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Legal-Ease: An Attorney’s Perspective: Alzheimer’s and Dementia

By June 18, 2021June 24th, 2021No Comments

Judd Matsunaga, Esq.

Not too long ago, I was able to visit with an old childhood friend. After the initial greetings, we sat down. There was so much to say — it had been years (decades). What came out of her mouth next seemed jumbled and confusing. So, I said, “Just how long has it been since you lost your mind?” She hit me.

Currently, an estimated 50 million people worldwide are living with dementia, including more than 5 million Americans. According to the Alzheimer’s Assn., this number could reach nearly 14 million by 2050 without changes in prevention or treatment. More than 80 percent of care provided at home is delivered by family members, friends or other unpaid caregivers.

The terms dementia and Alzheimer’s are often used as though they mean the same thing. They are related, but there are important differences between the two. Dementia is a broad (“umbrella”) term for an individual’s changes in memory, thinking or reasoning. There are many possible causes of dementia, including Alzheimer’s.

Alzheimer’s disease is the most common cause of dementia. It makes up 60 percent- 80 percent of all dementia cases. Alzheimer’s is not a normal part of aging — it’s a progressive brain disease, meaning it gets worse over time. Two abnormal brain structures called plaques and tangles are the main features of Alzheimer’s disease.

Scientists believe they damage and kill nerve cells. Plaques are pieces of a protein fragment called beta-amyloid that build up in the spaces between nerve cells. Tangles are twisted fibers of another protein called tau that build up inside cells. Alzheimer’s disease causes nerve cells to die.

The brain has three main parts: the cerebrum, cerebellum and brain stem. Each has a job to do to make the body work properly. The cerebrum fills up most of the skull. It’s the part of the brain most involved in remembering, problem-solving and thinking. There are about 100 billion nerve cells called neurons throughout the brain that send messages in order to make memories, feelings and thoughts.

This causes the brain to lose tissue (also called shrinkage) and the loss of function and communication between cells. These changes can cause the symptoms of Alzheimer’s disease. These include memory loss; problems with thinking and planning; behavioral issues; and, in the last stage, a further decline in functioning, which can even include trouble swallowing.

Scientists know that nerve cell failure is a part of Alzheimer’s disease, but they don’t yet know why this happens. However, they have identified certain risk factors that increase the likelihood of developing Alzheimer’s.

The greatest known risk factor for Alzheimer’s is age. After age 65, a person’s risk of developing the disease doubles every five years. Thirty-two percent of people aged 85 or older have Alzheimer’s.

Researchers have learned that family history also increases the likelihood of developing Alzheimer’s. Another risk factor is genetics. Two types of genes influence whether a person develops a disease: risk genes and deterministic genes. Risk genes increase the chance of developing a disease but do not guarantee it will happen. Deterministic genes cause a disease. This means anyone who inherits a deterministic gene will develop a disorder.

Age, family history and genetics are all risk factors that we can’t change. However, research is starting to show clues about other risk factors that we may be able to influence. Studies show a strong connection between serious head injury and future risk of Alzheimer’s. For this reason, it’s important to protect your head.

Research also shows there are healthy lifestyle habits that people can adopt to help keep their brain healthy and lower their risk of cognitive decline. These include eating a healthy diet, staying socially active and exercising the body and the mind. Not using tobacco and avoiding excess alcohol is also good.

Currently, there is no cure for Alzheimer’s, but nondrug treatments and medications may help with memory, thinking and behavioral symptoms for a while. Nondrug treatments for behavioral symptoms can offer physical and emotional comfort. Many of these strategies aim to identify and take care of the needs of the person living with Alzheimer’s. It’s important to talk about treatments with your doctor.

The information above is just a portion of information from an Alzheimer’s Assn. publication titled “Understanding Alzheimer’s and Dementia.” The entire pamphlet can be found online at www.alz.org/media/Documents/understanding-alzheimers-dementia.b.pdf.

Finally, here are some tips for coping with symptoms:

  • Check for personal comfort. Look for pain, hunger, thirst, constipation, full bladder, fatigue, infections and skin irritation. Keep the room temperature comfortable.
  • Don’t argue about facts. For example, if a person would like to visit a parent who died years ago, don’t point out that the parent is no longer alive. Instead, say, “Your mother is a wonderful person. I would like to see her, too.”
  • Redirect the person’s attention by getting them to think about something new. Try to be flexible, patient and supportive. Respond to the emotion, not the behavior.
  • Create a calm environment. Avoid noise, bright lights and television, which causes distraction.
  • Have rest times between lively events.
  • Give the person an object to hold that makes them feel safe.
  • Show the person that you hear them and answer his or her questions.
  • Look for reasons behind each behavior. Talk to a doctor about behaviors that could be connected to medications or illness.
  • Try to find more than one solution.

Judd Matsunaga is the founding attorney of Elder Law Services of California, a law firm that specializes in Medi-Cal Planning, Estate Planning and Probate. He can be contacted at (310) 348-2995 or judd@elderlawcalifornia.com. The opinions expressed in this article are the author’s own and do not necessarily reflect the view of the Pacific Citizen or constitute legal or tax advice and should not be treated as such.

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