DATE=2/13/04

TYPE=English Feature

NUMBER=7-38350

TITLE=Alzheimers Nurses

BYLINE=Tracy Samilton

TELEPHONE=260-1623 (Editor)

DATELINE=Ann Arbor, Michigan

EDITOR=Faith Lapidus

CONTENT=

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INTRO: More than four million Americans have the degenerative brain disorder known as Alzheimers, and the number is expected to grow as more Americans age. There is no cure for Alzheimer's, but it can be managed, especially with skilled nursing care. But, as Tracy Samilton reports, there are fears that the number of patients will soon outstrip the nurses.

TEXT: Alzheimer's is the most common of a group of cognitive disorders in the elderly known as dementias. People who develop Alzheimers have trouble remembering, planning, organizing and thinking. The symptoms always worsen over time. While there are now some drugs that slow the progression, there is no medication to reverse or cure Alzheimers. It's fatal, if the patient does not die of some other disease first. Most people with Alzheimers will eventually need 24-hour nursing care. It's a challenging field, because some of the patients show difficult behaviors like aggression or wandering and they often can't communicate their needs.

AUDIO: CUT 1 AMBI NURSING CENTER

TEXT: The Glacier Hills Nursing Center in Ann Arbor, Michigan is home to about 200 patients, including many with dementias. After working for nearly 20 years on the Alzheimer's wards, Debbie Priest says she's learned to find rewards in the smallest of gestures.

AUDIO: CUT 2 PRIEST

If you're talking with them, and you're feeding them or caring for them, you might see a glimpse, or something familiar, some relaxing of facial muscles, or they might grip your hand or something… something little that they do that they still know it's you, and that's your reward. It's still there. You have to look a little harder for it, but the patient is still there.

TEXT: Ms. Priest says above all else, people with Alzheimer's need to believe that they're in good hands and have faith in their nurses. Once that trust is there, she says, patients are much easier to deal with, for example when they want their nurses' attention immediately and can't get it. She says just because Alzheimer's patients get confused or lose control of their emotions, they are not children.

AUDIO: CUT 3 PRIEST

These are adults. These are adults who have very successfully maintained independent lives. This is not their choice to be here. They don't have the perception as we see it, and they might not have coping skills to handle large amounts of frustration, but they're not childlike and they shouldn't be treated as children. They know when they're being treated that way.

TEXT: Because it erodes the basic personality, Alzheimers disease is very difficult on the patient's family. Many Alzheimer's patients eventually forget even their own children or spouses. John Flozar says it was painful watching his strong, capable father decline.

AUDIO: CUT 4 FLOZAR

It's a real contrast to what you remember him as. I guess we look at our own mortality… is this what I'm going to be in 20, 25 years? It's a scary proposition.

TEXT: Alzheimer's patients can become hostile to their loved ones' attempts to care for them - or completely unresponsive to them. So nurses often find themselves providing education and emotional support for patients' family. Doreen Gifford is a manager at Glacier Hills. She says many families feel tremendous guilt over the need to place their loved one in a home.

AUDIO: CUT 5 GIFFORD

They're very worried about if their loved ones needs will be met when they leave the nursing home. We try to make them feel comfortable, to let them know we are an extension of them, so that when they leave they know that there's still someone like family caring for them.

TEXT: Half of all nursing home residents have Alzheimer's disease or a related disorder and caring for them requires a set of special of skills that is usually glossed over in nursing schools. Donna Algase is a faculty member at the University of Michigan School of Nursing.

AUDIO: CUT 6 ALGASE

People whose cognition is intact can still follow directions, direct their care, express their preferences, tell you what's not working or what is. People with dementia can't always do that, so you have to become a detective to find out what is needed.

TEXT: Professor Algase says it's time that Alzheimer's care became a recognized specialty of its own, and she's developed the nation's first nursing program focusing on dementia. For now, she says, the main challenge is convincing nursing students to consider Alzheimer's care as a career.

AUDIO: CUT 7 ALGASE

Many of the younger students entering nursing are not concerned about the problems of old age. They want to take care of mothers, babies, be in intensive care, fast-paced, exciting types of environments. They don't understand that 60% of the people they see in these kinds of environments other than labor and delivery - are older people.

TEXT: The University of Michigan Nursing School has set up a special support group for those students who are interested in caring for elderly patients, hoping their numbers will grow over time. Other nursing schools are also considering introducing Alzheimer's care programs. For the hardworking nurses at Glacier Hills, those extra hands can't come soon enough. For Coast to Coast, I'm Tracy Samilton, in Ann Arbor, Michigan.