stealing their lives long before they actually die. More that 4.5 million Americans suffer from the disease; 80,000 of them live in Alabama. There is no cure for Alzheimer’s, and doctors are not even sure what causes it.
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Your hometown paper for Talladega and St. Clair counties
Ford achieved by chance what Hoping and coping others strive for
Living with Alzheimer's and dementia
By Darlene Superville
What is certain is that, for the victims of dementia and Alzheimer’s, the prognosis is grim. Life is almost as difficult for their loved ones and caregivers.
Over the next few days, The Daily Home will examine what this disease is, what it means for patients and their families, and what is being done to find new treatments and possibly a cure.
The cost of Alzheimer's Financing care for dementia patients
Associated Press writer
WASHINGTON — Gerald R. Ford was a man of limited ambition who, through bizarre circumstances never before experienced by the country, achieved an office that others win through the greatest determination and calculation. The nation’s 38th president, Ford wanted only to become speaker of the House. History had another place for him. Ford was comfortable in the House, representing a Michigan congressional district for 25 years, rising to Republican leader and working toward his dream of one day running the chamber, when President Nixon called. He needed a new vice president; scandal had chased Spiro Agnew from the office. Ford wasn’t Nixon’s first choice, but the president agreed
that the amiable Republican would be the easiest to win confirmation by both houses of Congress. So it went, and Ford became vice president in December 1973. Yet eight months later, the scenario got even stranger. The scandal of Watergate drove Nixon to become the only president to resign. Ford, who died Tuesday at 93 at his home in the California desert, again was left to fill a void. And so the man who did not covet the presidency, who never had sought national office and who wanted only to become the ‘‘head honcho’’ of the House, became president by chance — unlike many since who have devoted huge amounts of time and money in pursuit of the Oval Office. ‘‘I have not campaigned either for the presidency or the See Ford, Page 8
Local leaders react to Ford's death
The best way to make sure you are cared for the way you would want when you are no longer able to make that decision is to make arrangements well before the need arises. Home managing editor
The costs for medical and other supportive care for someone dealing with Alzheimer's disease and other forms of dementia can be astronomical. “It can take every dime to provide nursing home or other care,” said local attorney Larry Morris of Alpine. And while government services do cover some of the expenses, that only happens after all other resources are exhausted. To ease the financial burden on loved ones, the best way to tackle the problem is by planning ahead — way ahead, Morris said. And he should know. Morris not only has experience dealing with the legal issues surround-
Thursday
Index Editorial.............................9 Lifestyles............................4 Sports....................... 1B, 2B Community Calendar......10 Dear Abby.......................6B Comic/Television.............6B Classified.................. 8B, 9B See Obituaries, Page 2
ing such financial prudence as an attorney, he holds a degree in counseling and is the executive director of Cheaha Mental Health. As such, he is also familiar with many of the clinical issues surrounding dementia. Before Medicaid kicks in to help with the expenses, the federal government has a right to most of the individual’s privately owned assets. That includes some of their money — anything over $2,000 — and property, including their home if it is not jointly owned by a spouse or other individual, he said. But, with proactive planning, much can be done to protect an individual’s finances and help pay for their care, either in their own home or in a managed-care facility, such as a nursing home. “This whole issue, what someone does to preserve their
assets, is a real personal choice,” Morris said. “Each individual needs to consult an attorney to address their specific individual situation.” For many people, it’s more important to preserve their estate for their children and grandchildren. Others believe what they earned should be used to take care of them when they can no longer do it themselves. Keeping it in the family Preserving the estate can be tricky, especially since the government has a right to most private assets to help pay for longterm care, though it can’t take jointly held property, such as a home a couple owns together, Morris said. But it can be done, especially See Cost, Page 5B
Online
By Richard McVay Home staff writer
PELL CITY — As the area continued to experience a residential building surge, a local retailer saw the market for a discount building supply business. Lake Home Center, now open in the Starzz Performing Arts Center, sells factory closeout and salvage building materials at discount prices. Owner Danny Lambert said with the ongoing growth in the area and
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See Reaction, Page 8
See Preuitt, Page 8
President Gerald Ford
Area growth, friendliness reasons for new business
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Preuitt: Enough votes for Senate control
burglary. “Probably one of the single greatest things he did was to pardon Richard Nixon,” Thibado said. “That may have cost him re-election (in 1976, when Ford lost to Jimmy Carter). He was a man who did what’s right without considering how it would affect himself.” Gov. Bob Riley issued a statement Wednesday echoing Thibado’s sentiments. “Gerald Ford was a great man,” Riley said. “He served the country at a crucial time in American history and brought a sense of honor to the White House.” Riley ordered flags at state buildings to be flown at halfstaff Wednesday. Talladega County and city government
Home staff writer
Local and state Republican leaders remembered President Gerald Ford, who died Tuesday at his California home, as the man who held the nation together after the Watergate scandal. Paul Thibado, chairman of the St. Clair County Republican Party, described Ford as the “right man for the right time.” “He came along as a man who never desired to be president, but he took control of the country at a very, very difficult time,” Thibado said. “He was the right man for the job to soothe the country after Watergate and the Vietnam War.” Thibado said Ford was “noncompromising” and had high praise for one of his most controversial decisions: pardoning former President Richard Nixon soon after his resignation for any crimes he may have committed with his involvement in the cover-up of the Watergate
Sen. Jim Preuitt
Sen. Jim Preuitt issued a statement Wednesday claiming 19 senators, including himself, are committed to supporting him for president pro tem of the Senate when the state Legislature organizes Jan. 9. With the recent addition of Sen. Rodger Smitherman, DBirmingham, and an announcement by the Senate’s 12 Republicans that they will support him, Preuitt said he has at least a slight majority for the top position in the 35-member Senate. “The numbers have grown,” Preuitt said Wednesday. “We have a majority committed to organizing, one over the 18 needed. We feel there are other members interested in trying to come together with us and have a better, more efficient working Senate than we’ve seen in the past.” If the reported coalition of seven Democrats and 12 Republicans holds, Preuitt, DTalladega, will succeed Sen. Lowell Barron, D-Fyffe, who has held the position since 1999. Political action committees linked to Barron and allies contributed at least $148,000 to the campaign of former Talladega Mayor Larry Barton, who tried to unseat Preuitt in the June Democratic primary, but Preuitt said his takeover of the Senate leadership was not motivated by
By David Mackey
By Graham Hadley
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the friendliness of people there, he felt Pell City would be a great place to run a business. Lambert and manager Billy Adcox have nearly 60 years combined in acquiring factory closeout and salvage building materials, and are settling in their new home at Starzz. Plans for a new performing arts center are under way, and Lake Home Center will occupy all 21,000 square feet of the building by mid-2007, Lambert said. He said he had planned the
business long before finding a prime location. “We had the name before the building,” he said. “We’re fond of Pell City and want to be part of the community. People are just friendlier up here.” The business currently has a myriad of building supplies for sale, including an extensive collection of fully assembled kitchen and bathroom cabinets — all acquired either through See Business, Page 8
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4B — THE DAILY HOME, Talladega-Sylacauga-Pell City, Ala., Thursday, December 28, 2006
hoping and coping
Long-term care insurance makes all the difference Living with Alzheimer's and dementia
Insurance policies protect family Hoping and coping assets and can increase quality of life
By Kellie Long Home staff writer
LEFT: Blanche Kilpatrick works a crossword puzzle while she gets her hair dried at the beauty shop at The Village at Cook Springs. Kilpatrick has been a resident for the past several months.
Blanche Kilpatrick, a resident of The Village at Cook Springs, was married to what her daughter, Annie Weathington, calls an early planner. Kilpatrick’s husband, Charles, bought a long-term care insurance policy 20 years ago to pay for the couple’s care as they needed it. “My dad decided years ago to be ready when they got older,” Weathington said. “He purchased this policy about 20 years ago, and it’s been a lifesaver.” Weathington said her mother entered assisted living at The Village at Cook Springs just a few months ago and her benefits are in place. By having the long-term care policy in place, her mother is able to enjoy the company of people her own age while staying active and not worrying about losing everything she owns to pay for her care. “Mother lived with us for awhile after my father passed,” Weathington said. “She took part in all our family activities, but since she’s moved into The Village she is happier and enjoys the company of people her own age. Having the insurance in place has allowed her to be able to enjoy this without having to use everything she has. “If she had depended on Medicare, she would have had to sell her house and property, or at the very least gotten it out of her name.” Benefits of long-term planning Caring for an elder loved one can be expensive, especially in assisted living facilities or Alzheimer’s wards of care facilities. However, early planning can prove to be a lifesaver for many families faced with providing the intensive care often needed by seniors. Long-term care insurance benefits cover these costs and provide peace of mind for loved ones while allowing seniors to enjoy their golden years. “It’s something everyone needs and not many people have,” said Sam Davidson of Davidson Insurance Agency in Pell City. “Having longterm care insurance helps families take care of their seniors while maintaining their assets such as their home and property.” Davidson said that, when elderly loved ones enter an assisted care facility due to mental illness or other reasons, many times they must give up their homes, property and possessions to pay for the care they need. “Long-term care is so expensive that if people don’t have any insurance in place, they risk losing their home,” he said. “Some people believe their Medicare is enough to take care of them, but Medicare pays only a minimal amount. It pays so little that you don’t want to depend on it.”
Long-term care insurance benefits can include caregiver training and home health care where seniors can remain in their own homes for as long as possible. It also offers nursing home and assisted living benefits as well as bed reservation benefits. “The benefits can also be used in an assisted living facility for those who do not have mental issues or aren’t bad enough for a nursing home but still need assistance,” Davidson said. Experts say there are a few things to look for when choosing a longterm care insurance policy. First, look at the per-day benefits paid by the policy. The average long term care facility charges between $3,000 and $3,500 per month. Longterm care benefits should pay daily benefits on an average of $100-$150 per day. Riders can also be purchased with the policy to provide additional benefits such as an inflation clause that provides for the increase in care costs. There is also a ‘return of premium’ rider that refunds premiums at the death of the insured if the benefits are not used. “The inflation rider is a very important thing,” Davidson. “Costs are climbing each year, and I wouldn’t sell a policy without it.”
Premium payments are based on the daily coverage rate, age of the insured and the length of the elimination period. The elimination period is how long the insured must live in the nursing home before benefits kick in. Elimination periods range from zero, 30, 60, and 90-day periods. “The elimination period describes how many days the insured must pay for their own care before the insurance benefits start,” Davidson said. “For example, a 90-day elimination period would offer a lower premium payment and the family would pay for the first 90 days of care before benefits start. For a higher premium payment, benefits can start the day the insured enters the facility.” Long-term care insurance can be purchased at any age, and Davidson said the younger the buyer, the cheaper the premiums. “The ideal time to buy is when you’re in your 40s to 50s,” he said. “Prices are lower then. Folks trying to buy in their 60s and 70s are finding they can’t afford it. You need to get it while it’s cheap.” Once a long-term care policy is in place, the insured must meet at least two of a list of criteria to collect benefits. The criteria include difficulty bathing themselves, continence problems, needs help dress-
Gary Hanner/The Daily Home
ing, needs help eating, or needs help with toileting, or they have major cognitive impairment. Weathington said she sees what an asset the long-term care policy is to her mother and family and said she and her husband are planning to put policies of their own in place soon. Davidson said even though the
BELOW: These certified nursing assistants at The Village at Cook Springs have enjoyed caring for Blanche Kilpatrick the past few months. From left are Robyn McCullough, Kilpatrick and Tonisha Oden.
benefits provided by a long-term care policy are invaluable, few people have them. “I don’t write very many of them right now,” he said. “People have to realize that this is not a Medicare supplement. There are no long-term benefits in the supplement. The only way to have them is to pay for your own policy.”
