Mayor Kelly, along with Justin McDonough, president of the Alzheimer Society of Nova Scotia, raised the official Alzheimer Society "Forget-Me-Not" flag at City Hall to honour Alzheimer Awareness Month.

Alzheimer's disease is the most common form of dementia. The Alzheimer Society of Nova Scotia provides a provincial network of support and education to people concerned with memory loss and families impacted by dementia.

Interview with Professor June Andrews, Dementia Services Development Centre: The Cost of Doing Nothing

Dementia already affects 20% of seniors who are over the age of 80, and a new case of dementia is diagnosed every five minutes. A generation from now, more than a million people in this country will have some form of the disease, such as Alzheimer's.

To hear Professor June Andrews speak on Maritime Noon, please click here.

     Over the course of the last two years, the Alzheimer Society of Canada has been working on a report, Rising Tide: The Impact of Dementia on Canadian Society, which detailed an expected surge in Alzheimer’s patients in Canada. With funding for the project starting in 2008, incidence and prevalence information about the disease was released in January 2009 and information about the economic impact on Canadians was released on January 4^th, 2010. Meant as a call to action to governments across Canada as well as an educational tool for the Canadian public, the report acts as a voice for those with dementia, and also serves to bring the next 25 years of dementia statistics into context.

     Debbie Benczkowski, Interim, CEO of Alzheimer Society of Canada, recently attended CDKTN’s September 2010 Management Committee meeting to present the Rising Tide report. To recap the last 2 years following the release of the two parts of the report, Debbie’s presentation outlined the current statistics and trajectory of the disease. As it stands, approximately 500,000 Canadians are living with Alzheimer’s. Within the next 25 years, this number is said to increase to 1.1 million. This increase is expected to bring significant economic and social strains on the country. According to the Alzheimer Society of Canada, everything from caregiver labor to medical care costs will increase drastically.

     Despite the looming crisis, the report recommends a series of interventions that could stem the trajectory of the disease. The economic impact and number of cases can be reduced dramatically by incorporating prevention strategies and support systems for patients and caregivers. The Alzheimer Society of Canada outlines these measures as key components of preventative action, but makes mention that Canada has yet to develop any type of dementia management strategy, as have a number of other countries around the world. The report details how Canada’s population will be affected without proper action, how changes can take place, and what must be done to make a difference.

     To view a recent presentation of the Alzheimer Society of Canada’s Rising Tide report, please click below. For further information, please contact us at [email protected].  

The primary objective of the Program is to provide training opportunities in knowledge translation (KT) for doctoral students and post-doctoral fellows already engaged in, or who intend to become engaged in, research on dementia. Doctoral students are required to have been accepted into a research training program on a dementia-related project. All trainees are expected to use the funds awarded to augment their research portfolio through the acquisition of first-hand knowledge about KT, applying KT as an integral component of their research, preferably gained by participation in a research project with one of the Canadian Dementia Knowledge Translation Network (CDKTN) members. Successful candidates are expected to participate in at least one KT workshop.

The program will be open to applications from trainees as outlined in section II. General Provisions and section III.1 Training awards of the Alzheimer Society Research Program (ASRP) 2011 Application Guidelines. Applicants should familiarize themselves with the details provided therein.

To apply, applicants must fill out the Application for Training Award form.

Application forms and Application Guidelines are available on ASC's Web site (www.alzheimer.ca/english/research/resprog-download.htm). All application materials are provided in downloadable format.   The deadline for submitting applications for this doctoral and post-doctoral training award is 5pm November 19, 2010.     

For further information regarding this RFA, please contact: Research Department
Alzheimer Society of Canada
20 Eglinton Ave. W.
Toronto, ON M4R 1K8
Tel:  (416) 847-2968, toll free 1-800-616-8816, x2968
Fax: (416) 322-6656
E-mail: [email protected]

CDKTN and the University of British Columbia are offering fellowships for investigators, academic faculty, and clinicians to conduct research in dementia and knowledge translation. Funding 2-6 month fellowships, the program hopes to produce innovative multimedia dementia and knowledge translation resources across Canada.

Dr. Judy Illes, Director of the National Core of Neuroethics, and Dr. Lynn Beattie, Acting Director of the Clinic for Alzheimer’s Disease and Related Disorders at the UBC Hospital will be hosting the program.

For more information regarding applicant qualifications and contact information, please click on the attached poster, or contact us at [email protected].

The University of Virginia School of Medicine is launching Memory Commons – an interactive, first of its kind educational website for physicians and healthcare professionals that focuses on Alzheimer’s disease and dementia.

