Alzheimer’s Disease (AD) is now as epidemic as heart disease, diabetes or cancer in the U.S., except Alzheimer’s is always fatal. Alzheimer’s is the sixth-leading cause of death for all Americans, and the only cause of death among the top 10 in the United States that can’t be cured, or even significantly slowed.
With AD, there is no silver lining, no blessing in disguise, no happy ending whatsoever for anyone involved. It sucks the Spirit out of everyone it touches—patient, family and caregivers alike—until it has extinguished at least one Spirit forever, if not more. And as you wither inside watching your loved one’s mind turn into mush, sometimes it can take everything you’ve got to hold onto some sense of meaning, some sense of faith that world isn’t random and cruel.
I’ve personally experienced the toll this wretched disease takes on everyone around it. You see, Alzheimer’s has been my hateful, horrifying houseguest every day for the last three years. And I have a lot to say about it.
Every minute—in fact, before you get to the end of this article—another American will develop Alzheimer’s. One out of every eight older adults, or 5.4 million Americans have already been formally diagnosed, and millions more are undiagnosed—or diagnosed with some form of dementia that could actually be Alzheimer’s.
Alzheimer’s disease cost Medicare and Medicaid $140 billion last year. Individual Medicare costs for people with AD are nearly three times higher than for seniors without the disease, and Medicaid costs are 19 times higher. As 78 million baby boomers enter their golden years, the numbers of Alzheimer’s patients is expected to grow to 16 million people and the cost to American society is expected to be $20 trillion between now and the year 2050.
There’s no doubt about it: We are in the midst of a national emergency, and we’re woefully unprepared.
The Full Cost Accounting of Caregiving
But if the direct cost to society weren’t high enough, in 2011, the Alzheimer’s Association estimated that more than 15 million friends and family members provided over 17.4 billion hours of unpaid care valued at $210 billion dollars.
The role of caregiving for a family member with Alzheimer’s disease or dementia is primarily a woman’s role, and this role has grave financial and medical repercussions for us. Of the 15 million Americans caring for a person with Alzheimer’s Disease (AD) or other dementia, about 75% are women, mostly wives and daughters.
For decades, women have fought for respect as mothers and for recognition that mothering is real work. Now we have to fight for respect as caregivers and recognition that caregiving is real work, too—billions of dollars worth of stressful, heartbreaking, often thankless work.
Many women also face the extremely difficult challenge of balancing the demands of caregiving with their marriage, children and employment. Including me.
For most women, the time, energy, and stress of caring for an elder family member or spouse leads to a significant reduction in work hours and annual salary, as well as a loss of benefits, including health insurance. It also leads to a grave reduction in earned Social Security benefits later.
Primarily due to caregiving responsibilities, women average 14 years out of the paid workforce. And when a two-income family is forced to lose one person’s income altogether because of caregiving responsibilities, it is usually financially devastating, and deeply affects any children in the home.
And lest you think people can get help from the government, let me tell you that in California, budget cuts have eliminated virtually all funding for caregiver services like respite and adult day care services, making it almost impossible for caregivers to work or even get a short break from providing care, unless they either have tremendous extended-family support or can afford the exorbitant cost of these services on the for-profit, free market. ($50-$100 per day for adult day care; $100-$200 per night for respite.)
Residential facilities specializing in the unique needs of people with dementia cost between $3,000-$6,000 a month, and are NOT covered by Medicare or Medicaid at all. Medicaid (MediCal) only covers the cost of a board-and-care ($2000-$4000 a month) or a nursing home ($5,000 a month or more) once a person with AD has no other options or can no longer feed, bathe or toilet themselves—which doesn’t happen for many, many years with the disease.
Medicaid can provide a part-time, in-home assistant, which can be enormously helpful, if you qualify, but seldom is the help substantive enough to allow a caregiver to do things like resume a career or bear children. Filling in the gaps with an in-home assistant hired from the free market costs $10-25 per hour, and you definitely get what you pay for in terms of quality and skill.
The situation is very similar in most states, and our country’s lack of preparation and support for citizens with dementia and AD essentially gives most families no real choice but to take on full-time caregiving in their homes, even when they don’t have the money, skills or resources to do it—simply because they cannot afford to do otherwise.