Take legal action now to ensure a better life later By Chris Norwood Home staff writer
There are few experiences more emotionally devastating than caring for a parent or loved one as they slip away into the darkness of Alzheimer’s disease or dementia. But just as daunting on a purely practical basis is caring for someone who can no longer care for themselves without all the necessary legal documents and other paperwork. Birmingham attorney Lynn Campisi, who specialized in elder law, recommends having everything in place well before there is any need. “At age 19, you are considered an adult,” she said. “You could be incapacitated in an accident and suddenly you’re facing the same issues as a 79year-old with dementia. All adults need to be thinking about things, because even in cases of temporary illness or incapacity, you could be looking at the same problems as someone with Alzheimer’s.” The first two documents to be prepared should be durable powers of attorney for financial and medical decisions. “Every individual has the right to make their own decisions until they lose the ability to do so,” she said. “If there is no power of attorney in place, the courts will have to step in and appoint a medical guardian and a financial conservator.” If a person is no longer able to make their own decisions,
the financial conservator is responsible for paying the bills, keeping the house in order, filing insurance claims and making other financial decisions. A medical guardian is responsible for making decisions regarding medical care and treatment. It is also important to have a living will and to appoint a proxy to see that the living will is carried out, Campisi continued. “Most people will want every type of treatment they are entitled to until it becomes futile,” she said. “When everything has been tried and you are down to extreme measures, that’s when you need the proxy.” A medical power of attorney should also include a waiver of the stringent privacy guidelines included in the Health Insurance Portability and Accountability Act, or HIPAA, she continued. Even with a medical power of attorney, under HIPAA guidelines, detailed information about the patient’s treatment and condition cannot be disclosed without the proper waiver. “Then the last priority would be a will,” Campisi said. “It’s important, but managing your assets during life is more important.” Although it is critical to have all of these documents in place before they are needed, in some case court intervention is not entirely a bad thing. “All of this assumes you have great loved ones to take care of you,” Campisi said. “If you’ve got reasonable, good children you can delegate
Bob Crisp/The Daily Home
Families of those who may be entering the early stages of Alzheimer’s disease or other forms of dementia should make sure they have several documents prepared, including power of attorney over medical and financial affairs, HIPAA release forms and a living will. to, great. But sometimes, for instance, you’ll have two or more involved, and one will not give up control no matter what. In that case, it’s not a bad thing to go to court. Or in some cases, there is no one close enough or trusted enough. Going to court is the best option in that case.” In that circumstance, assets can also be put into a trust and a trustee can be appointed to
handle financial decisions. “That will depend on the extent of the patient’s assets,” Campisi explained. “It should be handled on a case-by-case basis. But you want to have someone in control.” This can be an institutional trustee, such as a bank. Also, certified public accounts have protocols for elder care services. Trustee fees can be discouraging,
but it’s really a small insurance fee to make sure your assets are protected. “It’s a perfect world until it’s not,” Campisi said. In the absolute worst-case scenario, state law also allows the appointment of a surrogate if no living will is available. According to Campisi, the surrogate will be allowed to make the decision when to provide or withdraw life-sustaining
treatments and artificial nutrition and hydration. There are also situations where the patient may want one thing and the person with power of attorney wants something else. “You can be vulnerable there if the patient has not been adjudicated incompetent by a court. That can be a big gray area, and sometimes in those cases, the doctor will step in and request a court order for guardianship. Say someone has been living in a nursing home for five years and then starts acting out. “The doctor could call the patient’s wife to ask for guardianship just to keep him from walking out the door,” she said. Each patient’s circumstances will vary, and all of those variables should be taken into consideration. “If you’ve got folks that you trust, whether it’s a spouse or an adult child or whatever, give them the power. If not, start looking at your options.” Ideally, she stressed, all of the planning and contingencies should be in place well in advance of any actual need. The financial and medical arrangements should be made while the person is still able to make those decisions on their own, which in turn, will ease the burden on the family at least a little bit when the disease comes. “If you’ve got all the planning done, then you concentrate on finding a good doctor that you feel you can communicate with and search out local support groups you can hook into.”
THE DAILY HOME, Talladega-Sylacauga-Pell City, Ala., Thursday, December 28, 2006 — 5B
hoping and coping
Benefits and limits of Medicare and Medicaid Living with Alzheimer's and dementia
Hoping and coping
Government funding can help, but it does not cover everything By Samantha Corona Home staff writer
When a loved one is diagnosed with Alzheimer’s disease, physical health isn’t the only concern families have to face. As the deadly illness eats away at the mind and the body, emotional stability and financial security can also wear thin. For senior citizens with only Medicare and Medicaid to count on in their twilight years, the questions and concerns can be even greater: What is covered? What’s going to be left for my family? Will I be taken care of without becoming a burden? Both government programs can offer a cushion when it comes to Alzheimer costs, but no more so than other insurance programs. Experts say a backup policy may be the way to go. Benefits like everyone else Every senior citizen over the age of 65, some people with disabilities under the age of 65 and people with end-stage renal disease are all eligible for Medicare benefits. The program is broken down into two parts, defining all the coverage Medicare can provide. Part A takes care of hospital insurance, including inpatient services, skilled nursing facilities, hospice care and some home health care. Seniors or their spouses who accumulated Medicare taxes while they worked do not pay a fee for Part A. Part B helps with medical insurance, doctor’s services, outpatient hospital care, some services of physical and occupational therapists, and some home health care, but usually requires a monthly premium fee. Monica Rowe, principal social work coordinator and long-term care ombudsmen for the East Alabama Regional Planning and Development Commission in Anniston, said the Medicare benefits for Alzheimer sufferers are no different than for any other senior citizens with medical ailments. “Medicare pays the first 20 days of skilled care and rehab,” Rowe said. “After that, the family is responsible for the co-pay up to 100 days.” In other words, if a patient
comes in the hospital with a broken hip and needs physical therapy or rehabilitation to walk, Medicare will pay the full price for 20 days and the patient will pay the co-pay for the remainder of the therapy, up to 100 days. The same goes for any illness requiring seniors to check into the hospital or a skilled nursing facility or to have home health services. Seniors on Medicare have 100 days of insurance, no matter what their situation is. After those are gone, Rowe said, any other costs fall on the patient and their families. …With problems different from everyone else For most healthy people 100 days of covered hospital time and care would be more than enough, but Alzheimer victims are anything but healthy. In addition to deteriorating brain functions, Alzheimer’s can bring in several other chronic conditions, resulting in more hospital stays and increased Medicare costs. According to the American Alzheimer’s Association, 95 percent of Medicare beneficiaries with the disease show one or more serious problems such as congestive heart failure, diabetes and coronary heart disease. Mary Robinson, case manager and social worker at Citizens Baptist Medical Center in Talladega, said Alzheimer’s patients often contract serious urinary tract infections, develop bad diets, injure themselves and can forget to take their regular daily medications, making them more vulnerable to other illnesses. “A lot of times, toward the end of the disease, they’ll quit eating. If you ask them, they won’t remember, so they’ll tell you they already ate. …,” Robinson said. “Sometimes these other medical conditions exacerbate the Alzheimer’s and make it come along quicker, make it worse quicker.” With the number of illnesses and necessary treatments involved, those allowed 100 days can fly by faster than the patient or the family realizes. Because of the small cov-
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Dr. Daniel Marson, professor of the Department of Neurology and interim director of the UAB Alzheimer’s Disease Center, says dementia is a brain disorder that seriously affects a person’s ability to carry out daily activities. erage amount, Robinson said, some Medicare patients already have a supplemental insurance plan in place from companies like Blue Cross/Blue Shield or United Healthcare, just in case they need more coverage to pick up where Medicare leaves off. But that’s not always the case. And once a person has been diagnosed with Alzheimer’s disease, it makes it that much harder to get more insurance. Factoring in family and friends “You can’t let them drive, you can’t let them go anywhere, you can’t let them cook and that’s sad to watch. They’ll (relatives) quit their jobs and as the disease progresses, they end up requiring 24-hour care,” Robinson said. “Sometimes it’s not all requiring skilled care, but it requires eyes on them all the time because they don’t sleep, they wander, they turn (stove) eyes on and leave them on and a lot of times they need more than a family can do.” Caregivers have a variety of options when it comes to making sure a loved one with Alzheimer’s is safe and secure. Sitters, boarding houses,
assisted living, even quitting their own job to stay at home are all available choices, but only if the families are willing to foot the bills entirely themselves. Medicare and Medicaid, or any other insurance plans for that matter, don’t cover sitters or assisted living care, Robinson said, whether that’s for Alzheimer’s or any other illnesses. For families that can’t afford to pay outside sources for help, and with more than seven out of 10 people with Alzheimer’s disease living at home, almost 75 percent of their care is provided by family and friends. The Alzheimer Association says the remainder is “paid” care, costing an average of $19,000 a year, and families pay almost all of that out of pocket. Finally, if private funding and home care are not an option, that’s when some families have to turn to nursing homes and eventually Medicaid. “A lot of people say, ‘I don’t want to put mama in a nursing home because they’re going to get her house,’” Robinson said. “But you don’t want something like that to stop you from putting someone with Alzheimer’s
in skilled nursing if that’s what they need. If you can’t take care of mama at home, put her somewhere with someone who is skilled and can be around 24 hours a day.” After a patient has reached the 100-day mark on Medicare and the family decides a nursing home is the best choice, Rowe said, they have 30 days to apply for nursing home Medicaid. Medicaid differs from Medicare in that it’s only available to low-income families and has specific requirements to qualify. Age, pregnancy, disability, income and assets that can be bought or sold can all factor in deciding whether a person is a candidate. Robinson said once a senior citizen has been approved for nursing home Medicaid, it is decided that the patient doesn’t have any assets for the nursing home to consider, and the program will pay for the remainder of their stay. Rowe said one non-negotiable rule is that the applicant can’t have more than $2,000 to their name. Families, who fall above that $2,000 mark must pay all the nursing home costs themselves
with no means of help. “A person can go into a nursing home and be on private pay, and the costs can run into around $4,000 a month, it just varies,” Rowe said. Those who are at $2,000 or below usually got there because of overall Alzheimer’s cost in the first place. Hope for the Future Medicare costs for beneficiaries with Alzheimer’s are expected to increase 75 percent, from $91 billion in 2005 to $160 billion in 2010, and Medicaid expenditures on residential dementia care will increase 14 percent, from $21 billion in 2005 to $24 billion in 2010. Numbers are increasing so fast, the American Alzheimer’s Association is calling on Congress to modernize Medicare by adding a chronic care benefit to help alleviate part of the pressures on Alzheimer patients and their families. The association has awarded more than $200 million in research grants since 1982, and the federal government also estimates spending approximately $647 million for Alzheimer’s research in 2005.