“Getting reliable and up-to-date information on dementia-related topics has been difficult for many health care providers. Memory Commons is an important advance in professional education for dementia-related topics. It uses the latest in internet and computer-simulation technologies to allow providers convenient real-time access to high-quality educational content in this rapidly developing field”, Dr. David Geldmacher of UVA’s Department of Neurology.

More than 35 million people in the United States are over 65 years old; that number is expected to more than double through the year 2050. The risk of Alzheimer’s disease increases dramatically with age, and the growth of the aging population means that Alzheimer’s disease is already a major public health challenge. The Memory Commons site is designed to provide the latest clinical and research advances in the diagnosis and management of people with dementia and Alzheimer’s disease. Memory Commons includes links and adds to the significant body of content and information that the Alzheimer’s Association already provides to patients, families and caregivers.

Memory Commons employs multiple learning formats to encourage learning and advances in dementia and Alzheimer’s disease care, as well as improve quality of care and access to the latest treatment guidelines. Learning methods include tutorials, interactive case discussions, open case consults, blogs and an innovative interactive simulation of outpatient clinic encounters using a computer-gaming platform. 

The University of Virginia School of Medicine is collaborating with the UVA Institute for Aging, the UVA School of Nursing, the Alzheimer’s Association, the University of Pittsburgh ADRC (Alzheimer’s Disease Research Center) and the Virginia Commonwealth University Department of Gerontology to develop this program.  

“The Association realizes the value and importance of collaboration to meet our goal of providing quality medical information on Alzheimer’s disease, diagnosis and treatment to physicians and health professionals. Memory Commons is designed to meet this growing need through a convenient and accessible format.  Memory Commons will also include valuable links to the Alzheimer's Association, providing current information of benefit to those with the disease, their caregivers, and the general public", says the Alzheimer’s Association Central and Western Virginia Chapter. 

For further information or questions, please contact us at [email protected].  

Jim Mann has become nationally recognized as an avid supporter of dementia research. Presently, he is a member of the National Board of Directors for the Canadian Dementia Knowledge Translation Network (CDKTN), as well as a board member of the Alzheimer Society of Canada. At home in British Columbia, he maintains a position on the community advisory committee with the Centre for Research on Personhood in Dementia and is a board member of the Alzheimer Society of British Columbia.

What provokes such an interest in dementia? At only 58 years old, Jim was diagnosed with early-onset of Alzheimer’s disease.

Jim started to recognize his progressive decline in memory in his 50’s – by most standards, an early age to notice signs of mental illness. Typically, signs of Alzheimer’s disease are not noticeable before the age of 65.

“You can’t have it because you’re too young…you can’t have it because [you’re] able to communicate”, were a couple stereotypes that Jim found himself considering – but the signs were there.

In the airport when he was returning to Vancouver, Jim was very confused and disoriented; walking the dog or going for a drive left him lost and wondering what he was doing. Areas he commonly visited and tasks he was used to were quickly failing his memory. Jim saw these memory problems and recognized them as early-onset signs of Alzheimer’s disease – something that affects only a small portion of Alzheimer patients.

Many people may see the warning signs, but out of lack of knowledge or even fear, may not wish to confront the issue. The subtle clues that indicate an early-onset can be anything from memory lapses, failure in recognizing simple objects, or changes in personality.

Being able to recognize the early-onset symptoms of Alzheimer’s disease may be one of the most important aspects of early diagnosis. Rather than ignoring the warning signs, Jim began looking at securing his financial well-being, banking, and future legal issues before his symptoms started limiting him. Many people are blindsided when diagnosed with Alzheimer’s disease, leaving them uncertain about their future affairs.

For Jim, there was a process of remodeling and adapting to a new way of life. Reducing confusion is now a priority for Jim: difficult scenarios like going to the airport are better handled by going early enough to avoid crowds. Early-onset patients need to communicate to their caregivers – friends and family need to know how the disease will progress, what they can expect, and how they can help.

Pfizer has created four short videos of how to prepare for and recognize symptoms of Alzheimer’s disease. “Diagnosed at Just 58 Years Old”, one of the four films, focuses on Jim Mann’s personal experience with early diagnosis and how he deals with his illness.  

Please click below for a link to view this video, or contact us at [email protected].

A recent collaborative effort by the Canadian Red Cross Atlantic Zone and Canadian Dementia Knowledge Translation Network (CDKTN) followed Continuing Care Assistants (CCA) and Home Support Workers (HSW) in their care of people with dementia. Partnering together with the assistance of a CIHR grant awarded to the CRC, two videos were produced to educate practitioners and caregivers.