At these prices, could you?
And if things weren’t already hard enough for families living with AD, if the current Congress somehow manages to pass their recently proposed draconian budget, there won’t be any Medicaid or help for people with AD at all. That means that the $140 billion we currently spend every year on Alzheimer’s care through the fixed pricing of Medicare and Medicaid will triple or quadruple as it falls to taxpayers to foot the for-profit, free-market cost of unpaid emergency room visits, medical treatment, prescriptions and mental health care for AD sufferers and their caregivers who can’t get health care any other way.
Caring for someone with AD is very, very stressful. In fact, the American Psychological Association’s recently released report on Stress in America was dedicated in large part to their findings about the most stressed out population in America. No, it’s not cops, or poor people, or even soldiers returning from Iraq, as stressed out as these folks might be.
The most stressed out people in America, with the shortest life expectancy of all, are caregivers, particularly caregivers living with a family member with dementia or AD.
Institutionalization and specialized care is very expensive, of course. But, taking care of your spouse or parent at home is not much cheaper, and it has other collateral costs too. Unless you’re a professional caregiver, you’re unlikely to be able to cope with the demands of caring for a loved one with Alzheimer’s.
You will eventually have to give up your job, and even your social life as your loved one grows to need 24-7 supervision. If you have children, their needs will be frequently compromised as you become increasingly unable to leave the house (even for a quick trip to the store), and more and more of your time is spent managing the disturbing symptoms of Alzheimer’s.
And imagine your heartbreak and grief as your spouse or parent transforms into a shell of their former self, right in front of you, in spite of all your sacrifices and hard work!
Many people don’t realize that AD is primarily a mental illness until the later stages. Alzheimer’s doesn’t just take your memory, it takes your sanity. Many people with AD not only lose all short term memory (as if that weren’t undignified enough!), but they also often exhibit symptoms of clinical depression, anxiety and panic, schizophrenia, psychosis, and/or paranoid delusions.
I’ve either heard stories of, or personally experienced, AD patients chasing their family caregivers with guns or knives; physically and verbally assaulting their caregivers; going on credit card sprees costing tens of thousands of dollars; letting themselves into strangers’ houses; developing drug or alcohol addictions (even if they never touched either in their lives before AD); stealing and shoplifting; undressing or masturbating in public; and expressing dramatic personality changes that leave one wondering if they ever really knew their loved one at all.
In later stages, Alzheimer’s takes away the ability to learn, read, speak, eat, walk, and use the bathroom, rendering the victim as dependent on the caregiver as a 150-pound newborn baby, until the brain finally atrophies so badly it can no longer sustain a heartbeat.
Watching this happen to your loved one (despite your best efforts) is hard—traumatic even. Depending on the source, up to 80% of dementia caregivers report very high levels of stress, 65% of dementia caregivers have depressive symptoms and up to a third of dementia caregivers have clinical depression. It is extremely common for caregiving spouses to die from stress-related illnesses before their charges do.
Chronically high levels of caregiver stress have serious health impacts, including depressed immune response, and elevated inflammatory markers in the blood which are associated with cardiovascular disease and increased vulnerability to cancer and autoimmune disease. Caregiving is precisely why I cannot get on top of my chronic fatigue syndrome and adrenal burnout, despite adopting the best diet and treatments for the illness.
The chronic stress of caregiving doubles the risk of cardiovascular disease, and increases the risk of mortality 63% over non-caregivers. Family caregivers report having more than twice the rate of chronic medical conditions as non-caregivers. And since many of these caregivers are uninsured because they cannot work, this costs families—and the nation—greatly.
Due to the physical and emotional toll of caregiving on their own health, Alzheimer’s caregivers had $8.7 billion in additional health care costs in 2011.
Women are particularly vulnerable to the stresses of caregiving. We tend to compromise our own lives and personal health when we assume the caregiving role, whether for our children or our dependents with AD. We are often quick to give up exercise, leisure activities, socializing, and personal time for the needs of our loved ones—and our families often let us do it.
This is by no means sustainable for us or for our country, much less for the world.___________
Now that I’ve got you totally freaked out and sad, the good news is that, like heart disease, diabetes and cancer, Alzheimer’s disease was once very rare. And like heart disease, diabetes and cancer, AD certainly is not inevitable, even if it runs in your family.