Cost From Page 1A if someone has planned well ahead for the eventuality that they may not be able to take care of themselves some day. One of the best ways, Morris recommends, is insurance that specifically covers long-term care. He says people who have the financial ability to do so should start paying in their 50s or younger. “The earlier you purchase a policy, the less expensive it is,” he said. Generally, such insurance will pay for assisted living or to have someone help out in the policyholder’s home. Morris said people who can afford it should not wait to purchase insurance until dementia symptoms appear. “Do not wait until it is too late,” he said. Another option for people looking to preserve their assets is by setting up what’s called an inter-vivos, or living, trust. This is an irrevocable trust that you fund to help pay for future care needs. The trust is set up with limitations on how the money can be spent. It can even be written so specifically so that it would not cancel out other benefits like health care coverage that people may have from another source, such as through an employer or from the government, Morris said. “If someone has benefits, you try to create a trust that would not do away with those benefits,” he said. Someone who wishes to preserve their estate can also transfer some of it to a relative or other individual so it will be considered legally jointly owned. This can be especially important when it comes to someone’s home. They can deed the property to a relative, but create a legal docu-
ment giving them control and partial ownership of the assets until they are no longer legally competent. While this is one way to preserve the estate, like most of the other options here, it must be done well in advance. “Transferring of assets must be done well before — years — someone is declared incompetent, or the (government) looks at it like it was done” to keep the property out of their hands, Morris warns. He also said that such measures as the trust and transferring property are no guarantees the government will not challenge the action in court. “Anything you do is subject to litigation in a court of law,” he said. Taking care of yourself When it comes to those who want their assets used solely for providing care and comfort, Morris again suggests setting up a trust which specifically outlines how the money can be spent. “People sometimes say, ‘I earned this,’ and want their money to be used to keep them in comfort,” he said. Again, the directives in the trust can be used to preserve benefits, but it can also be specified to cover things like patient comfort. Spelling out how you want to be taken care of if you are no longer legally competent is essential to receiving the kind of care you want, he said. If someone is still competent, Morris also said they should specify who their guardians will be and what control over the assets they will have through legal arrangements like a durable power of attorney. When finances run short While many people are concerned about preserving their estate and making sure they are well cared
for, just as many others do not have the financial resources to plan ahead or sometimes even pay for their care. Morris said, after all assets are used up, the federal government steps in to cover the costs of longterm care, often through Medicaid and Medicare. Even for people with limited financial means, some options are still available for their families. One of the big things, especially in small, close-knit communities like those in Talladega and St. Clair counties, Morris recommends is for caregivers — most often a surviving spouse or other relative — to seek help from churches, charities and support organizations. Social workers with government organizations also can sometimes offer advice and find agencies willing to help with the care. Also, most nursing facilities have someone on staff who can provide legal guardians with help on financial and other issues relating to the care of someone with dementia. Regardless of whether someone is just trying to get by, preserve an estate or have their wealth spent to keep them in comfort, Morris recommends that everyone involved in the person’s care seek professional guidance. That can come from nursing homes, counselors, health care professionals, social workers and attorneys. The latter can be especially important for people who are planning for their future, and it is an absolute necessity when handling the transfer of assets or setting up trusts. When large sums of money are involved, some of the proactive measures can even save people on their taxes, but Morris said they will need additional advice from experts who specifically deal with tax law before those issues are considered.
By creating a trust, people can spell out exactly how they want their money to be used to take care of them. What's more, the legal document can be written to preserve other benefits, such as medical coverage for rehabilitative services.
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Friday, December 29, 2006
Webster’s Dictionary defines dementia as: “A usually progressive condition marked by deteriorated cognitive functioning often with emotional apathy.” In older people, Alzheimer’s disease is the most common form of dementia. It robs people of their memory and reason — stealing their lives long before they actually die. More that 4.5 million Americans suffer from the disease; 80,000 of them live in Alabama. There is no cure for Alzheimer’s, and doctors are not even sure what causes it.
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Page 5B
Coalition’s mission Shelter plans await closer to reality Hoping with $10,000 grant clean report
Living with Alzheimer's and dementia
and coping What is certain is that, for the victims of dementia and Alzheimer’s, the prognosis is grim. Life is almost as difficult for their loved ones and caregivers.
Over the next few days, The Daily Home will examine what this disease is, what it means for patients and their families, and what is being done to find new treatments and possibly a cure.
Coping with Alzheimer's 'long goodbye'
From adult day care to supervised living
By Samantha Corona Home staff writer
TALLADEGA COUNTY — According to its mission statement, “The Talladega County Education Leadership Coalition desires to strengthen Talladega County through collaborative, capacity-building efforts, targeting children and families in atrisk situations.” As of last week, the coalition is one step closer to following through with its promise. The coalition was awarded a $10,000 grant by the Alabama Civil Justice Foundation to create and pursue a Community Needs Assessment plan for all of Talladega County. The assessment will look at important needs for local residents, children and struggling families and help prepare the groundwork for a solution. “I’m very excited. I think it’s going to give us the momentum we need to do what needs to be done for Talladega County,” said Dr. Terry Graham, president of the Alabama Institute for Deaf and Blind and co-chairman of the coalition. “When I think of the people who have gotten together on this, I’m pleased because I think it demonstrates that the leadership of the county can come together for the needs and benefits of the county.” The idea to apply for the grant was first derived after members of the Leadership Coalition realized how important a Community Needs Assessment would be for Talladega County,
particularly in the preschool and adult education programs. According to the grant proposal, out of the 66 counties that make up Alabama, Talladega County ranks 29th on the poverty level, a position that shows “a high number of people within the county are in need of assistance or defined as ‘at-risk.’” As a possible solution to the communitywide problem, the coalition suggested working toward creating one carefully outlined preschool program for both city and county school systems, as well as an adult employment training program. Then it turned to the ACJF for help. Instead of individually looking for ways to see what needs improving throughout the area, the group, comprised of college, city and county school leaders, decided to pool their resources — grant writers, ideas and expertise — and come up with one grant proposal that would include and accommodate every agency and system involved. “This is the first time we’ve done something like this together,” Graham said. “We wrote the grant together, we received the money, and what it tells me is that it’s all starting to come together for us.” The $10,000 will go toward developing a Community Needs Assessment program that will help with reviewing and understanding the severe needs in the county, which the coalition can See Grant, Page 4
from ADEM By Christa Jennings Home staff writer
SYLACAUGA — The Alabama Department of Environmental Management recently completed the first phase of a Brownfields assessment on property near Taft Brown Road, making the city’s plan to develop the former unpermitted dump site for use as a humane shelter closer to a reality. Mayor Sam Wright said the city had asked ADEM to come in and perform the Brownfields assessment so it can utilize the land later. Currently, the city uses the property to store waste and debris, such as limbs and leaves, according to Wright. He said the city has used the property for that purpose for many years. Brownfields consist of abandoned, underutilized or vacant industrial or commercial properties that can impede economic development. Many of these properties have real or perceived environmental concerns that prevent prospective buyers from considering the sites for redevelopment. According to ADEM, the property near Taft Brown Road is owned by the city of Sylacauga, which requested ADEM’s involvement to evaluate remediation efforts needed to help stimulate reuse of the See Assessment, Page 4
Only memories remain after 40 years of serving community By David Atchison Home staff writer
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Residents at The Village at Cook Springs’ Alzheimer’s unit participate in religious activities at the unit’s chapel. Administrators say religion remains a long-term memory long after short-term memory deteriorates in patients. “Faith is very important to them,” Wisteria Springs Administrator Anne Henry said. “They start singing. Some that can’t communicate at all can sing hymns. Even if they can’t get the message, they know the ritual.” By Richard McVay Home staff writer
After her mother was diagnosed with Alzheimer’s disease in 2001, Patsy Desaulniers decided to keep her mom in her home for what she hoped would be a temporary arrangement. “She moved in with us to recuperate,” Desaulniers said. “I thought she would be able to go back to her apartment.” But her mother would never return to her apartment. During her three-and-a-halfyear stay with Desaulniers, her mother took on unusual behaviors, typical among those suffering from Alzheimer’s disease. “She would forget where the
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bathroom is or wear seasonably inappropriate clothes, and would wear her clothes inside out,” Desaulniers said. “She would bring three combs to the breakfast table along with assorted pairs of underwear. You have to learn to choose your battle. The clothing issue is not a big deal unless you’re going out.” Desaulniers’ mother’s condition worsened to the point that she walked out the front door, attempting to get home. “There was only one time she wandered off,” Desaulniers said. “It just so happened we were lucky. My husband had broken his back and was listening to music when all of a sudden she said, ‘I have to go home.’ She
only made it to our front porch, fortunately.” The Desaulniers changed their locks the next day to prevent it from happening again. “Basically my husband and I became prisoners in our own home,” Desaulniers said. The stress took a toll on her and her husband. Both experienced high blood pressure from the constant care her mother required. “I can’t tell you the stressful things that happened. It’s unbelievable stress 24/7,” she said. Tough decision Glenn Brewer, executive director of the Village at Cook See Home, Page 7
PELL CITY — After 40 years, James and Jeanette Perry are selling their business and retiring. “It’s like losing part of the family,” James Perry said of Perry Chevron, a family-run business. “I don’t want to, but it’s time to.” Perry, 67, and his wife, Jeanette, operated Perry Chevron for 40 years. The couple, who recently celebrated their 50th wedding anniversary, said they raised their four children at the gas station. “David pumped gas,” Jeanette Perry said. “Robert and Mike fixed flats. Andra used to play in her playpen here. All the kids grew up here.” The couple first opened the gas station, which is located along U.S. 231, in 1966. James Perry said during the first 23 years, Perry Chevron was a full-service gas station with three service bays. “I don’t even want to put on a windshield wiper after working 23 years on cars,” he said. For the past 17 years, Perry Chevron has served as a food mart and gas station. Perry was 27 years old when he saw the “For Lease” sign on the outside door of the gas station. Standard Oil Company owned the building back then, he said. He was able to lease the building, and in 1994, after
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James and Jeanette Perry are selling their family business and retiring. Chevron took over Standard Oil Company and put all the gas stations up for sale, he eventually bought it outright. “It was one of the last ones they sold,” Perry said. Twenty-four hours a day, seven days a week, Perry Chevron would fix flats, get vehicles out of ditches and tow broken-down vehicles into the gas station for repairs.
Perry said his wife was probably the first woman ever to work at a gas station. She worked the cash register and the children were there after school every day working. “We were together more than the majority of families,” he said. “I was with my kids all the time.” See Perrys, Page 4
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6 — THE DAILY HOME, Talladega-Sylacauga-Pell City, Ala., Friday, December 29, 2006
hoping and coping
As disease progresses, so does need for care Living with Alzheimer's and dementia
Hoping and coping
Adult day care is a godsend for caregivers and patients By Laura Nation-Atchison Home features editor
Sheryl Mulvehill is the type person people just feel good being around. The petite brunette has been a social worker specializing in geriatric care for 30 years now. It’s what she studied for her master’s degree, and she’s worked in specialized psychiatric geriatric care as well. Now marketing director for The Village at Cook Springs in St. Clair County, Mulvehill is called upon every day to help people make decisions about the elders they love. Mulvehill meets families with a contagious smile and an inviting attitude. And Mulvehill doesn’t mince words when it comes to care for Alzheimer’s and dementia patients. She’s seen too many scenarios with family members overwhelmed by their loved ones’ needs and loved ones not always having the best environment. “People often think it’s great having their family member at home or in their own home,” Mulvehill said, meeting with the family member of a former adult day care client at the Cook Springs facility. “But what are they (the patient) doing?” Mulvehill said people with Alzheimer’s who need specialized care and as much stimulation as possible may often be left to become more inactive than is healthy and less stimulated than they should be. That’s why Lynn Fancher and her husband Michael made the decision to try day care when Fancher’s mother fell victim to Alzheimer’s. The problems for Fancher’s mother, who was living by herself, started with a stroke Mother’s Day 2004. “We went to see her, and no one was there,” Mrs. Fancher said. As it turned out, the elder Mrs. Fancher was in the hospital. Before the stroke, Mrs. Fancher said her mother-in-law was a “busy lady. She cut her own grass and worked most of her life.” Looking back, there were some signs of Alzheimer’s before the stroke, Mrs. Fancher said, but they became obvious only in retrospect. No one is eager to embrace the signs of Alzheimer’s. “She had been repeating herself, saying the same things over and over, but we didn’t put it all together at the time,” she said. Most of the time, she said, you just think of it as the normal aging process. At first, Mrs. Fancher and her husband temporarily moved from their Pell City home into Fancher’s mother’s home to care for her. Nothing had been said during her mother-in-law’s treatment for the stroke about Alzheimer’s or dementia, Mrs. Fancher said. It was then Mrs. Fancher started a journal of her motherin-law’s medications, what and when she ate and eventually, her behavior. “I’m aging, too, she said, and I don’t always remember everything anymore,” she said. “I wanted to keep notes on everything she was going through.” Her mother-in-law’s forgetfulness continued, to the point Mrs. Fancher felt the family needed to know more. She called her mother-inlaw’s gynecologist and asked if he could make a recommendation. The family was referred to a neurologist, who met with the elder Mrs. Fancher to evaluate her. The doctor confirmed what Mrs. Fancher suspected, and she and her husband started actively educating themselves about Alzheimer’s disease. The Fanchers spent six weeks living with Mrs. Fancher, and then another family member stayed with her as he could, but he traveled in his work. Then, the Fanchers tried a sitter and brought their mother and mother-in-law to Pell City to stay with them on weekends.