Capturing the perspectives of the families and support workers of people with dementia, the Home Support project is a valuable tool to assist in care. The first video titled Family shows the importance of caregiver support and preventing burnout. The second video titled Support offers strategies and practices to care for dementia patients. Both films serve to educate novice caregivers, as well as reinforce good practices among experienced Red Cross workers.

Evaluated by groups of in-home support workers, the films highlight several useful themes involved with in-home care: how to keep aging patients active, maintaining their independence, and encouraging mental activity. Focus groups found the films relatable to their personal experiences and an excellent means of showing practices involved with in-home care.

Below are links to both Home Support Films. For further information or questions, please contact us as [email protected].

The Alzheimer’s Association recently released, “Changing the Trajectory of Alzheimer’s Disease: A National Imperative” – a report examining the projected costs of Alzheimer’s care in the next 40 years. It is predicted that without the intervention of disease-modifying treatments, America will spend approximately $20 trillion in healthcare services by 2050. This reflects the expected rise in Alzheimer’s patients: by mid-century, the current 5.1 million Alzheimer’s cases in America will have risen to nearly 13.5 million.

These projected numbers and costs are not without foreseeable solutions. In much the same way that innovative treatments have made breakthroughs for diseases like cancer and HIV/AIDS, there are possible solutions to reducing the national costs of caring, as well as the number of dementia cases in America. The report offers an evaluation of two hypothetical scenarios: a disease-modifying treatment to delay Alzheimer’s onset by five years, and a treatment that could slow the progress of the condition.

Currently, no such treatments exist. The report only outlines these scenarios as theoretical solutions to Alzheimer’s disease and other dementias. Still, they are innovative ideas to spark research in the right direction – not only as a means of treating the disease, but aiding the American fiscal burden as well. The Alzheimer’s Association sees these treatments as capable of achieving two things: reducing the number of cases of Alzheimer’s in patients over 65, and lowering the number of Alzheimer’s patients entering the severe stages (usually associated with the most expensive treatments) of dementia.

Please click below to read the full report and breakdown of costs, as well as the Alzheimer’s Association’s hypothesized solutions. For more information, contact us at [email protected].

Seniors are at risk of financial abuse – from telemarketing fraud to misspending of their money by well-meaning  family and friends —and a new publication has been created to help protect them. The booklet, prepared by the Legal Information Society of Nova Scotia and the Nova Scotia Centre on Aging, at Mount Saint Vincent University, is available free of charge to Nova Scotians and will be launched this spring at public information sessions across the province.

“The best forms of protection are knowledge and awareness,” says Maria Franks, Executive Director of the Legal Information Society of Nova Scotia. “This publication will increase seniors’ understanding of the issues to consider when planning and arranging their legal and financial affairs—a major step in making them financially safer and savvier.”

It’s in Your Hands: Legal Information for Seniors and Their Families was developed for seniors and their families, but it will also help other relatives and friends, educators and decision-makers, community volunteers, social agencies and enforcement agencies—as well as “early boomers” who are planning ahead for their retirement years. In addition, special information sessions will also be held for service providers in communities around the province where the publication will be launched. 

“The information sessions will help to raise awareness of the issues and give everyone a chance to have their questions and concerns addressed,” says Ms. Franks.

Each information session will last about two hours and will provide a walk-through of It’s in Your Hands. Refreshments will be served, and participants will receive a copy of the publication, which will later become available online.  Specific topics covered will include wills, power of attorney, internet fraud, property transfers, and grandparents’ rights.  

“With today’s growing senior population, we are seeing an increasing interest in their physical and mental health,” says Dr. Janice Keefe, Director of the Nova Scotia Centre on Aging (NSCA). “But financial health is crucial too.”

She notes that the publication is designed specifically for Nova Scotians, because many of the topics covered fall under provincial law. However, Dr. Keefe adds, “It may well serve as a model for other provinces and jurisdictions.”

“Care has been taken to make sure the material is accessible to a wide range of people,” says Dr. Keefe, who is also the Canada Research Chair in Aging and Caregiving Policy at the Mount. It is available in English and French, is written in clear and direct language, and addresses concerns for people on small, fixed incomes as well as those with complex investments and estates.

“It has been valuable for our two organizations to work together,” notes Maria Franks. “We at the LISNS provide Nova Scotians with legal information, when they need it, and NSCA’s expertise is in helping to improve the lives of older people by providing current age-related information to our community.” It’s in Your Hands was developed with funding from Human Resources and Skills Development Canada.  