In fact, just like heart disease, diabetes and most cancers, Alzheimer’s is a lifestyle disease.
Preventing Alzheimer’s Disease is the Only Cure
There is no cure for Alzheimer’s, and there won’t be one coming, because there is no way to replace brain tissue once it has died. Current medications only manage symptoms, and alternative therapies, while more effective than pharmaceuticals, only slow the disease down by reducing inflammation or providing an alternative fuel to the brain (see video below). Neither approach can reverse the root cause of this disease.
Even if you did find a way to stop AD, if you didn’t act very early on in the disease, you could never fully restore what was lost. A diagnosis of Alzheimer’s is the beginning of the end of the road—a road that begins decades before symptoms appear.
Preventing Alzheimer’s disease is the only real cure.
Since a diet high in processed foods, sugar and inflammatory, industrial seed oils is THE common denominator in a host of epidemic, chronic diseases that rarely occurred 100 years ago, it would stand to reason that diet might effect Alzheimer’s disease too. Well, it turns out that a very large body of evidence now suggests that Alzheimer’s is primarily a metabolic disease.
Some scientists have gone so far as to rename it Diabetes type 3. (See video below.)
In Type 3 diabetes, brain cells develop insulin resistance and simply cannot get enough glucose to function and die, leaving the brain tissue—and therefore the mind—open to a host of metabolic problems and side effects, just like Type 2 diabetes does to the rest of the body.
Just like Type 2 diabetes can lead to losing a limb or one’s eyesight, the metabolic changes caused by Type 3 diabetes destroys brain cells and jams up neural connections. And once those brain cells die, like an amputated limb, they are gone forever. This is why Alzheimer’s is always undignified and always fatal.
But, insulin resistance in the brain not only explains why so many AD patients have incredible sugar dependency (and why diabetics, alcoholics and sugar addicts are at highest risk), but it also points a gigantic, blinking arrow at where to look to prevent, or even treat, Alzheimer’s disease.
It is not an accident that people with AD are frequently diabetic, alcoholic or, at least, majorly sugar addicted. Diabetics and alcoholics are at three times the risk for developing Alzheimer’s compared to the general population. This month’s New Scientist lead story makes a powerful case that the standard American diet is as devastating for our brains as it is for our bodies:
Can you imagine the ramifications: 19 million people (and growing) at very high risk for Alzheimer’s, and another 79 million (and growing) at high risk? Plenty of research still needs to be done, but it is looking like Alzheimer’s disease could be another catastrophic impact of the industrial processed food system—and the worst discovered thus far.
And if insulin resistance in the brain wasn’t bad enough, a study released in the March 1, 2012 issue of Analytical and Bioanalytical Chemistry found that high fructose corn syrup commonly contains small amounts of reactive alpha-dicarbonyl compounds which can react with proteins causing neurodegenerative disease , among other problems. And early studies found high intake of fructose was associated with high risk of dementia.
Anecdotally, my mother-in-law has had a sweet tooth her whole life, but for much of the past decade, she took it to a whole new level by consuming 2 liters of orange soda or corn-syrup sweetened cranberry juice between breakfast (pastry) and dinner , followed by a dozen cookies and an entire bottle of cheap, sweet wine before bed—every single day! And I’ve heard similar stories from other AD patients and their families.
Wow! Can you imagine consuming that much sugar every day?
But, you don’t have to have a sweet tooth to get that much sugar though. The average American consumes 22 teaspoons of added sugar a day (up to 160 pounds a year). This added sugar is often hidden in things like yogurt, ketchup, crackers and low-fat microwave meals to make them taste more appealing. Then when you add in the fact that the USDA wants us to eat 11 (!) servings of grain-based carbohydrate a day (which is just converted into more sugar in your body), Americans are taking in massive amounts of sugar never seen before in human history.
Diabetes, obesity and heart disease are all epidemic because of our national carbohydrate addiction. Alzheimer’s appears to be no different.
According to new research in the journal Neurology, people who eat a diet rich in omega-3 fatty acids (DHA and EPA in particular, which is found mostly in wild-caught seafood) and plenty of vitamins B-6, folate, B-12, biotin, zinc, C, D, and E have bigger brains and better cognitive function than those whose diets are unhealthier.
