- The Washington Times - Tuesday, December 17, 2002

Lu Corbett Daly, 77, a mother of eight, used to be vibrant and full of the finest humor. But she, along with 4 million other Americans, is afflicted with Alzheimer's disease, a condition so debilitating it robs a patient not only of memory, sight and mobility, but even personality.
"It's a cruel disease in the sense that she can't enjoy the fruits of her labor," says her husband of more than 50 years, John Jay Daly, 74. "She raised eight children, picked them up when they fell on their bikes, comforted them when they broke up with their girlfriends and boyfriends. But she can't bask in their successes now."
Mrs. Daly, who was diagnosed in 1995, is in the late stages of Alzheimer's disease, and nothing that researchers and doctors can come up with pharmaceutically and therapeutically will help her.
However, there is good news on the horizon for future Alzheimer's patients, says Dr. Gene Cohen, director of George Washington University's Center on Aging, Health and Humanities.
"Probably the most encouraging is the increased understanding of what is going wrong in the brain when somebody gets Alzheimer's," Dr. Cohen says.
The brain of a patient with Alzheimer's experiences a loss of nerve cells and lower-than-normal levels of chemicals that carry messages between nerve cells. It also has plaque buildup.
Scientists are trying to produce a vaccine that will neutralize that buildup of plaque.
"I think it will take five to 10 years to find something that will change the course of the disease, possibly delaying it [substantially] without causing major side effects," Dr. Cohen says.

Every few weeks, or months, families of Alzheimer's patients can read in newspapers or on Internet sites about the latest promising Alzheimer's treatment.
One month it's vitamin E; another it's folic acid. Also, several pharmaceutical companies sell drugs that the companies claim delay the onset of the disease.
Dr. Cohen says the fact that most research on these treatments point to a six-month delay no more, no less may indicate that none of them is very effective.
"With so many of these having a similar time frame, you have to ask: Is it an impact of the treatment, or is it a type of placebo effect?" he says.
One of the therapeutic treatments Dr. Cohen believes may work is keeping the mind stimulated through intellectual endeavors. The idea is that the chemical connections become strengthened when the intellect is stimulated.
"It may not prevent Alzheimer's, but in people who are vulnerable to the disease, it may delay the onset," he says.
While the ultimate goal is to find a cure, the next generation of drugs is likely just to slow the progression, Dr. Cohen says. It may not sound like a major breakthrough, but it can make a big difference for patients and loved ones.
"They may die of other causes," Dr. Cohen says. "It may decrease the risk of institutionalization. It may be more sudden."

Patients can live with Alzheimer's from three to about 20 years. The death certificate usually says aspiration or pneumonia.
The prolonged nature of the condition can be a heavy burden for family members, Dr. Cohen says.
It took Mr. Daly several years of caring for his wife at home to realize that it was too much for him. During the home care, he received some help from his children, especially Maura Daly, 46, who took a year's leave of absence from work to help.
Eventually, Mrs. Daly had to move into the Auxiliary House in Bethesda, which is devoted to Alzheimer's patients, with around-the-clock care.
She has her own room, decorated and furnished with her own things:
A pillow is stitched with "Lu and Johnny, Good and Gold, 50," commemorating the Dalys' 50th wedding anniversary. A photo collage of Lu Daly and Audrey Hepburn (there is a striking resemblance between the two) adorns one of the walls a headline asks the viewer to "pick pic that's not Lu."
It is not uncommon for spouses or other family members to do too much for the loved one, at the expense of their own health.
"We often call them the 'second patient,'" Dr. Cohen says. "They have a higher frequency of illnesses and medical visits than others in their age group."
Because the disease can last such a long time, it's important for the family to become as informed as possible at the early stages of the condition, when the patient may still be able to make certain choices.
"It's important for the family to recognize that it is going to progress over time," Dr. Cohen says.
Mrs. Daly, who worked as a copywriter for National Geographic in the 1980s and 1990s, started showing signs of Alzheimer's several years before her diagnosis, indicating that the disease progressed slowly in the beginning.
"She would drive to work and then come home on the Metro, forgetting that she had taken the car to work," says Deirdre Daly, 48, the second of the Dalys' eight children.
Also, in the early 1990s, her mother, who had prepared turkey for many a Thanksgiving dinner, suddenly forgot how to do it.
"In retrospect, there were signs all over the place," Mr. Daly says.
When the signs are there and they should be confirmed by a doctor because they can be indicative of other conditions it's time to start planning for the future.
"The family will need good legal and financial advice. They will have to look into what kind of care they might need and find out what services are available in the community," Dr. Cohen says.

After the patient is taken care of, the spouse and other family members may need some help, too.
Mr. Daly joined a support group at Iona Senior Services in Northwest.
"You always learn something when you're there," he says.
A fellow support-group member, 95-year-old Bert Tracy, says a feeling of understanding and empathy fills the room at support meetings. Mr. Tracy's wife receives care in a nursing home.
"I come for the camaraderie," he says.
Five members who attended a meeting one recent afternoon seemed to have a special connection. They laughed more than they cried as they told the others of their experiences with their Alzheimer's-stricken spouses.
"Whenever we can, we look for humor," Mr. Daly says. "You have to. Otherwise, you would cry all the time."
It's difficult to find a silver lining to the condition, he says. Mr. Daly remembers, as if it were yesterday, how he and his wife met, but she can't share that memory.
"Lu and I met in a typical corny Catholic way" at a church play, Mr. Daly says. Lu, his "Doll Baby," was playing the lead.
Five decades of hard work followed for the Dalys. They raised a family and worked full time. "She was so busy in the '50s and '60s, she used to say that she completely missed Elvis," Mr. Daly says. "She was too busy changing diapers."
She can't share that memory, either. She is in the room, but she isn't.
If nothing else, Alzheimer's forces family members to become more introspective, Mr. Daly says while holding his wife's hand.
"You figure out what's important in life. At a wake, no one says, 'He should have spent more time in the office,'" Mr. Daly says.
"If I could have done it again, I would have cherished her even more."


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