The Best Of…Music Reduces Alzheimer’s Patients’ Agitation

Published August 19, 2002, Pawtucket Times

        After not being home for two years, I traveled to Dallas to visit my family and to celebrate my 88-year old father’s birthday party last week.

        My trip was a bittersweet experience for me as I reconnected with my parents and siblings.  It was great to spend time and catch up with everyone, but I saw firsthand how Alzheimer’s Disease had ravaged, both physically and mentally, my 80-year-old mother, and I saw the impact the disease had on my family.

        My mother, who is in the mid-to-late stage of Alzheimer’s was largely unaware of recent events or even to who I was.

         There was no recognition of my brother or sisters, and many times she did not even recognize my father, who has been her husband for the past 60 years.

         My mother could not tell time on her watch,was not aware of what day it was or even where she lived.

         Moreover, the staff warned me of my frequent mood swings and that she could get agitated very quickly.

         However, some say “music calms the savage beast.”

         That may be true, and it’s most certainly true for victims of Alzheimer’s disease — soothing music can reduce agitation.  While Alzheimer’s robs a person of their memory or cognitive abilities, a timeless tune can reduce agitation and can have calming positive effects on Alzheimer’s patients, too.  This point was driven home to me following my visit to my mother’s 28-bed Alzheimer’s unit at Dallas-base Marriott Brighton Gardens.

         On Friday afternoons, Carrie A. Johns of Blue Rose Entertainment keeps things hopping in the Alzheimer’s unit’s television room with her music therapy program.

        Popping CDs into a compact disc player, Johns plays a continuous string of popular tunes from the early 1900s to the 1960s.  That day, about 20 songs were played, ranging from golden oldies to country and western and Broadway tuns.

       Johns chooses from 8,000 songs in her CD collection, and she often selects songs during her one-and-a-half-hour program that reflect memorable happy periods in the residents’ lives.

       Johns, who raises Arabian horses on a 12-acre ranch in Mabank, Teaxa, has a client list of more than 500 nursing facilities, assisted living facilities and senior centers in the Dallas-Fort Worth metroplex region.

       Swaying, Johns sings the Andrews Sisters’ 1942 hit “The Boogie Woogie Bugle Boy of Company C” into her microphone, residents Rose Grimes, Helen Webb and Francis  Donathan dance up a storm with Ashina Jackson, a personal care assistant, big smiles lighting up all of their faces.

       “It is a joy to make these residents happy when their families are not here,” Jackson tells me.  “I like to see their expressions when they remember the tunes. It’s like I’m going back to their time.”

         To the beat of the 1920s tune “in’t She Sweet,” Activity Director Dave Mandt dances with my mother.

         She belts out the song remembering all the words, not even missing a beat.

          Jane Atobajeun, special care manager, says music helps to calm the residents down.  While residents with Alzheimer’s disease don’t remember recent events — what they ate for lunch, for instance — they will remember songs that were once popular in distant eras, since they can retain long-term memory.

       “Music makes them laugh,” adds Atobajeun, noting that it “touches their very being and also triggers me memories and emotions.”

       According to Atobajeun, throughout the day residents can get frustrated if they can’t remember things.

       But singing makes them very happy because they remember the words.  Dancing can also get the residents up and moving, she adds, noting that even wheelchair-bound residents are assisted to stand and move.

       Throughout the program my father and I traded off dancing with my mother.  Several times, my smiling mother goes up to the microphone, and dances with Johns.

       You guessed it — she automatically knows every word of the song.  When the music ends, I say goodbye to my mother.

       knowing the challenges she faces with Alzheimer’s, I at least know that there is a brief period of pleasure in her life — at least twice a week when she attends the Alzheimer’s unit’s music program.

        Herb Weiss is a Pawtucket-based freelance writer covering aging, health care and medical issues.  This article was published in the August 19, 2002 Pawtucket Times.

