Westgate Manor: pioneer in Alzheimer’s special care

Westgate Manor, taking the lead from its parent Hillhaven Corp., has developed two special-care units for patients with Alzheimer’s disease. Darlene Field, Westgate Manor’s Alzheimer’s coordinator, is responsible for the programming for both units.

“Throughout the country, Hillhaven operates 55 special-care units for Alzheimer’s patients. The company has been a pioneer in this field, having developed the special-care unit concept,” said Field.

Lack of information about Alzheimer’s disease often leads to confusion and sometimes fear. People often confuse dementia with Alzheimer’s disease.

“In long-term care, it is generally accepted that 50 to 60 percent of people in long-term care have dementia,” Field said. She explained that dementia is a syndrome — not a disease — that can be caused by many things.

“Many people are threatened by this. Things like a drug interaction could be responsible,” she said. “As people get older, sometimes they have a long list of medicines that they must take. When this is carefully looked at, the symptoms can go away.

“Education is a really important for people to understand. Some causes of dementia include a malfunctioning thyroid, clinical depression, and malnutrition,” Field said. Identification of Alzheimer’s is a process of information collection and elimination of other possible diagnoses.

The first symptom that could lead to a diagnosis of Alzheimer’s disease is short-term memory impairment. “Severe problems with short-term memory is not a normal part of aging. In this case, as new information is taken in, it is not stored so it can’t be retrieved. Everything is a new experience,” she said.

“A second signal is impairment in long-term memory of the recent past. Other symptoms can include difficulty with language,” she said. “When people have the inability to retrieve or use words it is called aphasia. Agnosia is the inability to recognize objects, faces, or other familiar things.”

Other signals that could indicate the onset of Alzheimer’s disease may include: “People may have difficulty with planning and sequencing. For example, meal planning may be difficult,” she said. “They have difficulty thinking in the abstract and are unable to understand double meanings. They can no longer think logically.

“They may lose the ability to perform normal activities of daily living and may begin to wander aimlessly.

“It’s important to have a full diagnosis. Dementia and Alzheimer’s are not forms of insanity,” Field said. “Nontreatable Alzheimer’s disease is the number one ause of irreversible dementia.

“The second major cause is called multi-infarct dementia, which is a series of small strokes that cause brain damage,” she said. “People with these symptoms have a noticeable change in behavior that over time has a cumulative effect.

“Other major causes of irreversible dementia include AIDS; some people with Parkinson’s disease will have dementia,” Field said.

Field related some statistics on the incidence of Alzheimer’s disease: “Ten percent of people over 65 will have Alzheimer’s. That increases to 47 percent for people over 85. This is predominantly a disease of the very elderly. The youngest known person with the disease was 22 years old.

“There is no way to diagnose Alzheimer’s disease without the exclusion of all other known causes of dementia. The onset of the disease is an insidiously slow process,” she said.

“Dr. Alzheimer, a German neurologist, was the first to identify the disease. Short circuits in the brain cause fluctuations of behavior,” Field said. “The causes are not yet known. There is no cure and there is no test that can lead to a definitive diagnosis.

“Alzheimer’s disease is a unique process. It sneaks up. It’s imperceptible at first,” Field said. “It’s a degenerative, fatal disease. The number one feeling that a person with Alzheimer’s has is fear. We treat them by validating their feelings and trying to reduce their anxiety.

“The question most often asked by friends and family is `When are they going to get violent?’ Combativeness is not inevitable progression,” Field said.