“The Forgetting: A Portrait of Alzheimer’s!”

“The Forgetting: A Portrait of Alzheimer’s” is a 2003 Public Broadcasting Service Documentary that was patterned after a book by David Shenk by the same title. The made-for-television special portrays the entire spectrum of Alzheimer’s history from the ancient legends of demented folklore to its original diagnosis in 1903 by Dr. Eloise Alzheimer and on to the cutting edge of Alzheimer’s research today.  I highly reccommend this series for all who are interested in Alzheimer and is available on youtube.com. I will focus my reflection upon this relentless disease and how it will impact in the future my work as a hospice and/or hospital chaplain.

Alzheimer’s can be separated into two broad categories: early-onset Alzheimer’s and old-age Alzheimer’s. Behaviorally, early-onset Alzheimer’s can be defined as dementia that begins prior to the seventieth birthday, and conversely, old-age Alzheimer’s is everything else. Clinically, all forms of Alzheimer’s are caused from the interruption of synapse (electrical brain connections) secondary to the accumulation of plaque (starchy deposits). This interruption ultimately results in the death and shrinkage of brain tissue. Of the two, early-onset Alzheimer’s is more aggressive and the progress from diagnosis from onset to death can be very rapid (<5 yrs.), while old-age Alzheimer’s takes much longer (13-20 yrs).

In 1987 Alzheimer’s was already considered epidemic with 500,000 living with the disease in the United States alone. By 2002 the ranks of those diagnosed with Alzheimer’s were well over 5 million people (more than 10 times). While this number is alarming, it should not be construed to be spreading to new populations. Rather consider this: in 1980 there were 2,250 people in the United States that were over 100 years old. In the year 2000 that number had swollen to 250,000 people over 100 years old (also more than 10 times). This fact is solely responsible for the increase in the vast number of those diagnosed with Alzheimer’s, because the increase is in the old-age Alzheimer’s category.

Ten percent of all 75-year-old Americans have Alzheimer’s. The number is a little harder to determine (due to other forms of dementia being present as well) in Americans that reach the age of 85. However, studies show a range between 25 and 47% of all 85-year-old Americans as having Alzheimer’s. Due to advances in other areas of health care, more and more people are living to such a ripe, old age, and therefore the number of Alzheimer’s patients continues to grow. This growth is at an unprecedented cost to Americans with 100 billion dollars being spent in 2002 for the treatment and care of Alzheimer’s patients alone. With baby boomers soon to reach ‘old-age,’ the number of Alzheimer’s patients is expected to multiply by 10 again, reaching 25 million by 2030. By this time the cost of treatment and care for Alzheimer’s will be larger than the United States government’s entire annual budget. It is obvious that something must be done, and research is at a furious pace, with many new breakthroughs in recent years.

While praying for a cure and/or an effective treatment for the disease is prudent, there is little doubt that there is (and will be increasingly so) a great need for chaplains who will be willing, prepared, and qualified to provide spiritual care to those demented patients walking in the shadows of their old age.