Published olnine at The Toronto Star, March, 2010.
For eight years, Ann Marie Wilson sought marriage counselling for what she believed to be her poor communication skills.
Conversations she was having with her husband, Carl — to whom she had been married for 39 years — were going around in interminable circles. They seemed to be constantly misunderstanding each other and, gradually, everyday routine discussions started to become major headaches, putting a strain on their relationship.
“It was driving me nuts,” Ann Marie, 68, says from her New Hamburg home. “I couldn’t understand where he was coming from and he couldn’t seem to understand where I was coming from. Often I’d have to stop him and ask, ‘Where are we in this conversation?’ ”
She blamed herself for being a “witch” and being impatient, and her adult children scolded her for being unreasonable.
It wasn’t until they discovered that Carl, 72, had Alzheimer’s disease that the pieces started to fit together.
Scenarios like this one are expected to multiply exponentially in Ontario over the next decade, as cases of dementia are expected to increase by 40 per cent to more than 255,000 people.
And with an aging population, the province needs to address the problem now, says the Alzheimer Society of Ontario.
In its report, 10 by 20: Ontario Action Plan for Dementia, released Wednesday at Queen’s Park, the society calls on the province to make dementia a health priority and provide support for patients, caregivers and professional health-care providers.
The report focuses on key areas, such as launching a public awareness campaign on prevention and early diagnosis, caregiver support, a better-trained dementia workforce, greater research investment and provincial leadership.
“We want the government to make dementia more of a conscious focus of attention,” says David Harvey, chief member services officer of the Alzheimer Society of Ontario. “Because the majority of services and investments made come as a result of dementia.”
Dementia is often at the root of many investment decisions in the health-care sector, Harvey explains, but is rarely acknowledged.
For example, he says one-third of alternate-care hospital beds are occupied by people with dementia. (Alternate care patients are those in hospital waiting to be discharged or transferred to another facility like a nursing home.)
Raising public awareness also means emphasizing the roles that diet and lifestyle can play in preventing or delaying the onset of dementia, says Dr. Sandra Black, director of the neurosciences research program at Sunnybrook.
“Some of the most important information from the last 10 years shows us that the risk factors for heart disease and stroke are the same for dementia,” Black says.
That includes lifestyle-related risk factors, like poor diet, lack of exercise and obesity.
“What that means is that there’s a lot within our power to protect our brains against the changes that go on in aging,” she says. “It’s a very important message, that people can do something about it.”
Recent research suggests that physical activity is just as important as mental exercise for the brain, she adds.
“That came as a shock. Everyone has been emphasizing mental activities, but it turns out that physical activity is just as important in optimizing brain function and blood flow.”
Carl has taken that message to heart. While he’s always been physically active, exercise is now a part of his daily routine. As a former half-marathon speed walker, he walks up to 6 kilometres around the neighbourhood every day and plays shuffleboard with friends.
He can’t ballroom dance with his wife anymore, because he can’t remember the steps. Nor can he write Christmas or thank-you cards, or solve math equations. Sometimes words escape him in conversation, and he describes calculators as “machines with numbers.”
But he’s still a sprightly man with a bright attitude and is active in the Alzheimer community.
The couple joke he’s “living the life of Reilly” now, participating in community programs for Alzheimer’s patients, which include morning workshops reviewing current affairs, music and exercise. But he counts himself among the lucky ones.
“I would like to tell people two things about the illness,” says Carl, who also takes medication for his condition. “It’s not contagious, and you still have time after diagnosis. You can still have quality of life.”
Dementia by the numbers:
• The number of Ontarians with dementia is expected to rise by 40 per cent from 181,000 today to 255,000 by 2020.
• Families and friends spend 87.1 million unpaid hours caring for people with dementia. By 2020, that will increase 65 per cent to 144 million unpaid hours.
• The total economic burden of dementia in Ontario is expected to increase by $770 million per year, to almost $18 billion by 2020. That includes direct, indirect and lost opportunity costs.
The 10 by 20: Ontario Action Plan for Dementia proposes a 10-step plan that includes:
• Launching a public education plan on dementia.
• Enabling early diagnosis.
• Increased access to community support programs.
• Introducing flexible workplace policies for family caregivers.
• Strengthening dementia-specific training in health and social service sectors.