In the early 1980s, most people with Alzheimer's disease would have simply been labeled as "senile." Spouses and adult children would take on the responsibility of providing care until it was time for a nursing home, where they received care in an institutional setting.
Since then, there have been remarkable strides forward in the diagnosis, understanding and care for those with Alzheimer's disease and other forms of memory loss. Reflecting on the progress we've made in the last 30 years helps us to prioritize new advances in the decades ahead.
Diagnosis, Treatment and Education
Every 69 seconds, someone develops Alzheimer's disease and one out of every eight seniors over the age of 65 has the disease. Yet 30 years ago, no one knew its name. If you search the New York Times archives from 1850 through 1977 for "Alzheimer's disease," only one story refers to the disease, although it was first diagnosed back in 1907.
The Alzheimer's Association, whose resources are invaluable to so many today, was not even founded until 1980, and it was not until 1982 that Ronald Reagan declared an official "Alzheimer's Awareness" week. Many people regarded the symptoms of confusion and memory loss as just a reality of getting older. The result was that little attention was given to treatment, diagnosis, and more importantly, care and caregivers.
While a definitive cure for Alzheimer's is still elusive, there are five FDA-approved drug treatments that help relieve the symptoms of the disease. These have all been developed in the past few decades and there are numerous new therapies in the research pipeline.
Prior to the 1970s, resources and services for people with memory loss were virtually non-existent, and care was given either at home or in nursing homes. Fortunately, a major shift occurred in the 1980s when the institutionalized medical model of care provided in nursing homes transitioned to the resident-centered social model provided in assisted living communities.
It was during this period in time that assisted living pioneers Paul and Terry Klaassen, founders of Sunrise Senior Living, designed the type of care and services that would always put the resident first, whether or not they have memory loss. This approach not only champions quality of life, but also honors the residents' wishes and promotes identity, independence and dignity.
As the assisted living industry grew, dedicated wings or free-standing buildings were built specially for residents with memory impairment. These homelike neighborhoods provided a secure, non-restricting environment and promoted a sense of community. Architects then began to focus on the design elements which give residents with memory loss a sense of orientation through built-in environmental cues that helped them find their way and reduce feelings of insecurity. Design innovations included automatic sensor lights and contrasting colors in bathrooms, tableware designed to be bright and contrasting -- all of which further promote dignity and independence.
By the early 2000s, a few assisted living companies identified a need for specialized programs and services specifically designed for residents with Mild Cognitive Impairment (MCI) or early stages of Alzheimer's disease. These programs were designed to assist seniors with early signs of memory loss to engage in activities that promote cognitive stimulation, social engagement, mutual support and stress reduction with a goal of delaying memory loss. Not until recently did studies suggest that lifelong learning, mental and physical exercise, continuing social engagement, stress reduction and proper nutrition may be important factors in promoting cognitive vitality.
Thirty years ago, there was little consensus about how best to help those who were disoriented and seemed to live in a different time and place because of Alzheimer's or other forms of memory loss. That changed in 1982, when internationally renowned social worker Naomi Feil published her seminal work, "Validation: The Feil Method, "which introduced caregivers to an empathetic way of communicating with disoriented seniors. Today, thousands of professional caregivers are trained to use validation techniques, through which they are able to tune into the inner reality of the person with dementia. This method helps build trust and restore the person's dignity.
Activities in memory care have also transitioned away from the large group, one-size-fits-all approach to more intimate small groups that focus on shared interests and promoting a sense of purpose and belonging. Most care also now centers around social engagement with well-designed activities to increase quality of life.
As progressive as the last 30 years has been to improve care for those with Alzheimer's and other forms of memory loss, the future looks even more promising, especially in the area of technology. The safety-oriented devices such as motion sensor alerting and GPS shoes will continue to proliferate and enable greater independence. Scientists are also testing brain imaging tools and blood tests that may allow for earlier interventions. Computer-based brain fitness products and remote communication with family members are also promising to flourish and help keep those with memory loss connected socially.
Everyone is hopeful that this generation will be the one where a cure is found. While the search continues, there will be even more emphasis on prevention and controlling contributing risk factors. Until then, one of the most important advances we can make is to continue educating, training and supporting everyone who is touched by Alzheimer's disease and other forms of memory loss.
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