By this time, the behavior included reports of seeing people who weren’t there. By July, after the stroke in May, the Fanchers had Mrs. Fancher living with them full time. There were sitters to help some, but the Fanchers weren’t entirely happy with Mrs. Fancher’s situation. “Her activity consisted of sitting, rocking and eating,” Mrs. Fancher said. “That was it.” Every couple of months, Mrs. Fancher said she would notice another change in her motherin-law’s behavior. She wrote the activities in the journal she kept, thinking it would help doctors adjust medications as needed. “About every two months, there would be a progression of some kind in her behavior,” she said. Sitters couldn’t offer the quality care Mrs. Fancher and her husband felt they wanted, so they started looking for other ways to help. They found The Village at Cook Springs, met Mulvehill and got information about the possibilities of a day program. The day program is offered through the facility’s Alzheimer’s care unit, and space is limited. There can only be 16 in the unit overall, day and full care included. Mrs. Fancher said instead of popping the idea on her mother-in-law all at once, she took another approach. “We brought her for supper one night,” she said. “I just said, ‘Let’s go out for a ride – she liked that – and we did it a lot to keep her content. I told her we had been invited to eat supper out with some ladies and that was fine with her.” Mrs. Fancher said her mother-in-law enjoyed the dinner and the people she met, so she and her husband took steps to get her enrolled in the day program. The first day of December 2004, seven months after the stroke, Mrs. Fancher joined the day care program at Cook Springs. Mrs. Fancher said her mother-in-law didn’t resist joining in with the others in the Alzheimer’s unit. “She talked to the other ladies just like they were the ones she had worked with (at the telephone company),” Mrs. Fancher said. Mrs. Fancher said she believes her mother-in-law realized there were changes going on, but couldn’t fully process them. She said making the transition into the day program was a lot like taking her children to school for the first time. “I tried to stay very connected with her caregivers, just like I did with the teachers when my children started school,” she said. At first, she wondered about the trust she would have to have in the new caregivers, Mrs. Fancher said, “but it turned out they were angels. God sent them to us, I know.” Prayer was a big factor, too, in finding the right answers, Mrs. Fancher said. Stages determine next step During the progression of the disease, there were times her mother-in-law was combative, she wouldn’t want to do things she normally accepted, such as returning to her home from a visit to the Fanchers’. She had also started getting up in the night, one time leaving out the Fancher’s back door, heading toward the waters of Logan Martin Lake. “I heard her and shot out of bed,” she said. “That’s one of the most frightening things.” The Fanchers secured their home with locks that couldn’t be tampered with, but there were still worries about being entirely aware at all times of Mrs. Fancher’s activities. After Christmas in 2004, Mrs. Fancher said she and her husband needed some extra help, and it came in the form of a week break from their care routine.
Laura Nation-Atchison/The Daily Home
Activities assistant Debra Wills gets a hug form a resident of the Wisteria Unit at The Village in St. Clair County, where Alzheimer’s patients have access to activities from sing-alongs, beauty and barber shop visits, arts and crafts, and visiting entertainers. In December, the women had their own Wisteria Pageant. They arranged for Mrs. “When Babe (her nickname) what they’ve faced. Fancher to stay for a week at would tell me she saw peo“I’ll be standing in line at The Village. ple, I didn’t argue with her,” WalMart and it comes up,” she When Mrs. Fancher visited Mrs. Fancher said. “There’s no said. “I feel like I’m supposed to her mother-in-law, she found point.” tell them to call someone.” BELOW: Lynn Fancher her content. Having access to specialized If she had it all to do over would spend time every ”She was having the best care was a lifesaver for Mrs. again, she said, there isn’t a day making entries in a time, she seemed to feel at Fancher, beginning with the day thing she would change. journal to keep precise home,” she said. program through the full care ”And that’s a wonderful records of her mother-in“She was the leader of the needs. thing. I know we did everything law’s activities, whether it pack, they were all going to sing “That was my greatest com- we could for her to have the best was what she ate or the together,” she said. “And she fort,” she said. “The people care, and that she was happy.” medications she took. was very verbal. She kept some- were professionals. They recogthing going all the time, joking nized the symptoms in a way we with the nurses and other staff.” wouldn’t.” Mrs. Fancher thanked her daughter-in-law for visiting that Supporting others day, saying, “I’m glad you came Now, Mrs. Fancher said she to see me,” and she didn’t have feels moved to advise others issues with remaining at The with Alzheimer’s in their famiVillage as her daughter-in-law lies to seek the help her family went home. found. “She loved it there, and I did, “It was the hardest 18 months too,” she said. “So we asked we’ve had, there’s no doubt of about transitioning her in.” that,” she said. “There were lots In early February, Mrs. of times there was little time for Fancher moved in full time with anything else.” her own furniture and other perMrs. Fancher feels she has sonal things she wanted. gone through the experience for Things were going well, but a reason, and most likely, it’s to in April, Mrs. Fancher slipped help others with what she and and fell, the beginning of her her husband learned. mobility being affected. She might take parts of the Another fall in July put her in journal she kept and turn it into The Village’s rehabilitative unit a book, she said, something for for skilled nursing and another people to have to help underfall left her in a wheelchair. stand what they’re facing or Laura Nation-Atchison/The Daily Home In September 2005, Mrs. Fancher was in the hospital, not eating well and having trouble with blood sugar levels, which started in April. It was apparently the rising blood sugar levels that put her mother-in-law into a coma Nov. 15, and she died that day. The Fanchers had gone home to eat supper and were planning to go back to The Village and check on Mrs. Fancher afterward. “They called and told us she was gone,” Mrs. Fancher said. Throughout the illness, Mrs. Fancher said she prayed her mother-in-law would have a more merciful death than going on through years of progression of Alzheimer’s. During a seminar held at The Village, a nationally known Alzheimer’s specialist pointed out something to the Fanchers they took to heart. “One thing she said that day was, ‘It would be better for people to go from another cause than to linger with this disease,’” Mrs. Fancher said. The Fanchers learned another important lesson that day from Teepa Snow, the specialist from Laura Nation-Atchison/The Daily Home Duke University. She stressed “going with the flow” with Sheryl Melvehill, marketing director for The Village, has been working in geriatric Alzheimer’s patients and keep- care settings for 30 years. Here, she talks with family members of a patient in the ing them from getting agitated. Wisteria Unit.
THE DAILY HOME, Talladega-Sylacauga-Pell City, Ala., Friday, December 29, 2006 — 7A
hoping and coping
Private care an alternative to nursing homes Living with Alzheimer's and dementia
Hoping and coping
By Gary Hanner Home staff writer
After working for Alacare Home Health for five years, Ragland’s Shea Thrasher came up with the idea in 1997 to start private care for the elderly out of her home. While working for Alacare, Thrasher said it was difficult to go see her patients who had family who worked or lived out of town — they were there all day by themselves. “The biggest part of their day was when we came in to care for them and see them,” Thrasher said. “I told my mother there needed to be a facility opened to take care of patients like these. The basement of the threestory home owned by Thrasher’s parents, Tommy and Diana Bean, became Hidden Hills in 1998. The very first resident of Hidden Hills was Lester Cash, who had Alzheimer’s and died eight months after moving in. “He was a character, and we loved him so much,” said Thrasher. “He, along with all of our residents, become our extended family.” Today, they average four to six residents. Diana Bean said dementia is what doctors have diagnosed as the very first stage of Alzheimer’s. “Some families decide not to put their loved ones in a nursing home,” Thrasher said. “I opened this private home care to give families another option other than a nursing home; not that there is anything wrong with nursing homes.” Bean said that, when her daughter came to her about wanting to open a private care facility, she was afraid. “Afraid of the liability that goes with it,” Bean said. “But I was also afraid Shea was about to lose her job at Alacare because of cutbacks. We decided to go ahead with it and it has been such a wonderful blessing.”
Normal day During the Thanksgiving and Christmas holidays, Hidden Hills was home to five residents. Currently, there are two fulltime workers and two part-time workers. Residents start waking up around 7 a.m., and they are ready for breakfast and medicines by 8:30 a.m. They receive three meals each day and all eat together. Thrasher said Alacare comes out periodically to see certain residents who need home health service. “It’s just like you would take care of anybody; it’s just a home setting,” she said. “Family members of our residents are very pleased with our services. Since we have been open, we have taken care of about 50 residents and have had only one who was not happy and went back home.” Benefits Bean said the benefits of private home care include a family-type atmosphere for the residents rather than a more institutional environment. “That’s what we try to provide for them,” Bean said. “Here, they feel like they still have family. This becomes their home and we have become part of their family. One of our residents has family come and visit two to thee times per year, so we are his family. We are all he has who sees him on a daily basis.” Bean said a large majority of the residents have family members come by about two to three times per week. “So many of them tell us how thankful they are that we are here,” Bean said. “Nursing homes are great, but to them, it is not the same as a family. Here, that’s what they feel like — family. Limitations Bean said once they take in a resident, they normally stay until they pass away. “We have had a couple of
Gary Hanner/The Daily Home
Sugar Valley Homes has been in operation since 1998 and is located at 400 Valley Road in Ragland. Seated, from left, are two residents currently living there, Mary Peck and Ira Tidwell. Standing, from left, is owner Peggy McDill and employee Jeanette Lemley. people whose condition got so bad, we were unable to care for them,” Bean said. “Our care can only go so far and once they get to a certain point, they may need that nursing home care so a doctor can see them on a daily basis.” Regular routine Bean said one of the most important things for a resident with Alzheimer’s is for them to stay in a regular routine. “If they stay in a regular routine every day, they do better,” Bean said. “They do not like change because change affects their minds. Sometimes, an Alzheimer’s patient will forget how to talk during the middle of a sentence, forget how to walk and take that next step going from the kitchen to the den or forget how to eat during the middle of a meal. They forget how to do everything.” Bean added there is no cure
for Alzheimer’s and that it can only be slowed down. “If a person is not diagnosed early enough with Alzheimer’s, most of the time medicine does not even help,” she said.
“The other places were large and never felt like a home to her,” Pitts said. “Hidden Hills is only 20 minutes from my home and every time I drive up, it feels like home.”
One individual case Drama Haynes of Bynum has been living at Hidden Hills for the past few months and is in the early stages of dementia. The person responsible for Haynes is her granddaughter Leslie Pitts from Alexandria. “My mother knew Diana and had recommended that I call her when I was looking for a place for my grandmother,” Pitts said. “I love it here, and she has adjusted really, really well and quickly. Generally, you worry when you put them in a new place but she was comfortable the first night.” Pitts said Hidden Hills is more like home than the other places she has placed her grandmother.
