It’s clean, bright and quiet within the Alzheimer’s ward at Good Samaritan in Pipestone.
Puzzles attached to the walls in the hallways provide entertainment for those bound to wheelchairs. There’s a chapel with regular Bible study and both single and double rooms with private baths. The date is written on one white board, the day’s menu on another and still another contains the schedule of activities, such as coffee times, crafts and puzzles, and a beanbag toss.
A couple residents sat at a table one recent morning awaiting breakfast that’s served from a steam table wheeled into the unit. A few others sat in the spacious living room with the TV tuned to low. One of them dozed with a doll in her lap, another watched the newcomers and smiled. One women walked briskly down the hall until one of the caregivers caught up and directed her back to the dining area.
Though the courtyard attached to the unit carries the colors of impending winter, in summer it blooms with tomatoes and flowers that residents regularly help water. There are benches to sit upon within the outdoor enclosure and a semicircular walkway reinforced with a railing for those who are not as steady upon their feet.
The unit has become the world to the 14 residents who live there, a safe unit that’s locked 24/7 against the wandering tendencies of patients diagnosed with Alzheimer’s disease (AD) or dementia.
The unit is the only designated AD ward in the area. Ashton Care has residents with AD or dementia, but they are largely undiagnosed and reside with the general population of 43 residents, according to, Kris Carson, social worker for Ashton Care.
In the Good Sam unit, the residents are aged from their late-70s to 100 and all have been diagnosed with varying levels of AD or some other form of dementia.
“I have people who can carry on a conversation and you wonder do they even have Alzheimer’s, and then I have people on the other end who can’t do anything for themselves; we feed them, we dress them,” said JoAnn Straw, LPN, the special care unit coordinator.
Straw said she’s witnessed the disease lasting more than 10 years before the brain cells have deteriorated to the point where a person’s systems begin shutting down.
“There are medications we prescribe for them so they can maintain a plateau of abilities for awhile,” Straw said. “But as the Alzheimer’s get worse, those medications are ineffective and we just deal with it as best we can.”
On the fourth Monday of each month at 2 p.m., family members and caregivers meet in a Good Sam support group. Straw said it’s open to anyone and draws people from Leota, Edgerton and Flandreau.
“Some are family members of residents, others have them at home, some have them placed elsewhere,” Straw said. “One lady, her husband was a resident and he passed away three years ago and she still comes; she’s a wealth of information.”
The support group allows family members to meet people who are going through the same things they are. They talk about what works for them and how to deal with the emotions, the fear, the sadness.
Speaker to talk about AD and dementia Nov. 23
AD is an irreversible, progressive neurological disease that attacks brain cells and slowly destroys memory and thinking and eventually, the ability to carry out the simplest tasks.
Research suggests that certain lifestyle factors, such as a diet, exercise, social engagement and mentally stimulating pursuits, might help reduce the risk of cognitive decline and AD. But at this time, scientists don’t know what causes AD. Genetics, environment and lifestyle factors may all play roles, according to the National Institute on Aging, the lead research AD agency for the National Institute of Health.
“We don’t know the cause and there’s no cure,” said Dr. Myles Zephier, a family practitioner at Pipestone County Medical Center. “It’s a progressive decline that people die from. The goal is to try and keep people as functional and independent as possible.”
Since age is the number one risk factor for AD, Zephier said it makes sense that practitioners would be starting to see a higher incidence of the disease as the population ages. Typically, the disease strikes the short-term memory first.
“Usually they can remember very vividly what happened to them as a child but what happened to them last week they may not remember,” Zephier said.
If a person or a family member has a concern, visiting a primary care physician is, “a great first step,” Zephier said. “If someone is having a problem with memory and they are at the right age, there’s a screening test we can give that takes less than 10 minutes, called the Mini Mental Status Exam. It’s a 30-point mental examination we can give.”
Once diagnosed, however, there is no medication that can halt the disease’s progression and treatment largely consists of finding support through organizations such as the Alzheimer’s Association.
Gerise Thompson, regional center director for the Minnesota-North Dakota region of the Alzheimer’s Association, works out of an office in Rochester that provides AD and dementia resources for 25 counties, including Pipestone. Through programs, services, education and support, the Association seeks to help people diagnosed with AD, as well as their family members and care givers.
“Anytime we can help a family member with a new diagnosis, we’re very encouraged by that,” Thompson said. “The sooner we can intervene and provide that assistance, the better prepared they are for the journey ahead. That’s how we feel about early detection too. We encourage people to go in and get an early diagnosis. We hear from people in the early stages and they say, ‘At least I know what the issue is, what the problem is.’ They feel comfort in knowing that because it’s not just their imagination.”
