In the United States, an estimated 4 million people have Alzheimer’s disease—one form of dementia in older adults. In Marion County, there are an estimated 529 cases of Alzheimer’s.

While dementia, a medical condition that disrupts the way the brain works, is a common part of the natural aging process—forgetfulness, short-term memory loss—Alzheimer’s disease is not.

“Alzheimer’s is a progressive disease, and the natural aging dementia is not,” said Pam Ratz­laff, a social worker at Hillsboro Community Medical Center.

About the condition

Alzheimer’s disease is named after Alois Alzheimer, a German doctor who, in 1906, noticed changes in brain tissue of a woman who had died of an unusual mental illness.

Alzheimer discovered abnormal clumps, now called plaques, and tangles of bundles of fiber, which are common indicators of the disease.

In more recent years, scientists have also discovered a loss of nerve cells in the brain that are vital to memory and other mental abilities. There are also lower levels of chemicals to carry complex messages back and forth.

The cause of the disease, however, remains unknown and there is no cure.

Stages and symptoms

Ratzlaff said there are three stages of Alzheimer’s disease: early, middle and late.

The average person with Alzheimer’s disease will live an average of eight years and as many as 20 or more from the onset of symptoms.

Symptoms in the early stage are subtle. Individuals may have a hard time concentrating, experience short-term memory loss or be unusually forgetful.

“In the early stages it’s very frustrating for them because they know they can’t remember,” Ratz­laff said. “They feel lost.”

Because people in the early stage of the disease know something isn’t right, it creates anxiety.

“You may see some anger with that or some lashing out because they are frustrated and they’re confused and they can’t make sense of it,” Ratzlaff said. “But as the disease progresses, they don’t have that awareness anymore. It’s moved on and they’re just pleasantly confused and they’re not really aware.”

The middle stage tends to last longer than the early and late stages, and can last anywhere from two to 12 years.

During the middle stage, memory loss becomes more severe and symptoms more pronounced.

Ratzlaff said one thing people shouldn’t do when communicating with people in the more advanced stages of Alzheimer’s is correct their statements.

“The thing you don’t want to do is correct a person that perceives something to be a certain way or do what is called reality-orientation,” she said.

For example, if a patient believes he or she is 12 and is talking about their mother, it isn’t appropriate to attempt to explain the mother is dead, Ratzlaff said.

“That just adds to the agitation and confusion,” she said. “We try to enter their world. Instead of saying, ‘No, your mother died,’ you say, ‘Tell me about your mom,’ because they’re obviously thinking about her.

“You want to be supportive and talk with them—do supportive listening and reassurance—and enter their world somehow with what they’re thinking.”

In the late stage of the disease, caregiving shifts toward 24-hour nursing care.

Institutional care

HCMC is equipped with a 10-person Alzheimer’s unit, designed around the specific needs of the patients. The unit currently houses nine patients.

“In that environment, we try to provide a quiet, consistent, home-like environment for them,” Ratz­laff said.

While it is important to retain a simple, consistent routine for individuals in any stage of the disease, people in the late stage of Alzheimer’s often react negatively to an altered environment.

“Keeping a routine consistent and simple is very important,” Ratz­laff said. “(Regular nursing care) would be far too stimulating and create too much confusion.”

Individuals in the late stage of the disease become severely disoriented. They no longer recognize family members, nor do they know their own name.

Despite the severity of the disease, Ratzlaff said it is important for patients to have regular brain stimulation.

“We’re committed to the resident, of course, to providing him or her with every opportunity to maintain their optimal level of function for as long as possible,” Ratzlaff said.

The Alzheimer’s unit at HCMC gathers information from the patient’s family to determine what the patient’s preferences were at one time in terms of hobbies, interests and abilities.

“We try to incorporate that into their daily routine so that we can help maintain their optimal level of function,” Ratzlaff said.

“We want to keep their brain stimulated and their bodies stimulated, because if you don’t keep those things active, they will lose the abilities they have more quickly.”

With patients who are in more advanced stages, the senses are stimulated in other ways such as aromas and textures like sand.

HCMC also continues physical excercise for as long as possible.

“(We) tap in to who that person was and try to maintain that as long as possible through the use of activities and other tools,” Ratzlaff said.

HCMC to host free workshop

Hillsboro Community Medi­cal Center will host an informational presentation called “Dementia diagnosis: What next?” from 2 p.m. to 5 p.m. Friday, Feb. 29, in the long-term care unit chapel at 701 S. Main.

The presentation, sponsored by HCMC, the Alzheimer’s Association, Greenhaw Phar­macy and the Hutchinson Clinic, is designed for families and individuals living with Alzheimer’s or other types of dementia.

Information will be available for those newly diagnosed, those who have been living with dementia for a length of time and those who want more information.

“Alzheimer’s is becoming such a prevalent thing, and even if you’re not affected by it directly as a family member, it’s just good information to know living in this world,” said Pam Ratzlaff, a social worker at HCMC. “We need to educate ourselves so we can support the people in our life we know are dealing with this.”

The featured speakers will be James Isaac, a neurologist at Hutchinson Clinic, Tim Hodge, an attorney for Adrian & Pankratz, Eric Driggers, pharmacist at Greenhaw Pharmacy and Celia Koudele, a helpline specialist with the Alzheimer’s Association.

The presentation is a free and open to the public. For more information, contact the Alzheimer’s Association, 1-800-272-3900, or HCMC, 620-947-3114.