Sugar Valley Homes Another private care facility in Ragland is Sugar Valley Homes, owned and operated by Peggy McDill. The facility opened in 1998 and is located at 400 Valley Road. At full capacity, there is room for six residents. Currently, there are two senior citizens with Alzheimer’s living at Sugar Valley. After working for First American Home Health Care for 10 years, McDill said, she realized she loves the elderly and decided to open the private facility. “We are just one big happy family,” McDill said. “They are not just residents here. They are our family. Relatives of our extended family are very pleased
with how their loved ones are treated here. They visit as often as they can, and I’m always calling them to let them know how their loved one is doing.” At the present time, McDill has one full-time employee helping her, Jeanette Lemley, who has worked at Sugar Valley a little more than a year. “I love older people and have so much respect for them,” Lemley said. “They are so smart, and I love spending time with each of them, hearing stories from many years ago.” McDill said what makes her place different from a nursing home or assisted living facility is the one-on-one care and attention she gives the residents. “Being able to help these people brings joy to my heart,” McDill said. “My goal is to know that one day as I become older, someone will take me in and care for me like I’ve taken care of these residents.”
Home From Page 1A Springs, which has two Alzheimer’s units, said most families wait to take disoriented relatives to a specialized facility until they feel they can’t keep them from wandering off. “The No. 1 reason families bring people in is when they wander off,” Brewer said. “They can’t watch them 24 hours a day … They’ve tried to take care of them as long as they can, so they feel guilty.” Desaulniers first began to notice differences in her mother when she had trouble balancing her checkbook — a household task, like many others, she had never had trouble accomplishing. “She had been able to (handle money) before,” Desaulniers said. “She told me she was broke. It turned out she had made a monumental error in arithmetic in her checkbook.” While Desaulniers knew her mother wasn’t well, she couldn’t make her see a doctor. “Unless there’s a crisis, you just let everything muddle along,” she said. “You can’t make an adult go to the doctor if she doesn’t want to go.” But her mother would eventually end up in a medical setting. After experiencing a shortness of breath, her mother went to the emergency room. Being away from a familiar setting, she acted evasive toward medical professionals. Doctors diagnosed her with a thyroid problem and Alzheimer’s disease. Now that her mother’s been in professional care for two years, Desaulniers says she wishes she had admitted her a year earlier. Making the transition Two facilities in the area that have units for Alzheimer’s patients are The Village and Beverly Living Center Pell City, formerly known as Ingram Manor. The Village can take Alzheimer’s patients in its assisted living facility if the patient can function independently. Patients with more intermediate stages are housed in a specialty-care assisted living facility known as the Wisteria unit. Wisteria provides more advanced medical care than traditional assisted living facilities. Patients with more serious Alzheimer’s are housed in the Sunset Trace unit, which operates more like a nursing home. Patients in Sunset Trace are often introduced to other patients several times a day, although they may have been in the unit with them for a year
Bob Crisp/The Daily Home
Residents at The Village at Cook Springs play bingo as part of Wisteria Springs’ activities programs, which encourage keeping Alzheimer’s patients’ brain cells firing, effectively slowing progression of the disease.
or more. Desaulniers’ mother currently lives at Sunset Trace after her initial stay in Wisteria. She no longer recognizes her daughter or her daughter’s husband. “I can go visit her, but if I don’t put a chair directly in front of her and touch her, she wouldn’t know I was in the same room,” Desaulniers said. Beverly Living Center admits patients in the middle stages of Alzheimer’s. Unit administrator Jessi Mahmoudi said they emphasize a social model over a medical model. Employees at the facility do not wear traditional medical dress, and residents help prepare their own meals. “It’s like a giant house,” she said. When residents with Alzheimer’s are admitted to The Village, they are initially given a mini-mental examination to determine the level of memory loss, according to Wisteria administrator Anne Henry. The exam tests shortand long-term memory. “We tell them a number to remember at the beginning of the test, and most don’t remember it,” Henry said. “Some don’t remember who they are or where they live. They could leave the facility and are an elopement risk. Those are immediately placed on SCALF (specialty-care assisted living facility).” Each patient is given a tailored plan of care after initial interviews, and
plans are updated as patients’ needs change, Henry said. “The plans are specialized on each patient’s behavior, and they’re not preprinted,” Henry said. A basic point of Alzheimer’s treatment is keeping patients’ minds occupied. “It’s really use it or lose it,” Brewer said. “You’ve got to keep their minds occupied to slow the progression of the disease.” Henry said some patients’ mini-mental scores have increased after being on the unit, but they will always descend as the disease progresses. “You can’t stop the disease, but you can deal with the symptoms,” Henry said. “Every symptom has a cause. You can medicate and deal with the symptoms, but it is a progressive disease, and there’s no way to stop it.” Dealing with the symptoms With dementia, patients are regularly disoriented, and professionals are taught to redirect lines of questioning rather than beg an outburst. “We don’t put up many mirrors here, because I can see myself in the mirror,” Henry said. “In their heads, they still see a 25-year-old. When they look in the mirror, they say, ‘Who is that?’ “They have to know this is their home,” Henry said. “What was their
home is not; they can’t go back to that. That leads to agitation.” Alzheimer’s patients can’t always describe routine medical problems, such as a urinary tract infection, to nurses, but pain and infections are often manifest in behavioral changes, Henry said. Behavioral changes are often signs for a patient to have a check-up. Patients can also suddenly relive emotional or traumatic experiences from years before. That’s when their lines of questioning, such as ‘where’s my husband?’ or ‘my daughter’s having a baby’ are redirected. “I tell people I lie Monday through Friday and go to church on Sunday,” Henry said. “You try to support them; you can’t retrain them into reality.” Professionals at both facilities are confronted with those types of questions daily when the afternoon begins to wane, in a symptomatic phenomenon known as sundowning. “Some want to go home at sundown,” Mahmoudi said. “Some relive an awful or stressful event in their life. Sometimes they’ll say they have to leave because their daughter is having a baby. “You can get them talking about that person, and that’ll keep their mind occupied, and in a moment, they’ll forget about what they were concerned about.” Mahmoudi said Ingram Manor employees control sundowning by keeping lots of lights on and using aromatherapy. During the day, both facilities use activities to keep residents occupied, including showing classic movies and playing music from their generation. Chapel or church programs often pull the most people. “Faith is very important to them,” Henry said. “They start singing. Some that can’t communicate at all can sing hymns. Even if they can’t get the message, they know the ritual.” Mahmoudi said Christianity plays a larger part in treatment in the South. “In this area, we use gospel and the Bible more,” she said. “The rhythm and the words are familiar and remind them of the past. It hits on long-term memories and what gives a sense of wellbeing. Singing really helps to calm behavior down.” Another mother As Alzheimer’s progresses, parents often lose recognition of their children, and those children often see their parents as different people from those who raised them. “In dealing with other caregivers,
a lot of families are in denial because you just don’t want to recognize that their loved one is … not the same person who took care of them,” said Desaulniers, who is writing a book about her relationship with her mother through the progression of Alzheimer’s disease. “My book is titled, ‘The Long Goodbye,’ because that’s really what Alzheimer’s is,” Desaulniers said. Despite a lack of recognition, Desaulniers visits her mother four times a week, mostly to ensure that she’s receiving good care. “She doesn’t have a clue who I am, but she’s excited someone is there,” she said. “The important thing is just to visit and make sure she is receiving proper care. The staff is very loving toward her. "It’s really a calling to deal with these elderly people. It can’t be just a job, or they wouldn’t do it.” Henry said families often find it too hard to confront their parent after they become another person. “We have some sexual acting out, especially with men,” Henry said. “If they’re both in assisted living and both are OK with it, we don’t interfere. If they’re in SCALF, there’s no ability there to consent (to sexual activity). We have sent one man elsewhere because of that, and his children said, ‘He’s not Dad anymore; he’s someone else.’” Henry said the staff keeps close contact with SCALF families whether or not they come to visit. “I often have families wanting to take their parents out of this setting for an anniversary get-together,” Henry said. “I ask them why don’t they have it here. It’s more comfortable for them,” which makes outbursts less likely. Mahmoudi said that lack of recognition can be compounded with unease over seeing one’s parents in specialized care. “Family members often feel guilt because they promised their parents they would never put them in a home,” she said. Desaulniers said children should visit their parents regardless of how painful it is. “There are some who say, ‘I can’t see Mother this way,’” she said. “If they don’t go, they’re doing a disservice to their parents.” Mahmoudi said that, over time, residents become accustomed to the facility. “They’re always wanting to go home,” she said. “Once they go home, they want to come back here. They do feel this is their home.”
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Saturday, December 30, 2006 Webster’s Dictionary defines dementia as: “A usually progressive condition marked by deteriorated cognitive functioning often with emotional apathy.” In older people, Alzheimer’s disease is the most common form of dementia. It robs people of their memory and reason — stealing their lives long before they actually die. More that 4.5 million Americans suffer from the disease; 80,000 of them live in Alabama. There is no cure for Alzheimer’s, and doctors are not even sure what causes it.
50 cents
Your hometown paper for Talladega and St. Clair counties
Living with Alzheimer's and dementia
Hoping and coping
What is certain is that, for the victims of dementia and Alzheimer’s, the prognosis is grim. Life is almost as difficult for their loved ones and caregivers.
Over the next few days, The Daily Home will examine what this disease is, what it means for patients and their families, and what is being done to find new treatments and possibly a cure.
