816 North

Memory-care centers develop specialized treatments to slow Alzheimer’s disease

Daylin Airington (upper right), wellness coordinator for Stratford Commons, helps residents with their artwork during a water-painting session April 20. Stratford Commons uses brain-fitness therapy to care for residents with Alzheimer’s.
Daylin Airington (upper right), wellness coordinator for Stratford Commons, helps residents with their artwork during a water-painting session April 20. Stratford Commons uses brain-fitness therapy to care for residents with Alzheimer’s. skeyser@kcstar.com

As the number of baby boomers approaching or passing age 65 grows, so do fears about who among them will lose their mental faculties to Alzheimer’s disease.

Marcia Hines, who manages community relations for the Alzheimer’s facility Wexford Place in the Northland, understands the anxiety. Some say it now equals or even exceeds that for cancer.

“When you forget somebody’s name, let’s say, are you getting Alzheimer’s, or is that just a symptom of you being in your 60s?” Hines said. “That worry’s especially true if there’s a history of Alzheimer’s in the family.”

It’s what led Wexford Place and Stratford Commons Memory Care Community, an Overland Park facility, to pursue specialized Alzheimer’s care. The facilities are similar in size — each with room for about 45 patients — and each receives educational support from the Alzheimer’s Association of Kansas City and the University of Kansas Alzheimer’s Disease Center in Fairway.

After starting with its pilot program in 2011, Stratford Commons converted what had been an assisted-care facility into a memory-care unit in 2013. Laura Tenpenny, its executive director, said the facility replaced outmoded treatment practices for Alzheimer’s patients with research-based methods.

For example, anyone who has contact with patients at Stratford, from the receptionist to food-service employees to skilled nurses, knows to see life from the patients’ point of view, rather than argue with or scold them when memory loss distorts their perceptions.

“That’s allowed us to focus on them and an individual’s needs,” Tenpenny said. “Sometimes they’re on target, sometimes they’re not.”

Like Wexford Place and other memory-care facilities, Stratford Commons uses specialized training for employees based on the latest research at KU and elsewhere.

“The training for a memory-care person isn’t the same as for a residential-care person,” said Meda Green, who serves as a liaison between Stratford and families who seek care for a relative.

Since there is no available cure for Alzheimer’s, the goal of memory-care centers is to incorporate research findings for treatment into strategies for possible prevention.

“I think we need to increase the actions for prevention and then quell the fears, so we’re researching right along with Dr. (Jeffrey) Burns,” Hines said.

Burns, a neurologist and researcher, is co-director of the University of Kansas Alzheimer’s Disease Center. He spoke at Wexford Place in March, where he discussed the advances made in diagnosing Alzheimer’s, treating it and ultimately finding a cure.

Stratford Commons is working to arrange a similar speaking engagement for Burns.

KU’s scientific findings on the benefits of exercise and diet — particularly exercise — have been put into practice at both memory-care facilities. They’re seen as a way to slow Alzheimer’s progression once it begins, and maybe even prevent it.

In his talk at Wexford, Burns said that diet, especially the Mediterranean diet, and aerobic exercise can slow the rate at which Alzheimer’s impairs the brain. Researchers are also studying whether a combination of diet and exercise might prevent Alzheimer’s in some people.

Marsha Rufener, executive director at Wexford, said the facility is experimenting with merging facets of the Mediterranean diet, which is heavy on fruits, vegetables, olive oil, fish and lean meats, with its current menu for residents.

Both Wexford and Stratford advocate exercise and movement in daily routines for patients who are in the early and middle stages of Alzheimer’s.

“Anything that’s healthy for the heart is helpful for your brain,” Green said.

Exercising the brain is as important as exercising the body, says Johnna Lowther, who oversees Stratford Commons and other senior facilities for Tutera, a Kansas City-based company.

“We’re trying to exercise the part of the brain that’s still working,” Lowther said of brain-fitness programs and other therapies Stratford uses.

Advances made in caring for Alzheimer’s patients are the result of a growing body of data provided by the KU center and other researchers.

“I think it’s just exploded,” Rufener said. “People are talking more now, and the more we learn about the unique needs of people with Alzheimer’s, the more we can provide memory services for them.”

Burns mixes realism and optimism in evaluating the current state of Alzheimer’s treatment and pursuit of a cure.

“When we started, we were just talking about it,” Burns said. “Now we’re studying it.”

KU has around 75 research projects and patient trials underway, he said. The findings will eventually be published and disseminated to memory-care facilities, which can then incorporate them into patient care.

“We are seeing this huge diversity of approaches in studying this,” Burns said. “I really think this is an optimistic time in the study of Alzheimer’s.”

But significant hurdles remain in treatment and finding a cure, Burns said.

Alzheimer’s is a progressive disease that physically shrinks the brain, attacks its memory center and gradually impairs a person’s ability to function. Death results once a patient’s brain and body cease to communicate.

There has been progress, Burns says. It wasn’t long ago that neurologists were saying Alzheimer’s couldn’t definitively be diagnosed without an autopsy. But thanks to mental acuity tests, brain scans and patient histories, that’s no longer the case.

“We can diagnose Alzheimer’s disease accurately and early,” Burns said. “And we can treat it; however, we can’t stop it or cure it.”

Doctors currently diagnose Alzheimer’s through blood tests, a description of a patient’s behavior (usually things such as memory loss, confusion in completing tasks and misplacing things), and an in-office mental screening (involving naming dates, the current president’s name, etc.). It’s a process of elimination that concludes with a brain scan.

The scans help doctors eliminate other potential causes of memory loss, such as vascular disease, strokes or brain injuries.

Burns said the patient history is often provided by the patient’s family.

“If someone has memory problems, they may not be able to give us a good history,” he said.

Burns said the inability to recall words and names, as well as problems performing complex daily tasks, are red flags in the initial diagnosis.

For example, a person who has executed complicated tasks in the past — cooking Thanksgiving dinner, for example — but gradually finds them overwhelming may be in the early stages of Alzheimer’s.

There are drugs that doctors can prescribe to treat symptoms. Donepezil, an inhibitor first marketed around 30 years ago, and memantine are often used separately or in tandem, Burns said, depending on the disease’s progression.

“The impact they have is not enough, but it is helpful,” Burns said. “The effect of one of those inhibitors is not a big boost, but a flattening of (mental) decline and a slower progression.”

It’s typical for a patient’s symptoms to remain stable for about a year once an inhibitor is prescribed, Burns said. But they may potentially experience “a slower decline in a later stage.”

Current trials target the production of amyloids — the substance that clumps and actually interferes with brain functions — and the production of tau, the so-called “tangles” that further disrupt the brain’s ability to communicate.

“We are now actively testing drugs that block the development of amyloids in the brain and are working on removal of amyloids from the brain,” Burns said. “The field is moving way beyond the amyloids now. I couldn’t say that 15 years ago.”

That’s good news for Stratford Commons, Wexford Place and other memory-care facilities.

“That’s what’s so exciting about this,” Hines said. “They’re now at a point that they have enough data and want to start sharing it with the community.”

Learn more about Alzheimer’s

▪ Alzheimer’s Association of Kansas City, 913-831-3888, www.alz.org.

▪ KU Alzheimer’s Disease Center, 913-588-0555, www.kualzheimer.org.

▪ health.mo.gov/seniors/nursinghomes/pdf/AlzheimersFacilityReport.pdf

Cost of services

According to the website www.alzheimers.net, the price of memory care “varies widely depending on location, care required, size of the resident’s living space and the level of luxury at the community. The price of memory care in Kansas City ranges from $3,500 to $7,000 a month.”