Map of life expectancy at birth from Global Education Project.

Tuesday, August 14, 2007

Nothing to be done?

Denise Grady in the NYT today wants us to go back to the summer of love and just go with the flow when it comes to our relatives with Alzheimer's disease. While I'm sure that's good advice as far as it goes, it's hardly a solution. People with dementia eventually become unable to manage activities of daily living, they become incontinent of urine and feces, they may engage in dangerous or offensive behavior, and ultimately it becomes, in most cases, impossible to care for them at home no matter how profound your spiritual enlightenment and they end up in nursing homes consuming family fortunes at the rate of $10,000 a month until everything is gone, whereupon they perform the same disappearing act on the taxpayers.

And yes, I'm talking about my own father (who actually, I believe, is properly diagnosed with frontotemporal dementia, but it doesn't matter) and it could be any of us some day. Half of all people over age 85 have Alzheimer's disease. Not all of them live long enough to end up in a state of total dependency, but everyone who does live for 8 years or so will.

So why haven't I written about this more? Basically because there isn't a whole lot to say about it. There you are. It's a big problem, that's just going to keep getting worse. Not only is there no cure or preventive measure in sight, we still don't even understand the etiology. Drug companies are working feverishly on the problem, but mostly in order to steal our money. They're hoping to find more drugs like Aricept and Nimenda, that do little or nothing but because they might do just a little something for somebody, desperate people are willing to pay a lot for them. They don't have any ideas for anything that will actually work.

I wish I could say it's all Karl Rove's fault, but he's in the clear on this one. Single payer health care won't help even a little bit, if it's modeled on Medicare, because Medicare does not provide coverage for long-term care. People with dementia have to pay out of pocket until they are flat broke, and then Medicaid takes over. Medicare or universal single payer coverage for long-term care would spread the burden more equitably, but it wouldn't reduce the total burden on society.

Even physician assisted suicide doesn't help because you have to be competent for that. My friend suggested that I take out a contract on myself with the mafia, to be executed only if I become demented, but they're criminals -- they'd just pocket the money and not bother to shoot me. Why take the chance? What am I going to do about it?

So that's it. This train is coming and it's going to run us all over. By 2050, something like 15 million Americans with the disease. I wish I had something useful to say but I don't. I'm stumped. We're stuck with this.

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