Grasping for hope
Few treatments now and no cure ... yet
Page 8B
Saddam dies on gallows By Christopher Torchia and Qassim Abdul-Zahra Associated Press writer
BAGHDAD, Iraq — Saddam Hussein, the shotgun-waving dictator who ruled Iraq with a remorseless brutality for a quarter-century and was driven from power by a U.S.-led war that left his country in shambles, was taken to the gallows and executed Saturday, Iraqi staterun television reported. It was a grim end for the 69year-old leader who had vexed three U.S. presidents. Despite his ouster, Washington, its allies and the new Iraqi leaders remain mired in a fight to quell a stubborn insurgency by Saddam loyalists and a vicious sectarian conflict. Also hanged were Saddam’s half-brother Barzan Ibrahim and Awad Hamed al-Bandar,
the former chief justice of the Revolutionary Court. Staterun Iraqiya television news announcer said ‘‘criminal Saddam was hanged to death and the execution started with criminal Saddam then Barzan then Awad al-Bandar.’’ Mariam al-Rayes, a legal expert and a former member of the Shiite bloc in parliament, told Iraqiya television that the execution ‘‘was filmed and God willing it will be shown. There was one camera present, and a doctor was also present there.’’ Al-Rayes, an ally of Prime Minister Nouri al-Maliki, did not attend the execution. She said Al-Maliki did not attend but was represented by an aide. The station earlier was airing national songs after the first announcement and had a tag on the screen that read ‘‘Saddam’s execution marks the end of a
Saddam Hussein dark period of Iraq’s history.’’ The execution came 56 days after a court convicted Saddam and sentenced him to death for his role in the killings of 148 Shiite Muslims from a town where assassins tried to kill the dictator in 1982. Iraq’s highest court rejected Saddam’s appeal Monday and ordered him executed within 30 days. A U.S. judge on Friday refused to stop Saddam’s execution, rejecting a last-minute court challenge. See Saddam, Page 3
Alabama Power asks to intervene in boat ban suit By David Atchison Home staff writer
Photo Illustration by Jerry Martin/The Daily Home
While there are several drugs on the market to treat Alzheimer’s, there is no cure for the disease. By Heather Baggett Home staff writer
When a person is diagnosed with Alzheimer’s disease, the prognosis is not a good one. With no cure for the disease, which affects one in 10 people over the age of 65, some turn to drugs that can slow the process of deterioration. Dr. Jimmy Davis, medical director at Talladega Healthcare, said family members probably wouldn’t see a lot of changes once the Alzheimer’s patient begins taking treatment. “There are several medications that are used, but we really don’t have anything in terms of medication that really changes things that much,” Davis said. “It may help stabilize the condition for several months, but there’s not any medication that really changes the course of the disease. It may improve things
Saturday
Index Religion.........................6, 7 Lifestyles............................4 Sports.......................... 1-3B Community Calendar......12 Dear Abby.......................6B Comic/Television...... 6B, 7B Classified.............. 10B, 11B See Obituaries, Page 2
or stabilize things, but it doesn’t really do that much.” In addition to dealing with patients who suffer from Alzheimer’s, Davis has seen firsthand the impact the disease has on the family of the person diagnosed. “My mother had Alzheimer’s and died from Alzheimer’s,” he said. “It’s very difficult because the person that you knew, they just deteriorate and all of a sudden they look like the person you knew, but you can’t relate to them like you did. They can’t communicate. “Over a period of time they lose the ability to eat, swallow. So it’s not the same person that you knew, that you grow up with over time. “It’s a very slow death. Alzheimer’s is a terminal disease. If you have it, you die of it. Usually the time course may
be 10-15 years.” Help for now The U.S. Food and Drug Administration has approved five drugs to treat Alzheimer’s disease according to the Alzheimer’s Association’s Web site. The most prescribed drug is donepezil, which is more commonly known as Aricept. The FDA approved the drug in 1996. More than 3.8 million people have taken the medicine, making it the No. 1 prescribed Alzheimer’s drug in the world, according to Aricept’s Web site. Aricept is taken once a day and is used to treat all stages of Alzheimer’s. It is a type of drug known as cholinesterase inhibitors, which the FDA approved to treat cognitive symptoms of Alzheimer’s disease. Memory, See Hope, Page 10A
MONTGOMERY — Alabama Power Company has filed a motion to intervene as a defendant in a lawsuit challenging a new law passed by legislators banning the use of large boats on three Alabama lakes. According to court records, APC asked to intervene as a defendant in the case last week. “Alabama Power’s interests are directly implicated by Plaintiffs’ Count IV regarding preemption, and those interests are not adequately represented by the existing defendants,” APC’s motion to intervene states. In the original case, a group of big boat owners and a boat dealer filed a civil suit against the Alabama Department of Conservation and Natural Resources in July, after new legislation was passed by legislators and signed by Gov. Bob Riley on April 14, banning large, fast boats on Weiss, Harris and Martin lakes. The legislation initially listed as many as 11 Alabama lakes, including Logan Martin, and would have prohibited house-
Online
By Samantha Corona Home staff writer
While most cities and counties across the globe are waiting to ring in the new year on Sunday night, businesses in Talladega and St. Clair counties are more focused on Saturday and the “New Year’s Eve-Eve” celebrations that will be going on. “I’ve got a sign on my door that says come and celebrate New Year’s Eve-Eve with us,” said Jack Burk, owner of Neighborhood’s Sports Bar in
Lincoln church to celebrate its second anniversary
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Alabama Power Company has filed a motion to intervene as defendants in a lawsuit challenging the new big boat ban law, which would ban houseboats like these on Martin, Weiss and Harris lakes. APC is a proponent of the new law. boats and other large vessels capable of speeds in excess of 60 mph from operating on APC lake impoundments. The list of lakes was eventually whittled down to three after lawmakers were flooded with calls in
opposition to the proposed legislation. The final bill passed for those three lakes only. Frank Wilson, who represents the plaintiffs in the case, See APC, Page 3
Area businesses plan 'New Year's Eve-Eve' parties
Weather outlook Religion Today ... Mostly cloudy. Slight chance of showers. Highs around 67. Tonight ... Cloudy. Showers likely. Lows around 57. Chance of rain 70 percent. Sunday ... Showers. Highs around 66. Chance of rain 90 percent. Lows around 49.
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Talladega. “That’s about all I can do, I guess.” On one of the most toasted holidays of the year, Talladega and St. Clair counties are just two of the many Alabama counties finding themselves left out of the mix for party-goers this year because of county laws prohibiting alcohol sales on Sunday. It happened seven years ago and, fortunately for area bar and restaurant owners, won’t rotate around again until 2017. Still, for the 2006 closeout, the party is scheduled for a
Sunday and businesses are trying to make the best of it by leading the party before they lock up the doors. Parigi’s Pizza in Talladega isn’t letting the “dry” day slow them down. The restaurant has billed Saturday as an “Eve-Eve” party and is focusing on celebrating into 2007, no matter when the actual day rolls around. Manager Lisa Paris said in addition to the usual weekend activities, Parigi’s will be See Parties, Page 3
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You can help While you are on vacation send your newspaper off to school Call Talladega, 362-1000; Pell City, 884-3400; Sylacauga, 249-4311
8A — THE DAILY HOME, Talladega-Sylacauga-Pell City, Ala., Saturday, December 30, 2006
hoping and coping
UAB key center for Alzheimer's research Patients living in poverty face more problems
Living with Alzheimer's and dementia
Hoping and coping
By Robin Bird Home staff writer
The mind is one of the last frontiers to be explored by medical science. Researchers at the University of Alabama at Birmingham are mapping out how the mind works and the course diseases of the mind, such as Alzheimer’s, take as they progress. UAB has been involved in studying Alzheimer’s disease since 1991 when the university received a grant funded by the National Institutes of Health and the National Institute on Aging. The grant paved the way for the formation of the Alzheimer’s Disease Center under the Department of Neurology at UAB and in 1999, the Alzheimer’s Disease Research Center was formed. The center is now one of the top National Institutes of Healthfunded research centers in the Southeast. “We’ve had a center here for 15 years, and over that time we’ve seen thousands of patients and carried out many research studies,” said Dr. Daniel Marson, the interim director of the Alzhiemer’s Disease Research Center at UAB. “Without a doubt, our center is known for its work in studying everyday functional change in mild cognitive impairment and Alzheimer’s disease.” He said there is a concern in the medical community about the lack of caregiver resources available as the nation’s estimated 4.5 million baby boomers get older. The population boom plus an increased average life span are factors that have led to the rise of occurrences of Alzheimer’s disease. Also, the increased medical knowledge to treat killer diseases, such as heart disease and cancer, has led to longer life expectancy, which gives Alzheimer’s disease a longer period to begin presenting symptoms. “We don’t fully understand how the disease develops, but if we can delay the onset by five years, we can reduce the number of cases by half,” Marson said. “The cure for this disease is going to come through research.” Several departments at UAB, including Neurology, Psychiatry, Genetics and Psychology, work with the Alzheimer’s Disease Center. The Center itself has more than 30 people on staff, but due to research being done through the other departments
By Robin Bird Home staff writer
at UAB, the number of people involved in studying the disease is much higher. New studies Several clinical trials are under way, including the study of the abnormal proteins or plaques that are found in the brains of Alzheimer’s disease patients, the study of genetic tendencies for Alzheimer’s disease in some families, investigational studies of new drugs as possible treatment options, and a long-term study that is following the annual progression of symptoms over the course of the disease. Marson, who in addition to being a neurologist is also an attorney, has a special interest in studying the loss of the ability to perform everyday tasks and developing tests that aid health care providers in determining when a patient has lost the ability to make sound decisions. “I’m interested in how people might lose the ability to manage financial affairs or lose the ability to make medical decisions or lose the ability to make a will,” Marson said. Researchers believe that mild cognitive impairment or MCI is the precursor stage of Alzheimer’s disease. During this stage, individuals begin to lose the ability to perform some everyday life skills such as financial management. “One project in the center is looking at functional change in people with mild cognitive impairment. It looks at what kinds of changes occur in everyday functions, in particular, driving,” Marson said. Marson was on a team that developed a tool to aid physicians in evaluating the financial competency of their patients. The 25minute clinical interview called the Structured Clinical Interview for Assessing Financial Capacity or SCIFC was introduced at the International Conference on Alzheimer’s Disease and Related Disorders July 19, in Madrid. SCIFC examines the patient’s ability to perform basic monetary skills, such as cash transactions, checkbook management, bank statement management, bill payment, managing personal assets and estate arrangements, and overall financial capacity. “Judgments of a person’s financial competency have important ethical and legal implications,” Marson said. “They can seriously restrict or even remove a patient’s freedom to make personal financial decisions, but can also help protect patients and the families from
Jerry Martin/The Daily Home
This is one of the cognitive tests given to patients to test memory skills. Studies show that higher cognitive functions start deteriorating in the early stages of Alzheimer’s Disease.
Jerry Martin/The Daily Home
Randall Griffith, an assistant professor in UAB’s Department of Neurology, examines brain scans for plaque, which is one of the indicators for Alzheimer’s disease. making poor financial decisions and from exploitation by others. “We believe this relatively brief interview can reduce physician concerns about their ability to assess financial competency, an area which they generally have little training.” The SCIFC study showed a decrease in the ability of participants to perform financial tasks as the severity of Alzheimer’s disease progressed. In the study, 94 percent of normal older adults were financially capable, but only 84 percent of MCI participants were financially capable. A staggering decrease in financial capability was seen in patients with Alzheimer’s disease. Only 26 percent of those with mild Alzheimer’s disease were financially capable and
Alzheimer’s difficult to research in poor patients Alzheimer’s disease is commonly associated with older people, but occasionally it is found in patients in their 40s and 50s. If these patients lack health insurance and are not on Medicare, then the possibility exists that they may go undiagnosed. “As part of the clinic practice there’s a portion we see who are indigent, and they don’t have private insurance. Although a number may have Medicare, some don’t,” Daniel Marson, interim director of the Alzheimer’s Disease Research Center at the University of Alabama at Birmingham, said. “In many cases they don’t have dedicated caregivers who are involved with them.” Marson said that, without another person to care for them, it is difficult for indigent people to participate in research studies. In addition, the early symptoms may go undiagnosed without access to regular medical care. “A patient with Alzheimer’s disease is not going to be able to come in on their own,” Marson said. “If you have Alzheimer’s disease, you have to have a dedicated caregiver because that person has to handle the appointment. “They (the patient) are coming in once or twice a year. They (the caregiver) are driving in and getting the patient ready for the appointment. For that reason, we might see people for clinical care who are indigent, but I think it is less likely on a sustained basis.”
only 1.5 percent with moderate Alzheimer’s disease were financially capable. “The findings suggest that financial capacity first becomes impaired in the MCI period, and then rapidly deteriorates in the mild and moderate stages of Alzheimer’s,” Marson said. Another study looks at the differences and similarities of the disease in different ethnic groups. “We’re increasingly interested in how the experience of Alzheimer’s disease is the same in part and different in AfricanAmericans as it is in caucasians,” Marson said. “One of the key issues is the role of cerebral vascular disease, which is very prominent in African-Americans in our region, and how that may
interact and perhaps increase the instances of Alzheimer’s disease in African-Americans.” The center also collaborates with national research groups which provide communication networks with other research centers around the nation. One such group the center collaborates with is the Alzheimer’s Disease Neuroimaging Initiative, which is a study to determine the brain imaging techniques that can be used to diagnose the early stages of Alzheimer’s disease. Another national collaborative effort the center is participating in is the Alzheimer’s Disease Cooperative Study that investigates treatments that are unlikely to be supported by drug companies. One recent study the center conducted as part of
that group examined the role of estrogen in Alzheimer’s disease. Work is continuing at UAB to find better drugs to deal with treating the symptoms of Alzheimer’s disease and ways to prevent the disease.“People who are cognitively active throughout life have a lower chance of developing a cognitive disease,” Marson said. Work is also continuing to develop methods to identify people at risk while they are in their 20s, so that lifestyle changes and early treatment medications will have the most success. It is through the dedication of researchers that hope exists for finding the causes for Alzheimer’s disease and one day to find its cure.
stand-still since he started taking the medication. I can’t say it has helped him, but I honestly believe if he were not taking the medication, his memory loss would be much worse by now.” James also takes Namenda. Even with the medication, Ada says she sees a strong aggression in James. “He was never aggressive before. He was a quiet man and never argued. But now, he argues about everything. He’ll say he has taken his medicine, and I have to get it and show him before he will accept my word. I have to tell him to bathe and brush his teeth. He would never have neglected those things before.” James no longer drives. Ada and her daughter took his keys, one of the more difficult actions they had to take. “But he has a stick shift in his car and mine doesn’t, and I was so afraid he would forget which car he was in,” she said. He doesn’t handle money anymore, and she says he doesn’t even bother to try to remember telephone numbers. He still dresses himself and selects the clothes he wears each day, but Ada says if they are going out, he is never sure how to dress and she has to tell him. Most of James’ days now are spent napping and watching television. “Occasionally he will go out and rake a few leaves,” she said. “He sometimes goes to the workshop, but he never tries to create anything. Instead, he takes the tools out and just lays them around.”