The standard American diet that most of us eat is very low in all of these nutrients, especially the omega-3 fats DHA and EPA, which are crucial for a healthy brain. Rather, the standard American diet is high in cheap industrial oils (like canola ) that contain omega-6s which promote inflammation, including in the brain!
This may not sound like anything new, but it is, reports Time Magazine . For years, studies have hinted at the right foods to eat to prevent Alzheimer’s disease and cognitive decline, but often these recommendations haven’t held up under further study or been replicated by other research. That’s because they tend to be based on observational studies and people self-reporting that they ate, which is notoriously unreliable data.
The new research, conducted at Oregon Health and Science University, is different. It’s the first study of its kind to measure a variety of nutrient levels in the blood of elder adults and compare them to cognitive test results and MRI scans that measure the brain changes associated with Alzheimer’s disease. It was also the first study to look at combinations of nutrients, rather than just one isolated vitamin at a time.
The bottom line: Those with healthy, nutrient-dense diets lower in sugar/carbohydrate had better mental function scores (including memory, attention tasks, visual skills, spatial skills, and language skills) than those who ate diets heavy in processed foods, packaged foods, fried foods, baked goods, and fast food.
Diet isn’t the only risk factor for Alzheimer’s, of course. But researchers say that diet plus the known factors of age, gender, and genetic mutations explain 76 percent of the variance between those with more cognitive decline.
“That tells us that structural changes in the brain may be very sensitive to dietary intake,” nutritional epidemiologist Gene Bowman told Time . “That’s quite remarkable.”
Indeed, it is.
A Time for Reckoning
A national conversation about Alzheimer’s and chronic disease and lifestyle in America is long overdue. As you learned in the video above, very promising AD therapies based on ketones from coconut oil can’t come to market because they aren’t Big Pharma pills, and can’t get funding for development.
If we can’t even fund the most promising therapy for dementia and Alzheimer’s to date because it isn’t “profitable,” how can we ever expect to handle this massive national problem, much less address the dietary and lifestyle factors that cause it?
The upside is that our good health is almost always in our own hands. Alzheimer’s disease takes 10-20 years to develop. This means that you need to start getting your diet and health right in your forties, at the latest.
To prevent Alzheimer’s and dementia decades before it develops, we can make sure that our families eat a whole food, traditional or ancestral diet today.
(If you would like help improving your health and preventing diseases like diabetes and Alzheimer’s with a grain free, low carb ancestral diet, check out the Go Grain Free E-Course over at Real Food Forager. Dr. Jill is a real expert, and I can’t wait to take the course myself!)
You Can Make A Difference Right NOW
Making sure you and your family eat whole foods and get enough sunshine, sleep and exercise is important, but it’s not enough. All of us (and our children) will soon feel the strain of the Alzheimer’s epidemic on our economy and our lives, no matter how healthy we are.
But, as the number of people with the disease grows, and the cost of providing care skyrockets, our nation can take steps to support Alzheimer’s research, public awareness and education, health provider training, and family caregiver support.
We can also advocate for a farm bill that supports health by subsidizing nutritious whole foods instead of more processed, sugar-laden, factory-made junk.
Right now, Congress has a chance to provide $100 million to address Alzheimer’s steadily mounting impact on families, our healthcare system and the economy. Initially proposed by the President in his recent budget request, these funds depend on Congressional action, as the power to actually provide this funding is limited to Congress.
Right now, go tell Congress it is critical that our nation make Alzheimer’s disease a national priority before it destroys us. $100 million is nothing compared to the $20 Trillion we might have to spend if Congress does nothing, as usual.
After you have signed the petition, look into buying a long-term care insurance policy , so in the event you are one of the 60% of people who will need care of some kind in your old age , it is does not fall entirely on the shoulders of your spouse, children and grandchildren—or the rest of us via our tax dollars—to provide it.Most importantly, if someone in your life is caregiving for someone with dementia, AD or other mental illness, you can make a big difference for them by giving them respite for a couple hours so they can go do something for themselves for a change. Caregiving is just too hard to do alone.
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