Advice on Slowing Onset of the Disease

My sister recently reconnected with an old friend only to find out that she is working in the same Alzheimer’s Department at the VA Hospital in Seattle that is running mom’s Study program. In the course of their conversation, the old friend advised my sister that one n 5 people in our country end up with Alzheimer’s. Since there are 5 of us kids, my sister asked her if there is anything that we siblings can do to stave off the disease. She gave my sister some great information, which we asked her to put into writing for us to share with you. Her response is attached below.  I know what I’ll be working on now, because I’ve seen what happens with this disease and I’m going to hold it off as long as I can!

Additionally, based on the insights and advice she gave us regarding the final stages of the disease, I will be contacting Hospice Care next week to see if they can evaluate mom’s situation. As you know from reading this blog for just the short window in which I’ve been writing it, Mom’s situation has been changing dramatically and all the facets which are identified as part of the final stage are notably present and escalating in mom’s case. I know that’s now what we want to hear, but it is what I’ve been seeing. It’s also what the caregivers who help us have been seeing, based on my questions to them about her situation, as referenced below in the letter.

Here is the letter:

“I don’t have any literature to send with the prevention issues I talked about. I do want to clarify though, these are only ways that we can REDUCE risk factors for, and hopefully delay onset and/or slow progression of Alzheimer’s disease. The hope/thought is that if we can keep the “disease pathways” healthier, we can slow the progression or onset of disease. We cannot change our genetic risk factors, but we CAN do something about managing vascular risk factors i.e.

         Avoid developing Type II diabetes:  through lifestyle management like daily exercise and a low fat/low sugar diet, avoiding high glycemic index foods – things that the body breaks down quickly into simple sugars, like a popsicle vs low glycemic index foods, like an apple, that take the body longer to break down therefore avoiding big peaks of both blood sugar from eating the food and the insulin that is produced in response to those big spikes of blood sugar. Our data shows that just 30 minutes of aerobic exercise will reverse, at the cellular level, insulin resistance ( pre-diabetes) for 24 hrs!..exercise is very, very powerful medicine!

         Manage high blood pressure:  again, through lifestyle management of diet and exercise. Watch foods with hidden sodium (canned soups, sauces etc). If you have been prescribed blood pressure meds, take them.

         Manage high cholesterol:  again, through lifestyle management of diet and exercise. Have yearly fasting cholesterol labs taken. If you’ve been prescribed a cholesterol lowering medication, take it. I use Red Yeast rice tabs from Costco. My cholesterol is borderline high, but has stayed steady for the 5 years I’ve been taking Red Yeast rice. I also have very high HDL’s, which are especially protective for women.          

         Manage and REDUCE stress levels:  Chronic, high levels of stress are really bad for brain health. When your body is in a constant state of stress, you are releasing the “fight or flight” hormone, cortisol. We know that constant high levels of cortisol in the body cause an inflammatory response (because you are NOT supposed to have any hormones as a constant in your body, they work on peaks/valleys) that not only affects your body but your brain. We know that these inflammatory responses in the body (including your body’s response to high blood pressure, high cholesterol, type II diabetes) are damaging to both body AND brain.

To answer your question about mom’s increasing sleep time, could be winter time affects but also could be her body slowing down as her disease progresses. Your caregiver is probably picking up on some more clues with your mom’s behavior than just the increased sleeping and decreased alertness. The fact that she is spending most of her time sleeping may very well mean she is moving toward the end of her life. However, with this damned disease, sometimes it’s just hard to tell. When she starts to have significant decrease in wanting to eat or drink, along with the increased sleeping, you are probably nearing the end of her life.

It would not be unreasonable to get hospices services in now, to offer emotional/ physical/ spiritual support for your mom AND the family/caregivers. If her PCP believes she meets hospice criteria i.e. increased sleeping, decreased verbal interaction, bladder/bowel incontinence, ( and some others that I can’t remember right now) I would highly recommend it. FYI, she may well rally with some hospice team care, then no longer meet hospice criteria and then get pulled off of hospice!...Alzheimer’s patients often “graduate” from hospice care, then when they start to decline again ( which they always do), then they can go back on hospice. Hospice benefits do NOT end after 6 months of care. Folks just get re-certified as meeting hospice criteria (via the PCP/hospice team agreeing that they meet criteria again) and go back on. It is an old wives tale that you only get 6 months of hospice care, simply not true. That being said, her PCP and Providence Hospice, may NOT agree that she meets hospice criteria at this time. Hospice is used far too late in far too many cases!  It’s a wonderful service and highly recommend it, especially for end stage Alzheimer’s patients.”