WASHINGTON (AP) — David Hilfiker knows what's coming. He was diagnosed with Alzheimer's so early that he has had time to tell his family what he wants to happen once his forgetfulness becomes incapacitating.
“When it's time to put me in an institution, don't have me at home and destroy your own life,” said the retired physician, who is still well enough that he blogs about his disease. “Watching the Lights Go Out” is his blog's title.
Nearly half of all senior citizens who need some form of care — from help at home to full-time care in a facility — have dementia, the World Alzheimer Report said recently.
It's a staggering problem as the global population ages, placing enormous strain on families who provide the bulk of that care, at least early on, and on national economies alike.
Indeed, cognitive impairment is the strongest predictor of who will move into a care facility within the next two years, 7.5 times more likely than people with cancer, heart disease or other chronic ailments of older adults, the report said.
“It's astonishing,” said Marc Wortmann, executive director of Alzheimer's Disease International, which commissioned the report. “What many countries try to do is keep people away from care homes because they say that's cheaper. Yes, it's cheaper for the government or the health system, but it's not always the best solution.”
And dropping birthrates mean there are fewer children to take care of aging parents, said Michael Hodin of the Global Coalition on Aging.
Today, more than 35 million people worldwide, including 5 million in the United States, are estimated to have Alzheimer's. Barring a medical breakthrough, those numbers are expected to more than double by 2050.
Overall, the U.S. has been investing about $400 million a year in Alzheimer's research.
The disease's financial toll in the United States is $200 billion a year, and medical and nursing home expenditures for Alzheimer's are expected to surpass $1 trillion by 2050 — not counting unpaid family caregiving. The report put the global cost at $604 billion.
Thursday, families affected by Alzheimer's and advocates for the aged said it's time for a global push to end the brain disease, like that when governments and researchers came together to turn the AIDS virus from a death sentence into a chronic disease.
“We need a war on Alzheimer's,” said Sandy Halperin, 63, of Tallahassee, Fla., who was diagnosed with early-stage Alzheimer's three years ago.
The report focuses on caregiving, stressing that the needs of people with Alzheimer's are very different from those of people with cancer or heart disease.
People with dementia begin needing some help to get through the day early on, to make sure, for instance, that they don't leave the stove on or get lost. Eventually, they lose the ability to do the simplest activities of daily life, and they can survive that way for a decade or more.
Often family members quit their jobs to provide round-the-clock care, and the stress can harm their own health.
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