Aging population challenges Alzheimer’s caregivers

Rabbi Richard Address

By Carol Wolf Solomon, Special to the Jewish Light

With every member of the baby-boom generation now past the age of 50, the need to shed the stigma and develop a Jewish communal response to Alzheimer’s disease takes on an even greater sense of urgency. Statistics released by the Alzheimer’s Association are eye-opening:

• One in nine people age 65 and older has Alzheimer’s disease.

• Alzheimer’s is the sixth leading cause of death, killing more people than breast cancer and prostate cancer combined.

• One in three seniors dies of Alzheimer’s disease or another dementia.

• In 2015, more than 15 million caregivers provided 18.1 billion hours of unpaid care.

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• Family caregivers spend more than $5,000 per year caring for someone with Alzheimer’s disease.

• In 2016, Alzheimer’s disease and other dementias will cost the U.S. $236 billion.

The St. Louis Chapter of the Alzheimer’s Association and the St. Louis Rabbinical Association partnered recently to begin the community conversation by presenting “Shedding Light on Alzheimer’s: A Jewish Perspective.” More than 120 people attended the three-hour June 5 program hosted by the Jewish Community Center. The event brought together congregational rabbis, community chaplains, professionals and synagogue caring community teams, as well as individuals and families affected by Alzheimer’s disease.

The program featured two speakers: Dr. George Grossberg of St. Louis University School of Medicine, who addressed the medical aspects of Alzheimer’s disease and other forms of dementia; and Rabbi Richard Address, founder and director of Jewish Sacred Aging, who focused on the Jewish and spiritual dimensions of the disease.

Grossberg, the Samuel W. Fordyce Professor and Director of the Division of Geriatric Psychiatry at SLU’s School of Medicine,  discussed “healthy and successful brain aging to prevent Alzheimer’s disease.” He said that while some risk factors, such as age, family history and certain genetic mutations, are beyond our control,  others, such as  hypertension, high cholesterol, diabetes and depression, can be addressed. Additional modifiable risks, he said, include head trauma; elevated homocysteine levels, which contribute to heart and blood vessel disease; and vitamin B6, B12 and folate deficiencies. 

Alcohol consumption, Grossberg said, can be both a protective and a risk factor. Moderate alcohol consumption has been shown to play a protective role in brain health and can lower the risk of dementia, he said. Heavy consumption, however, can increase risk, and any alcohol consumption by people who already display signs of cognitive and memory impairment can be harmful.

Grossberg said people can take steps to promote healthy brain aging and prevent Alzheimer’s, such as taking antioxidant vitamins such as vitamin E, nonsteroidal anti-inflammatory drug (NSAID) therapy, daily consumption of fish and omega 3 fatty acids, and following a Mediterranean diet that focuses on eating fruits and vegetables, whole grains, legumes and nuts. This diet also promotes the use of healthy fats, such as olive oil, and limits the consumption of red meat. 

Coffee lovers who drink one to two cups a day can lower the risk of Alzheimer’s, Grossberg said, although heavier amounts of caffeine can be harmful and cause heart arrhythmia.

One of the best ways to promote healthy brain aging, he said, is to stay active — physically, mentally, socially and spiritually. 

“Physical activity reduces the risk of vascular dementia,” he said. “Mental activity challenges the brain.” 

Examples of great mental exercise include learning new things, such as a foreign language, a musical instrument or even a card game. Reading challenging material is also good. Even something as simple as occasionally using one’s nondominant hand to perform a routine task can challenge the brain. 

Social activity helps to prevent depression, which is a risk factor for Alzheimer’s disease. Staying socially engaged also can slow the progression of the disease in those who already have it.

Finally, Grossberg said that in people for whom religion and/or spiritual belief has previously played an active role, maintaining these rituals and connections in later life, even in those with cognitive impairment, can have be healing and calming. This is why the role of faith communities is so important, he said.

Rabbi Address said the link between the medical and spiritual sides of Alzheimer’s disease is timely. Moses Maimonides, the great 12th century Jewish physician and philosopher, adhered to the same philosophy of treating patients that Grossberg presented, preaching the importance of movement, diet, and intellectual and spiritual growth.

Shedding light on Alzheimer’s represents a traditional Jewish image of the sacred divine spark, Address said. Those who are walking the path of Alzheimer’s disease ask, “Where is the light, the spark of our loved one?”

Address maintained that a discussion of Alzheimer’s from a Jewish perspective is about “light, soul, dignity, sanctity and ultimately love.” 

In a Talmudic discussion of the commandment to honor and respect one’s parents, dignity is an underlying value, he said.

“We cannot undermine dignity,” Address said. 

Alzheimer’s, aging and mental health have become big topics in Jewish life this year, Address said. Requests for pastoral counseling on these issues continue to grow. With the aging of the baby-boom generation, there won’t be enough geriatric doctors and caregivers to meet the demand. 

“This subject will be the most important social justice issue for most of us,” he said. “Loneliness and isolation are important issues for congregations to deal with.” 

To complicate matters, he said, many elderly people are no longer affiliated with congregations for a variety of reasons. 

Address made special mention of the role of family members as caregivers. 

“It’s personal,” he said. “It is an art, and it can provide unexpected moments of spiritual meaning.” 

Given the length of Alzheimer’s disease, multiple generations often are affected, Address said, acknowledging the tension and struggle that families face in trying to respect the dignity and sanctity of loved ones while ensuring their welfare and safety. 

He stressed the importance of families developing care plans and having frank discussions with parents on end-of-life issues.

Congregational caring communities should host at least one annual program to provide families with information and resources they need to help make these decisions, he said. Alzheimer’s is a lengthy disease, and people are looking for guidance on issues ranging from finances and legal matters to medical and care options. 

Address observed that while Jewish tradition has legal terms for boundaries relating to when life is about to end, we might need to develop a new vocabulary for illnesses like Alzheimer’s. He pointed out that in Judaism we pray for healing, as opposed to a cure. In this context, he provided examples of some new versions of the MiShebeirach prayer for healing that have been written expressly for those with dementia, mental illness and chronic illness, as well as for caregivers.

After the presentations, participants attended breakout sessions. Address led a session for congregational care teams, while Grossberg fielded questions on medical and health issues related to Alzheimer’s disease. 

In speaking with clergy and care team members, Address emphasized the importance of providing training and ongoing support for volunteers who are visiting individuals with Alzheimer’s. He also stressed the need to provide support and services to family members and caregivers. 

The event was chaired by Marsha Grazman, a faith ambassador for the Alzheimer’s Association, and was funded, in part, by a grant from the Jewish Women’s Auxiliary Foundation for Jewish Aged administered by the Jewish Federation of St. Louis. 

 

The Alzheimer’s Association maintains a 24-hour help line that can be reached at 800-272-3900 or [email protected]