Last week, I raised a concern that new emerging approaches to the social and psychological aspects of medical care and treatment do not receive the funding or attention they deserve. I discussed how areas of alternative medicine seem to be ignored among the billions that the drug companies invest in the world's quest for cures. Many believe it is because pharmaceutical companies cannot commodify such treatments.
One promising new study I mentioned explored how music therapy has shown positive results in improving depression and anxiety in dementia patients. Such studies point to a vital area of research. Alzheimer's disease and other dementias are the nation's top cause of disabilities in later life. According to the website Disabled World, in 2017, Alzheimer's alone cost the United States $259 billion. It is the most common and well-known form of dementia. More than 5 million Americans are living with Alzheimer's. Without a major medical breakthrough in the fight against dementia, as many as 84 million Americans could have age-related memory loss by 2040.
As uncomfortable as it is to talk about this subject, it is important we look at these emerging areas of care and treatment. We need to know about this work and get behind it and support it.
One such program of note was recently begun in a care facility in Switzerland. It started with a patient in the later stages of dementia who was shown a series of carefully selected photographs curated over the span of three years. After viewing them, the patient was asked to comment on them. As noted in a CNN report, for 10 minutes the patient sat there hardly saying a word, though one picture in particular seemed to have stirred a reaction. Then something miraculous happened.
"He was able to speak for five minutes in a row," Laurence Aegerter, a French visual artist based in Amsterdam, told CNN. "That image triggered something very deep in him, a very deep memory that made him feel so strong. In those minutes, it was like he had no disease at all."
This patient, as well as others at this facility, is part of the early stages of what Aegerter calls "Photographic Treatment." The intention is to see whether the quality of life of elderly people with dementia can be improved by staging "photo interventions." Researchers believe that this experiment prompts a reminiscence bump, connecting an individual with a memory from his or her childhood or early adolescence.
According to Ruth Drew, director of information and support services at the Alzheimer's Association, when trying to engage and connect with those who have dementia, asking questions based on recollection often sets them up for failure because of their loss of short-term memory. Such failure has been shown to increase stress levels and decrease the overall well-being of those with dementia. According to the Alzheimer's Association, in addition to the disease they struggle with, as many as 40 percent of patients also struggle with significant depression.
"Using these photographs may also help the person who wants to connect with a family member with Alzheimer's to have a jumping-off point that can help engage that person," Drew told CNN. The result of such connections helps the person feel much happier and healthier.
In an unrelated program in the Netherlands, another unorthodox approach to dementia is being pioneered. Rather than rely on the old prescription of bed rest, medication and, in some cases, physical restraints, doctors are attempting to harness the power of relaxation, childhood memories, sensory aids, soothing music, family structure and other tools to heal, calm and nurture residents, many in advanced stages of the disease.
Rather than treat them like patients in a hospital, the facility offers what are called snoezelen rooms. These rooms, now found in many care facilities in the Netherlands, feature light, aroma, massage and sound therapies. They are designed to allow patients to relax and access emotions that are often blocked in stressful clinical settings.
According to a New York Times report, patient rooms are decorated with books, rotary telephones and 50-pound typewriters — signposts to a past they can reconnect with. Patients are encouraged to view these rooms as their own domain. In the fight against depression and passivity, which are often symptoms of the condition, caregivers also try to stimulate residents by replicating the little things that make a life normal, done in a controlled, clinical environment.
Neuropsychologist Erik Scherder, one of the best-known dementia care specialists in the Netherlands, told the Times that the more stress is reduced the better. "If you can lower stress and discomfort, it has a direct physiological effect," he said.
Though many would agree with such conclusions, lacking are major scientific studies that support the effectiveness of this approach. The fact that patients need less medication and exhibit fewer incidents in which physical restraints are required with the newer techniques is considered merely observational rather than the result of rigorous scientific analysis. Such studies are costly.
"The idea is to challenge the patient a bit in a positive way," said Scherder. "Leaving them in the chair, passive, (makes) the disease progress much faster."
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