Many Seniors Struggle with High Cost of Medications

Published in the Pawtucket Times on June 18, 2001

Many seniors are struggling to pay the spiraling cost of prescription drugs as a politically divided Congress seeks a solution by crafting a bipartisan prescription drug benefit tied to Medicare.

Until this issue is addressed, a tragedy occurs in many communities across the nation.

Often, the high cost of prescription drugs has forced seniors on fixed incomes into not taking their medications at all or using only partial doses.

Noncompliance in taking medication can lead to hospitalization, nursing home admission or premature death.

According to the Families USA study released in June 2001, costly prescriptions continue to hit seniors hard in their pocketbook.

The report found that 50 of the most heavily prescribed drugs for seniors on average rose more than twice the rate of inflation in the year ending January 2001.

On average, the researchers found that prices increased by 6.1 percent from January 2000 to January 2001, though the rate of inflation excluding energy in that time period was 2.7 percent.

Furthermore, the 18-page report stated that seniors are most affected by any prescription drug price  increase.

Although older persons represent just 13 percent of the total nation’s population, they account for 34 percent of all prescribed medications dispensed and 42 percent of all prescription drug spending.

Of the 50 drugs used more frequently by seniors, the average annual cost per prescription as of January 2001 was $ 956, the report noted.

Drug prices rose significantly over the one-year period of the study.

The report findings revealed that the cost of Synthroid, a synthetic thyroid agent, rose by 22.6 percent; 22.5 percent for Alphagan, commonly used to treat glaucoma; 15.5 percent for Glucophage, prescribed for treating diabetes; and 12.8 percent for Premarin, used estrogen replacement.

While rising drug costs are national, Rhode Island fiscal nets are in place to make prescription drugs more affordable to low-to-moderate income seniors, says Susan Sweet, consultant and advocate for a variety of nonprofit agencies and minority groups.

Many aging advocates and state legislators know Sweet as “the mother of the Rhode Island Pharmaceutical Assistance to the Elderly Program (RIPAE).”

“Rhode Island is one of a handful of states that has responded to senior’s concerns and anxieties about the high cost of prescription drugs,” Sweet says.

In 1985, the Rhode Island General Assembly moved to assist elders with rising prescription drug costs by enacting RIPAE.

Initially, the RIPAE program covered only medications purchased by low-income seniors to treat hypertension, cardiac conditions and diabetes.

In the past fifteen years, the General Assembly has expanded the program,” Sweet adds, to over the cost of prescription drugs to treat glaucoma, Parkinson’s disease, high cholesterol, cancer, circulatory insufficiency, asthma, chronic respiratory conditions, Alzheimer’s disease, depression, incontinence, infections, arthritic conditions and prescription vitamins and mineral supplements for renal patients.

Additionally, the RIPAE Plus Program, proposed by Lt. Governor  Charles Fogarty with House and Senate leadership, allowed moderate income seniors to purchase prescription drugs at a lower rate that is negotiated by the state.

The state also pays a portion of the remaining cost of the drug based on the senior’s income level.

“The innovations in RIPAE have made Rhode Island a leader in assisting seniors to stay healthy and independently,” Sweet says.

With the end approaching to this year’s session of the General Assembly, lawmakers are considering legislation to again expand the RIPAE Program, states Fogarty, who authored the legislation.

Fogarty’s RIPAE Next Step would cover all FDA-approved prescribed drugs, excluding cosmetic and experimental drugs, cap out-of-pocket expenses at $ 1,500 annually, and open up the program to people age 55 and over who are receiving Social Security Disability Insurance.

While no one really opposes the passage of RIPAE expansion this year, ultimate passage of the entire legislative proposal is really a question of competing budget needs and limited state dollars, Sweet comments.

House Finance Chair Tony Pires (D-Pawtucket) remembers a time in the mid-1990s when Governors Bruce Sundlun and Linc Almond attempted to roll back the RIPAE program by calling for an increase in the senior’s co-pay and limiting access to benefits.

“The General Assembly made it very clear that it did not want to reduce state support, but rather moved to increase benefits,” Rep. Pires said.