Ada says James never initiates conversation anymore and contributes little to what she or others try to say to him. “I think it’s because he gets so confused, he can’t follow what is being said.” Ada says James can never remember where she is going when she leaves the house. “I will tell him over and over and when I get back, he wants to know where I’ve been.” He gets angry and says she’s keeping things from him. Ada and other members of the family have read books and articles on Alzheimer’s, and they
try to understand James. “If the Aricept keeps working, we may be able to go on like we are now for a long time. But I don’t know how long that will be, and I don’t think there is anyone who can tell you. “It could be like this for years, and it could change in the next six months. He’s 79 years old. I can manage now, but I am scared of what the future may hold for him and for me. “James has Alzheimer’s and that will never change. I just hope we started early enough with the medication. It’s hard to say.”
Treatments give one family hope and a little help
(Editor’s note: The names have been changed in this story to protect the patients’ medical history) By June Winters Home staff writer
Sometimes Ada feels like she’s imagining that her husband isn’t the man she married anymore and this person she’s sharing her life with now is a stranger. Where are the loving arms that used to make her feel so secure? And the look of love that used to be exchanged when their eyes met across the room? It’s just not there. This person has an almost wild look, and sometimes, Ada wonders if he really knows her or remembers “those days.” Ada and her husband are one of millions of couples in this country dealing with Alzhemer’s disease, and, while drug treatments have slowed the progression of the disease and helped maintain some level of quality of life, the dementia is still taking its toll. James and Ada have been married for 52 years. He had a successful career, and they saved money for retirement. They decided they would spend their last years on Logan Martin Lake and when the time came, they bought their dream house and settled in. The view was wonderful, and James could fish to his heart’s content. There was a workshop, and he loved working with wood. He was looking forward to spending as much time as he wanted “just messing with the
Bob Crisp/The Daily Home
Drugs have helped keep Ada's husband's Alzheimer's somewhat in check.
wood.” They joined several social groups when they moved to their retirement home, and life was good. He played golf several times a week, and Ada even bought some clubs and tried to join him for a few rounds. Then one day she noticed he kept forgetting things. “We would be invited to a party at the home of a friend — a home we had been to many times. And all of a sudden, James started saying, ‘I can’t remember how to get to their house.’ Even after I told him how to get there, he would argue with me and say we were going the wrong way.”’ Ada said when she would mention it to her friends, they laughed it off, saying he probably had so much on his mind, he
just forgot. Besides, they would say, he didn’t seem different at all to them. He stopped playing golf and told Ada he wasn’t interested when she questioned him. “It was about the time he celebrated his 75th birthday that I really started to worry,”Ada said. “I made an appointment with his doctor and took him in, explaining what was happening.” Ada said the doctor took her concern seriously and ordered an MRI. “The doctor called me and told me the tests showed James was in the early stages of Alzheimer’s.” The doctor immediately prescribed Aricept, and Ada says she believes it slowed the progress. “He’s been more or less at a
Tips for patients and caregivers
The Alzheimer’s Association recommends patients and caregivers understand the use of the medication prior to taking it. o Tell the physician all drugs the patient is taking so drug interactions can be avoided. o Do not change doses without consulting a doctor. Do not exaggerate symptoms in order to persuade the physician to increase dosage or prescribe a new drug. o Keep a written record of all current medications, including the name, dosage and starting date. o Give the medication at the same time and in the same way each day. o Caregivers shouldn’t assume an Alzheimer’s patient would take the medicine on their own. o Keep the medicine organized, especially if the patient takes more than one drug. A plastic container or small paper cups can be useful to help keep track of what medicine has been given. o Make sure all medications are kept in a locked cabinet or drawer and throw out old medicines. o Keep the number of the local poison control center or emergency room on hand and call if you suspect a medication overdose.
THE DAILY HOME, Talladega-Sylacauga-Pell City, Ala., Saturday, December 30, 2006 — 9A
hoping and coping
Future research holds promise
Understanding memory loss only part of the process
Bob Shepard/UAB photo
Dr. J. David Sweatt first learned about the university’s Alzheimer’s/dementia program when his mother became a patient there.
Mother's illness prompted career for researcher By Jim Smothers
Bob Shepard/UAB photo
Doctors and researchers at UAB are working to better understand all aspects of dementia and Alzheimer's, from what causes the disease at a cellular level to who is more likely to suffer from the ailments and how to treat them. By Jim Smothers Daily Home writer
bility that the nation’s medical resources will be overwhelmed.
There is no crystal ball to show what the future holds for Alzheimer’s/Dementia patients with regard to treatment, care and numbers. Several researchers at UAB drew on their experience to predict what we might expect to happen in fighting these diseases in the next five to 10 years. The University of Alabama at Birmingham has one of the 32 federally funded Alzheimer’s Disease Research Centers in the country, a state-of-the-art facility at the forefront of studies of the diagnosis and treatment of Alzheimer’s. The center’s faculty researchers are investigating how plaques are formed in the brains of Alzheimer’s patients and identifying how they impair brain function. They are also exploring other disease-related damage in the brain and are developing treatments that may be able to protect brain cells from the devastating effects of the disease. Researchers agree that one thing is very clear: with the population bubble called the “baby boomers” approaching the ages when different types of memory-loss diseases become apparent, there is a real possi-
Research targets variety of areas Research is being conducted on multiple targets, with a variety of goals. The National Institute on Aging lists three areas of research for Alzheimer’s treatment: • Helping people with the disease maintain their mental functioning. • Slowing the progress of the disease, delaying its onset or preventing it, • Managing symptoms. Much work is also being done to try to better understand memory loss and how it progresses so that physicians will be better equipped to make an early diagnosis and begin treatment. Genetic researchers have already identified genes in DNA that are associated with the accumulation of toxic proteins in the brain that destroy cells and brain function. Work is also proceeding on Positron emission tomography (PET) scans that can help pinpoint the accumulation of those proteins to help formulate a diagnosis. This is an imaging technique that allows researchers to observe and measure
National Institute on Aging graphic
APP is associated with the cell membrane, the thin barrier that encloses the cell. After it is made, APP sticks through the neuron’s membrane, partly inside and partly outside the cell. Enzymes cut the APP into fragments of protein, one of which is called beta-amyloid. Fragments of beta-amyloid come together in clumps outside the cell and join with other molecules to form insoluble plaques.
Living with Alzheimer's and dementia
Hoping and coping
activity in different parts of the brain by monitoring blood flow and concentrations of substances, such as oxygen and glucose in brain tissues. Baby boomer impact feared “The 2000 census estimated there were 4.5 million people in the country with Alzheimer’s. We expect that to multiply to 20 million in the next 15 to 20 years,” said John Brockington, M.D., assistant professor of Neurology at UAB. “The cost will be astronomical to take care of these patients — it may very well be the number one cost in our health care system; economics may overwhelm our ability to pay for it. “There may be a significant shortage of resources to take care of everyone. There is a lot of pressure on researchers.” Dr. Brockington is primarily involved with seeing patients at the Kirklin Clinic and working with the UAB Alzheimer’s Disease Research Center, trying to get a better understanding of the stages people go through — how they progress from mild memory loss to more severe problems. “We’re trying to determine who is likely to go on to Alzheimer’s from mild memory problems and who isn’t,” he said. “For some, mild memory difficulty may be normal for them. We’re working to discover what distinguishes that. We see patients in clinic, do a lot of neuropsychological testing and conduct studies looking at family members of patients.” UAB is also doing clinical trials with some patients who already have Alzheimer’s and is trying different medicines to stop or slow the rate of decline. “The most exciting area of research is in the area of new treatments specifically targeting beta amyloid. The drugs available now help by adjusting the level of brain chemistry involving memory loss. They can only delay decline, but the patients are still in decline. Right now, it’s not great treatment in a longterm sense,” he said. “Research now is showing that beta amyloid is one of the main mechanisms in the brain causing memory loss. It builds up in the neurons and induces cell death. New treatments focus on beta amyloid to prevent accumulation or reduce the amount of it.” New hope Dr. Brockington was also optimistic about a vaccine being tested that has shown promise in preventing the accumulation of beta amyloid. A trial that began in 2000 was stopped after several patients in the test unexpectedly died. Researchers re-evaluated the medication to find the problem, reformulated it, and started over with animal trials. It is now in limited human testing. If that is successful, it
will be tested on a larger scale in clinical trials that could include researchers at UAB. “It’s going to be a while, but we’re hoping to get it,” he said. “We have here a large group of people in many different areas doing science research who are all contributing to this group in a coordinated fashion. “Traditionally there has been a gap between what’s done in a lab and what’s done in a clinic. One thing many people are trying to work on is to expedite the process,” Brockington said. Work on genetics, proteins, the biochemistry of Alzheimer’s, clinical treatment and other approaches to the disease are all under way at the research center. Physicians and scientists from different fields meet on cases and attend various lectures and work together to find answers to help defeat Alzheimer’s and other causes of dementia. Prognosis “There probably will not be a silver bullet in the next few years,” said Dr. Richard E. Powers, an associate professor of neurology and pathology at UAB. He is a psychiatrist, geriatric psychiatrist and neuropathologist. Powers lists five causes of dementia, with Alzheimer’s being the No. 1 cause. The others are Lewy body disease, vascular dementia, alcohol and frontotemporal dementia. Alzheimer’s is characterized by two toxic elements, tau and beta amyloid. Lewy body is characterized by the molecule synuclein. Vascular dementia is caused by strokes, and frontotemporal by tau. Looking to the future, Powers said he expected to see screening of patients beginning at the age of 50 to 55, with genetic analysis to see whether any of the known markers are present which are associated with Alzheimer’s. Based on that screening, physicians may be able to recommend particular treatments to help ward off brain-damaging diseases. “A PET scan test is being worked on now to measure amyloid poison in the brain,” he said. In the future, “we will measure toxic proteins in the brain and put you on blocking medications to prevent the accumulation of the toxic proteins. “I can envision in a few years we’ll scan you for amyloids, maybe give one medicine to remove it, another to break it down, and another to stop its production. “UAB is about to invest a huge amount of money on neurodegenerative diseases. There’s lots going on.” UAB is already doing work with clinical trials of new drugs and working with people with mild cognitive impairment, and researchers are looking for reasons that some of them “get stuck” in the phase of being old and forgetful while others go on
Special projects editor
