November is Alzheimer’s Awareness Month and experts recommend a hard conversation

Nov. 24--November is National Alzheimer's Disease Awareness Month, and as families come together for the winter holidays, many experts say it's the perfect time to talk about end-of-life wishes.

Alzheimer's affects an estimated 5.4 million Americans, according to the Centers for Disease Control and Prevention, making it the sixth leading cause of death among adults. Symptoms of the irreversible, progressive brain disease typically don't occur before the age of 60, but can present themselves unexpectedly much sooner.

It's characterized by the destruction of brain function, including loss of memory, language difficulty, confusion and depression ­­-- which is one of the reasons it's important to have medical and end-of-life care conversations with loved ones early on.

"The biggest thing is to talk about it. It's not always a comfortable conversation, which is why it's important to talk about it before something happens," Barbara Morrow, vice president for long-term care at Samaritan's Summit Village, said of planning for one's final years. "Get a financial plan when you're not under stress, not after."

She also believes in designated health care proxies, filling out Medical Orders for Life Sustaining Treatments and getting one's wishes down on paper, even if it doesn't feel pressing.

Dr. Gary R. Berk, chairman of family practice at Canton-Potsdam Hospital, recommended designating someone to have the legal right to make decisions on the aging person's behalf.

"The job of a health care proxy is to put themselves in the shoes of the sick person and try to make the decision the sick person would if they were of full mind," Dr. Berk explained in September.

The CDC found that Americans fear the loss of their mental capabilities twice as much as the loss of physical abilities. In 2017, total payments for health care, long-term care and hospice for people with Alzheimer's and other dementias are estimated to be $259 billion.

While only a third of adults have completed written advance directives that spell out wishes for care or designate a health care proxy, research shows advance care planning increases the chance that a person's medical and end-of-life wishes will be fulfilled.

"The more planning you do before you're in crisis, the better," Andrea M. Montgomery, St. Lawrence County's Office for the Aging director, told The Times in September. "A lot of times, people don't think about end-of-life care until a catastrophe has happened and someone's in the hospital. Then it's difficult because you're already dealing with your loved one being ill."

Besides advanced care planning, choosing a power of attorney, having a will in place and pre-planning your funeral are other tasks that can be handled before a crisis hits, Mrs. Montgomery said.

Keeping insurance policies, wills and other paperwork in an organized file is also important.

The good news this month, beyond good food and family, is that advances are being made against Alzheimer's and other degenerative disease. While there is still no cure, a new, simpler blood test was developed this year to detect the disease early on, and research has found growing evidence that a healthy lifestyle including diet and exercise might reduce one's risk of ever developing Alzheimer's.

There's no easy way to talk about aging and death, but there are several online resources to start the conversation. Aging With Dignity offers an easy "Five Wishes" planning template, while The Conversation Project has starter kits for getting the talk going.

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