“This year we’ll be expanding the list of drugs to include prescription drugs used to treat osteoporosis,” Rep Pires tells The Times, adding that House leadership also supports an out-of-pocket prescription drug cap of $ 1,500 annually.

With the RIPAE Next Step’s price tag of $ 3.5 million dollars. “We can’t afford to pay for an open formulary program yet because of budgetary limitations,” Rep. Pires states.

In upcoming legislative sessions, coverage for gastrointestinal drugs will seriously be considered, he adds.

“In the upcoming years the state’s pharmaceutical assistance program will remain a top priority to the General Assembly, Rep. Pires says. “There will be an expansion of coverage to a full formulary when more state monies become available, he adds.

Currently, Lt. Governor Fogarty estimates that more than 170,000 Medicare beneficiaries in Rhode Island, who do not meet the state’s pharmaceutical assistance program’s income eligibility requirements, lack comprehensive prescription drug coverage.

With an aging population, Congress and state lawmakers must roll up their sleeves to find innovative ways of making prescription drugs affordable.

Alzheimer’s News often Confusing to Interpret

Published in Pawtucket Times on March 26, 2001

Everyday hundreds of thousands of caregivers scan newspapers, senior papers, Time, Newsweek, Modern Maturity or even National Enquirer in hopes of learning a little more about new, effective treatments for Alzheimer’s Disease.

Oftentimes it is confusing to determine which treatments are promising and which ones that are not, due to the diverse opinions in the research community. For instance, one article might report on Vitamin E; others might state how Ginko really improves your memory and is good for Alzheimer’s patients to take. Others might describe studies that indicate that estrogen replacement therapy is not really an effective treatment for Alzheimer’s Disease for some women. Or some might even warn the reader “Don’t eat off of aluminum plate

s” because research seems to indicate that an accumulation of heavy metals, such as aluminum, in the brain may surely cause Alzheimer’s.

Here are some helpful tips for unraveling the mysteries of Alzheimer’s Disease as reported in media.

Beware of glitzy headlines. Time limitations keep people from reading every article in their daily, weekly or monthly newspapers. As a result, many readers just quickly scan the headlines for information. Don’t judge an article by its glitzy title. The content of an article is much more balanced than the headline that is catchy and written to draw the readers in.

Look for authoritative commentary. You can consider an article more credible when it provides multiple quotes on the indications of an Alzheimer’s treatment. The reporter has done a good job in reporting if there is authoritative commentary on the significance of the study.  Two likely sources might be staffers from either the National Alzheimer’s Association  or the National Institutes of Health, a major funder of Alzheimer’s research studies.  Remember that the National Alzheimer’s Association’s point of view tends to be less biased and a more reliable opinion that those of researchers that have ties to a pharmaceutical company that issued the press release.

Disputes on findings. Keep in mind that even if a research study is reported there might be those persons who believe that the study is not well designed or has major research flaws. On the other hand, the study might just be accepted by the scientific community as a solid study. However, there might still be serious disagreements about how to interpret the results or how to classify it. Some researchers might consider it a major study while others would categories it as a minor one.  A well-researched article will include the quotes of those who oppose the findings.

Are you still confused by how to cull articles for tips on safe and effective treatments for Alzheimer’s? Where do we go from here? Caregivers should view any articles written about new Alzheimer’s treatments as informational in nature. The article can open the door to the researcher community and it now becomes your responsibility to do homework and find out more details about what the research findings indicate.

If the article describes the results of an actual published research study, obtain the scientific journal with the published study and carefully read it. If the findings are reported from a presentation at a conference, attempt to track the researcher down for more information.  Finally, cruise the Internet and check out the official Web sites of the Alzheimer’s Association or the National Institute of Aging to determine if they can provide information about a reported new treatment.

Finally, don’t hesitate to call your local chapter or the National Alzheimer’s Association to solicit their comments. They will gladly share all the information they have. Remember these groups closely monitor research studies and their implications for treatment.