Thompson will speak about AD and other dementias at 2 p.m. on Nov. 23 at Good Sam, with a presentation entitled, “Understanding Alzheimer’s.” Anyone interested in learning more about the disease or those who have questions or concerns about it, are invited to attend the presentation.
Improving the quality of life
Back at Good Sam, residents have crafted scarecrows out of paper plates that hang on their doors. The next activity for the holiday will be making placemats out of woven construction paper. The activities are projects they may remember having done with their children in the past.
“A lot of things we do are things from the past because they don’t have short-term memory,” Straw said. “So we build on things from the past. We do a lot of reminiscing. We ask them what they used to make for Thanksgiving Day dinner. Ladies tell me they would make their bread and the bowls would be so big they’d put the bowl between their legs to stir.”
Evidence suggests that activity-based care improves an AD patient’s quality of life, Thompson said. And activities include more than craft projects. As the disease progresses, AD patients must spend more time performing simple tasks. Activity-based care allows for interactions even while walking to the dining room, dressing or bathing.
“Every interaction is an activity; everything you do with them,” she said. “When you’re helping someone get dressed, if that’s part of what they need, that’s an activity. Mealtime is an activity. It doesn’t have to be a constructive craft.”
Being there for the patient shifts their focus away from what they can no longer do, and redirects them to the present and what they can do.
“So instead of thinking about not being able to do something anymore, we point out and pay attention to the good things…the strengths and not the weaknesses,” Thompson said.
Though Thompson’s organization deals with people facing incurable diseases, she said it’s still possible to deliver positive messages because “knowledge is power,” she said. Her organization offers hope that while the disease can’t be cured, people can maintain their quality of life with the proper understanding, education and support systems in place.
“The person is still an intelligent, active member of society,” Thompson said. “What they’ve accomplished doesn’t go away. With education and proper support in place, that sets them up for success. Maybe things are changed, but they are just as valuable as they ever were; now they just have disease.”
To learn about the Alzheimer’s Association and its resources, go to www.alz.org. To call its 24/7 Hotline, dial 1-800-272-3900.
What is Alzheimer's Disease?
Alzheimer’s (AHLZ-high-merz) disease (AD) is an irreversible progressive brain disease that destroys brain cells and slowly destroys memory and thinking skills and eventually even the ability to carry out the simplest tasks. In most people with AD, symptoms first appear after age 60.
AD is named after Dr. Alois Alzheimer who, in 1906, noticed changes in the brain tissue of a woman who had died of an unusual mental illness, according to the National Institute of Aging, the lead agency for AD research at the National Institutes of Health. Her symptoms included memory loss, language problems and unpredictable behavior. Over the past few decades, Alzheimer’s disease (AD) has emerged from obscurity. Once considered a rare disorder, it is now seen as a major public health problem that has a severe impact on millions of older Americans and their families and is the most common form of dementia.
Age is the number one risk factor for Alzheimer’s disease (AD). One in eight people over the age of 65 years has AD and almost half of those over age 85 are affected. Today, 35.6 million people are living with Alzheimer’s and dementia; by 2030, that number is expected to double. A new case of dementia occurs every seven seconds.
Alzheimer’s is not a normal part of aging; it gets worse over time and it is fatal. Today it is the sixth-leading cause of death in the United States. There is currently no cure for Alzheimer’s, but new treatments are on the horizon as a result of accelerating insight into the biology of the disease. Research has also shown that effective care and support can improve quality of life for individuals and their caregivers over the course of the disease from diagnosis to the end of life.
—Sources: Minnesota Department of Health, the 2009 World Alzheimer Report
and the Alzheimer’s Association
Alzheimer’s 10 warning signs
1. Memory loss that disrupts daily life
2. Challenges in planning or solving problems
3. Difficulty completing familiar tasks at home, work, or leisure
4. Confusion with time or place
5. Trouble understanding visual images and spatial relationships
6. New problems with words in speaking or writing
7. Misplacing things and losing the ability to retrace steps
8. Decreased or poor judgment
9. Withdrawal from work or social activities
10. Changes in mood and personality
The difference between Alzheimer’s and typical age-related changes
Signs of Alzheimer’s Typical age-related changes
Poor judgment and decision-making Making a bad decision once in a while
Inability to manage a budget Missing a monthly payment
Losing track of the date or season Forgetting which day it is and remembering later
Difficulty having a conversation Sometimes forgetting which word to use
Misplacing things and being unable
to retrace steps to find them Losing things from time to time
Source: Minnesota-North Dakota Chapter, Alzheimer’s Association