Dr. J. David Sweatt is involved in basic research at UAB, but he first learned about the Alzheimer’s/ dementia program at the facility when his mother became a patient there. “They were able to give a very firm diagnosis — that is one of the real difficulties with Alzheimer’s Disease, especially in the early stages,” he said. “They are very helpful here. They give patients a very thorough psychological assessment battery and clinical diagnosis to give the family as good a level of diagnosis as possible. The clearer and the earlier, the better, so that treatment can begin.” His mother has since passed away, leaving Sweatt with the desire to spend a significant part of his career in research in the field. Much of his work involves genetically altered lab mice. They are manipulated to carry known markers that cause Alzheimer’s. His work involves the use of a variety of proposed medications to see which ones show the most promise in preventing decline of memory. “In the broad field, there are a number of new drug targets identified as alternative therapies for Alzheimer’s. Everybody knows this is a critically important problem. Also, there is such a large percentage of aging population in the U.S. that is developing this problem, the drug companies know they have a huge financial incentive. There is a lot of investment and a lot of smart people working on this problem. to dementia. Powers also emphasized that good overall health played a major role in preventing the onset of dementia. “The brain is only as healthy as the heart that pumps blood to it,” he said. “Keeping the heart healthy keeps the brain healthy. Not exercising, not using your brain, bad health habits are not good for your brain. “It’s a good idea to change health habits so that you go into those declining years with more reserve.” Powers said that studies have shown that people with memory problems who quit drinking tend to regain some mental function, but it’s best not to drink. He advises patients 65 or older who drink to hold it to one or two drinks per day at a maximum, with just one or none the day after they have two. In addition to the tau, beta amyloid and synuclein molecules known to destroy brain cells, strokes and alcohol also kill brain cells. “All of these little things add up,” he said. As for future care of the elderly, Powers was not optimistic. “I think we’re going to have to develop models of care for taking care of people at home and move toward development of home services, but national health planners are moving in the opposite direction. “Everyone in the baby boom generation I’ve talked to says they want to grow old at home and spend their last days in
“Certainly in the next five to 10 years, there will be several types of new drugs available on the market that will be significantly different from the types of treatment that are available now. “The real detailed mechanism of Alzheimer’s is that every time you get a better understanding of the cell and chemistry of what’s going on, understanding the real mechanistic basis of the disease has led to the development of whole new categories of treatment.” The mice in his studies usually live about two years, and are considered old at a year and a half. When they have an Alzheimer’s gene inserted into their DNA, memory deficits are measurable at 6-12 months of age. That time frame gives researchers a quicker time frame for experimentation. The National Institute on Aging in its booklet, “Alzheimer’s Disease: Unraveling the Mystery,” says that current treatment options for Alzheimer’s consists of five FDA approved drugs. None of them offer hope for a cure; they can only delay the inevitable decline of brain function. Researchers are receiving support to work to find better treatments, but there are no guarantees, and the system of clinical trials takes time. There is hope for better diagnostic tools, and better treatments may be developed. While the researchers are doing their jobs, it seems the best thing the public can do is take responsibility for personal health habits and cut back on the alcohol. familiar surroundings.” But there may not be enough health care providers available for home care. Powers said that recently announced cuts of 4 percent in Medicare payments will be a signal to health-care professionals that care of the elderly is not a priority. Also, at a time when the number of elderly in the country is increasing, the number of geriatricians is decreasing. The number of geriatric psychiatrists is now so low, there is talk of doing away with it as a specialty, he said. “In Alabama at this time there is a 6 percent shortage in the number of nurses needed in the state,” he said, “and in 12 years it will be 20 percent. The reason is not because Alabama lacks people who want to go into nursing — last year we turned away 3,000 qualified applicants because we don’t have enough training positions. University leadership won’t spend the money to hire the professors. It runs down the quality of care and runs up the costs. “Baby boomers should be worried.” On the net: UAB’s Alzheimer’s Disease Center: http://main.uab.edu/ adc/ National Institute on Aging – download a PDF version of “Alzheimer’s Disease: Unraveling the Mystery” http://www.nia.nih.gov/ Alzheimers/Publications/ UnravelingTheMystery/
10A — THE DAILY HOME, Talladega-Sylacauga-Pell City, Ala., Saturday, December 30, 2006
hoping and coping
Education gives families hope, understanding Dealing with patients
Living with Alzheimer's and dementia
Hoping and coping
By David Mackey Home staff writer
When a family learns one of their loved ones has Alzheimer’s disease, they often don’t know where to turn or even what the diagnosis means. Lakeside Hospice in Pell City has several programs offering hope through education for those close to Alzheimer’s patients. Christine Eickmann, education coordinator at Lakeside Hospice, said more and more families seem to be confronting the issue in recent years. Knowledge can be one of the most powerful resources, she said. “What we do is offer new hope for the future to patients and their families,” Eickmann said. “The one thing we can do that can help more than anything is educate, educate, educate.” Lakeside began offering classes on Alzheimer’s disease and dementia, in addition to other topics, about three years ago, Eickmann said. Classes entitled “Alzheimer’s: An Overview” and “Tips for Dealing with Alzheimer’s Patients” have been very popular, Eickmann said. “It’s been phenomenal,” she said. “It’s growing every day.” The one-hour classes are offered free of charge to the public and medical professionals, who can receive continuing education credit for attending
the courses. There is no set schedule, Eickmann said, but the classes are offered on an as-needed basis about once every week or two in locations in Pell City, Talladega and Sylacauga. Learning about what is happening in a patient’s brain can help caregivers deal with and plan for their changing behavior, she said. For example, many families are astonished when a formerly prim parent begins cursing when they have Alzheimer’s disease. That’s because as the right side of the brain, which controls normal speech, deteriorates, the left side, which is responsible for swearing, compensates with a flurry of expletives. Knowing those kinds of facts can prepare a caregiver for what to expect, she said, and help control behaviors like wandering. “They can’t tie their shoes, but they can get out the back door with six locks on it,” Eickmann said. “The more they can understand this, the more they can take care of them and prevent tragedies from happening to their family.” The hospice also has educational videos and pamphlets on Alzheimer’s available, Eickmann said. For more information on Lakeside Hospice’s resources, call Eickmann at 205-884-1111.
Susie McClanahan, a registered nurse at Lakeside Hospice in Pell City, teaches a class as part of the hospice’s educational outreach efforts. Lakeside Hospice offers classes, video and pamphlets to help families of Alzheimer’s patients understand the disease and their options.
Lakeside Hospice education coordinator Christine Eickmann offered 10 tips for dealing with Alzheimer’s patients which are covered in the courses. The suggestions include: o Approach patients calmly, face the patient and speak clearly. Do not touch them from behind. o Give instructions to the patient with simple, one-word commands and gestures. o Give patients limited options for clothing and dress them in a consistent manner each day. o Bathe the patient at the same time each day, talking reassuringly. Use the bathtub or shower as they prefer while providing privacy. o Feed the patients their preferred foods when possible in a comfortable, upright position. Observe them while eating. Reassure them that the food is safe. o Placing stop signs or boundary lines around exit doors may keep patients from wandering. Keep them active to reduce the risk of wandering. o If a patient is hostile, they may have an acute medical issue or be reacting to a change in their environment or new medication. o If a patient likes to rummage through drawers or closets, keep them busy or give them a drawer specifically for rummaging. Ignore behavior that causes no problems. o Maintain a quiet, orderly environment without clutter or slick floors that could cause falls. Different decorating colors may help patients identify different rooms. o Remember that most of the time, patients cannot help their behavior.
Alzheimer's and dementia support resources Information
o Alzheimer’s of Central Alabama – www.alzca.org or 205-871-7970; o Alzheimer’s Disease Education and Referral Center (ADEAR) – www.alzheimers.nia.nih.gov or 1800-438-4380; o Alzheimer’s Association www.alz.org or 1-800-272-3900; o UAB Alzheimer’s Disease Center – www.uab.edu/adc.
Hospices
Pell City: o Alacare Home Health and Hospice – 205-338-3250 o Lakeside Hospice — 800-4273993 Talladega: o Comfort Care – 256-761-1250
Aricept is one of the drugs doctors use to treat Alzheimer's disease. The medication can sometimes slow the progression of the disease, but it is not a cure and the patients usually continue to deteriorate.
Hope From Page 1A thinking, language, judgment and other thought processes are affected by cognitive symptoms. Rivastigmine, which is also called Exelon, and galantamine, which is called Razadyne, are two drugs approved to treat mild to moderate Alzheimer’s. Tacrine, also called Cognex, was the first cholinesterase inhibitor and was approved in 1993, but it has a risk of liver damage as a side effect and is rarely prescribed today, according to the Alzheimer’s Association. With the exception of Cognex, the other drugs approved by the FDA for the treatment of Alzheimer’s disease have relatively minimal side effects. While the cholinesterase inhibitors are the most popular drugs prescribed to treat symptoms of Alzheimer’s, there is no cure for the disease. Aricept, Exelon and Razadyne are believed to delay or slow the worsening of symptoms in some
people for up to a year. “Some people take them for six months or a year and if it seems to be helping, they continue,” Davis said. “If they don’t seem like they appear to be working, sometimes they just discontinue, especially if they continue to deteriorate on the medications.” Another drug, Namenda, which was approved by the FDA in 2003, can be taken with Aricept, Exelon or Razadyne to help treat the disease. While results from the medications are varied, Davis said, improvement in some patients might not be because of the drug they are taking. “Some people progress at different rates,” he said. “Some people stabilize. I don’t think it’s necessarily related to the medication that we use.” Research The Alzheimer’s Association continues to search for new medications to treat and ultimately cure Alzheimer’s disease. According to the association’s Web site, researchers are
studying the effectiveness of nonsteroidal anti-inflammatory drugs on Alzheimer’s patients. NSAIDs are aspirin and similar drugs, which are used to treat inflammation and fever. Researchers are interested in these because informational studies found people who take large doses of the drugs for arthritis and other conditions have a “reduced likelihood of developing Alzheimer’s,” the association reported. Researchers found that NSAIDs may be more effective preventing rather than treating Alzheimer’s. Drugs targeting beta-amyloid, a microscopic protein fragment, are being researched as well. Some researchers believe betaamyloid is the primary cause of Alzheimer’s, but no drug targeting the protein fragment has been marketed as of yet. Davis said not knowing the cause of Alzheimer’s greatly hinders the process of finding a cure for the disease. “There are some experimental things that they’re working
on,” he said. “As you know, it’s a degenerative-type change in the brain. The medication really works on trying to stabilize the transmitters as much as possible, but it doesn’t create any new transmitters. “I think now we feel like there are multiple factors that cause cancer. I think it may be the same way with Alzheimer’s. I don’t think we’re very close; there’s no real good target to know what causes this disease. We know that with aging, the prevalence dramatically increases.” While Davis doesn’t know of a cure or have any idea when one could be found, he does believe one needs to be found soon. “It’s a disease of the aging, although you can get it at an early age,” he said. “It’s a field that needs a lot of research because of the mortality of the disease. I think we can be hopeful, but I don’t have anything right now to indicate that anything has dramatically changed.”
Sylacauga: o American Home Care – 256245-9212 o New Beacon Inc. – 256-2072055 o Gentiva Health Services – 256249-4363 o Southern Care (coming soon) 866-267-0629
Support groups
o The Village at Cook Springs: The first Monday of each month, from 5:30 p.m. until 7 p.m. Public invited. o First United Methodist Church in Moody: The second Thursday of each month, 7 p.m. Group leader is Carol Karrasch. o Citizens BMC in Talladega: The second Saturday of each month, 10 a.m. Group leader is Clifford Mosley. This list contains some of the agencies and organizations in the area that provide support and care for Alzheimer's and dementia patients in the area. Many of these organizations provide services and have offices in more than one city. Also be sure to check with your health care provider for additional groups that can provide help in Talladega and St. Clair Counties