—30— 

For more information or to arrange an interview, please contact:

Donalee Moulton

Quantum Communications

(P) 902-443-9600

[email protected] 

To find an information session near you, please click below.

The Personal Directives Act enables Nova Scotians to document their wishes regarding what personal care decisions are made for them and/or who makes them, in the event that they are incapacitated and are unable to make these decisions themselves.

Personal care decisions include those related to health care, nutrition, hydration, shelter, residence, clothing, hygiene, safety, comfort, recreation, social activities and support services.

The Act enables three things:

1. It allows individuals to appoint a substitute decision maker to make a personal care decision on their behalf should they become incapable of making the decision.
2. It allows individuals to set out instructions or general principles about what or how personal care decisions should be made when they are unable to make the decisions themselves.
3. It provides for a hierarchy of statutory substitute decision makers to make decisions regarding health care, placement in a continuing care home and home care where the individual has not prepared a personal directive in relation to those decisions.

For more information please visit: http://www.gov.ns.ca/just/pda/

The imminent crisis

According to a study published January 3 by the Alzheimer Society of Canada, Canada is facing an epidemic of dementia that will completely overwhelm our healthcare system and devastate our economy within one generation unless significant policy changes are made.

The report, entitled Rising Tide: The Impact of Dementia on Canadian Society, outlines the imminent crisis and calls for the institution of a coherent national plan to mitigate the damage.

Dementia encompasses a range of disorders distinguished by an acquired progressive decline in cognitive function. As age is a primary factor in its development, the prevalence of dementia among our population is expected increase exponentially when Canada’s baby-boomers begin to enter their senior years in 2011.

The Alzheimer Society report predicts that the number of Canadians suffering from dementia will more than double between now and 2038, from 480 618 to 1 125 184, representing an increase in the relative percentage of the national population from 1.5% to 2.8%.

* This means that in less than 30 years over 1.1 million Canadians will be affect by some form of dementia..

Over those 30 years, the model predicts that dementia will cost the Canadian economy over $872 billion dollars (see Fig. 1), encompassing a yearly cost increase from $15 billion per year to $135 billion per year.

* Direct health costs for individual dementia sufferers are predicted to more than double every 10 years for the next 30 years across all care types.

The report explains that the typical long-term care associated with dementia will not only push existing facilities to the breaking point, but place an added burden on informal caregivers—family and loved ones—as the demand for the construction of new long-term care beds will greatly outpace supply.

The Alzheimer Society predicts a shortfall of 157 000 beds by 2038—dwarfing the significant 15 400 bed shortfall of today. An increasing number of Canadians suffering from severe dementia will be forced to live at home, including many who are unable to live without constant assistance. This dependence on home care will increase the burden on informal caregivers, worsening the total economic impact of dementia through further lost wages and other opportunity costs.

The promise of lifestyle and community-care interventions

Recognizing the inevitability of a long-term care bed shortfall, the Alzheimer Society examines the potential effects on their predictive model of initiatives focused on keeping future elderly Canadians out of long-term care facilities.

These hypothetical, evidence-based programs would attempt to delay the onset of dementia or prevent it altogether through encouraging positive lifestyle changes and improve training for informal caregivers.

Suggestions include:

• Programs to increase Canadian seniors’ exercise levels by 50%
• Programs to promote healthy diet and lifestyle choices
• Providing training to improve the efficiency of informal caregivers
• Assigning a “system navigator,” or case manager, to each newly diagnosed person with dementia in order to improve their access to community support systems.

After applying the studied effects of such programs to the model, the report found that all four programs would significantly lessen the total cost burden on the Canadian health care system by 2038.

By far the most effective was the plan to promote healthy diet and lifestyle choices.

Studies show such a program could contribute to prevention, and at least delay the onset of Alzheimer’s dementia in Canadians for up to 2 years.

Modeled over the 30 year period, this particular intervention reduced the predicted number of Canadians with dementia by more than 409 640—36.4% of the predicted total—and subsequently kept over 153 870 dementia-sufferers out of long-term care. This would reduce the predicted cumulative total economic burden by more than $218.6 billion, or 25.1% (see Fig. 2).

In terms of a cohesive national policy to attack this crisis, the Alzheimer Society has found that Canada lags sorely behind her peers.

Australia, France, The Netherlands, Norway, Scotland, and the United Kingdom have all made the fight against dementia a national priority by launching national initiatives significantly investing in research, and improving clinical care and training for both medical professionals and informal caregivers.

