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Alzheimer’s Care and Treatment: "Still Alice" Shows Why We Cannot Cling to the Status Quo

- Thursday, March 05, 2015

We have only seen the tip of the Alzheimer’s iceberg.

Yes, Julianne Moore’s Oscar-winning performance in Still Alice marked a triumph in the struggle to raise awareness about Alzheimer’s. Yes, the 54-year-old actress who based her portrayal on a real-life person with Alzheimer’s acknowledged the hopes and dreams of millions in her acceptance speech: “So many people with this disease feel isolated and marginalized. And one of the wonderful things about movies is it makes us feel seen and not alone.”

Yet Still Alice only tells half the story. Left unchecked, Alzheimer’s is poised to become the social and fiscal nightmare of the 21st century. Alzheimer’s will wreck us collectively just as it wrecks Alice individually if all we do is cling to the status quo.

Here’s why: Within the next two decades, rates of Alzheimer’s will double. They’ll double again by midcentury. Considering the disease already consumes a breathtaking $604 billion annually – roughly 1 percent of global GDP – there is ample reason to worry about what the future holds.

While the extraordinary Moore in Still Alice has opened a broad window on how individuals and families struggle with Alzheimer’s, there remain plenty of dark corners.

Here are three overlooked and under-recognized aspects of Alzheimer’s:

1: The ‘miracle of longevity’ often comes with a terrible cost

One in every eight people over age 65 has some form of dementia, it is estimated. In the over-85 segment, it’s nearly one in every two. In times past, we didn’t have to worry about this very much because people died younger and dementia was an isolated problem.

In this era of population aging, this is no longer the case. Over the past century, the average life span has increased by an incredible 30 years, and with this longevity we have seen a parallel increase in Alzheimer’s.

Looking ahead, we cannot afford to continue to fight this disease only half-heartedly. Life expectancies will keep rising, most dramatically in poorer countries with inadequate health care infrastructure – and we must find better ways to deal with Alzheimer’s.  This is truly a global problem that requires a global solution.

2: Prevention may be the best treatment

Despite the impressive work being done by neurologists, geriatricians, private industry and other experts, we are still virtually in the dark ages with Alzheimer’s and remain woefully far from a “cure.” Yes, there are some promising therapies in development that could help alleviate the disease’s symptoms, but perhaps the first breakthrough may be in prevention, not treatment.

This is a radical break from how we have traditionally managed diseases.

Instead of treating the sickness, perhaps with Alzheimer’s Disease we need to focus on preventing it from arising in the first place. There’s no cliché more tired than “shift the paradigm” – but that’s exactly the case here. The paradigm needs to move so that it encompasses both treatment and prevention.

3: We need better and more efficient Alzheimer's care

Given the nature of Alzheimer’s, families can find the burden of providing round-the-clock care crushing. Not only do caregivers – most often the daughter or the aging spouse – become consumed with this new full-time job, they run into their own health and financial problems. As those with Alzheimer’s transition from healthy to the point of requiring full-time care, there is a years-long period of life filled with caregiver anxiety and decreasing independence.

Here, another paradigm shift is needed. In the U.S. we often ship off Grandma to a “home” with Jell-O desserts and adjustable beds. But as the number of seniors requiring care increases exponentially, this model no longer works. The costs are suffocating both for families and societies. And the much of the care is undesirable. Home care is catching on because of its personalized, dignified, familial approach, although it, too, has its challenges, as any caregiver knows.

One cannot fault Still Alice for failing to cover the full expanse of problems triggered by Alzheimer’s. Yet let’s hope Hollywood will do for Alzheimer’s what it has done for cancer and AIDS. Art is a magnificent tool to educate and provoke – let’s hope Alzheimer’s becomes a new subject of artistic study. Let’s hope we look back at Still Alice in 20 years as we look back on Philadelphia today.

For more information on Alzheimer’s care, contact Spring Arbor.