Just like the hypothetical interventions considered in the Alzheimer Society’s model, these policies are primarily concerned with keeping patients out of long-term care facilities, either through attempting to delay the onset of the disease or improving home care.

While Canada does not have any similar cohesive national plan to combat dementia, positive policies in research and home care do exist.

Over the past decade, the Canadian Institutes of Health Research (CIHR) has increased annual funding for dementia research from $4.5 million to $20 million, and the federal government does provide some financial support to home caregivers of elderly patients.

The report presents the Veterans Independence Program of Veterans Affairs Canada as a successful domestic program aimed at keeping Canadians out of long-term care facilities: it provides home care and support to 102 154 of Canada’s war service veterans while occupying only 4190 beds. The Alzheimer Society infers that a similar national policy aimed specifically at dementia could have an enormous impact.

One barrier to a cohesive national policy is the complex nature of dementia care and research.

Just as the treatment of geriatric dementia patients, often characterized by various comorbidities, may require the input of numerous specialists working in concert, the report observes that influence over dementia-related policy can be equally claimed by government departments for seniors’ issues, for chronic diseases, and for mental health.

This has been addressed on a provincial level, however, as many provincial governments have launched interdepartmental pilot initiatives to improve service delivery and research in dementia. So far, policy recommendations have yielded only one concrete collaborative provincial plan that includes a significant financial investment, Ontario’s $68.4 million Strategy on Alzheimer’s Disease and Related Dementias (ADRD).

Subsequently, many Canadian provinces have launched interdepartmental initiatives to improve service delivery and research in dementia. So far policy recommendations have only yielded one concrete provincial plan that has a significant financial investment: Ontario’s $68.4 million Strategy on Alzheimer’s disease and related dementias (ADRD).

Systematic change: an integrated model of care

As a system for overarching change, the Alzheimer Society’s suggests the national institution of an integrated model of care employing a Chronic Care Model.

An integrated model would better manage the aforementioned complexity of care required of the comorbidities commonly suffered by geriatric dementia patients. The report envisions a system that would focus on coordination and collaboration between specialist providers through shared digital information systems and standardized procedures, promoting collective accountability through all levels of treatment.

Recognizing our current medical system’s poor capacity to manage long-term illnesses like dementia, the recommended system would be purposefully structured to deal with chronic disease, providing financial incentives to promote prevention and rehabilitation. Additional costs could be minimized through the redistribution of resources in long-term treatment cases to the most appropriate and cost-effective providers of specialized services (eg. Nutritionists, physical therapists, etc.), while continuing to encourage collaboration and collective ownership.

The report explains that successful examples of integrated systems already exist in Canada, citing Montreal’s Integrated System of Care for Older Persons (SIPA). This program has been found to improve patients’ accessibility to appropriate services, increase reported caregiver satisfaction, and significantly reduce alternate-level-of-care beds—the unnecessary occupation of long-term beds after sufficient recovery—all without increasing the systems’ total costs.

A comprehensive national response

In its final section, the Rising Tide report offers specific suggestions that the Alzheimer Society feels should be incorporated into a national dementia policy.

Taking into account the results of their own modeled interventions as well as the policies of peer nations, the Alzheimer Society calls for:

• An increased financial investment into biomedical and clinical dementia research by the federal government, as well as further research into the provision of complex health services and the translation of research findings
• Further financial support and training for informal and community caregivers in order to lessen their burden, effectively delaying patients’ moves to long-term care facilities
• Emphasis on prevention and early intervention through public health programs
• The institution of an integrated, standardized system structured for chronic care, coordinating medical professional and community providers; and finally
• A greater government investment in strengthening and supplementing all levels of the dementia workforce, including supporting the development of specialist physicians and nurses, community and informal caregivers, and volunteers.

In the face of this impending crisis, the Canadian government must develop a cohesive and functional national policy.

The Alzheimer Society asks all Canadians to petition their provincial and federals governments to address the epidemic ahead and mitigate the effect on our economy and our healthcare system.

As the report concludes, “the time to act is now.”

In attendance were over 60 representatives from all facets of dementia care in Nova Scotia including physicians, nurses, allied health professionals, administrators, volunteers, industry representatives, policy makers, and researchers.

The objective of the Think Tank was to engage potential research-users in the creation of a research agenda in the area of dementia care. As a result, we hope to create a program that is responsive to the needs of those in policy and practice.

As well as exchanging knowledge in this vital and important topic, it is our hope that this forum will create collaborations and relationships that extend well past this one day event.

A report based on the information shared by all participants in this Think Tank will be produced by the GMRU and will be made available on this website in the near future.