Caregivers for Alzheimer’s patients face challenges during natural disaster
Researchers call it the “perfect storm.”
A hypothetical hurricane is brewing in the Gulf. You have your hurricane kit ready with water, nonperishable food and flashlights. You’ve boarded up the windows and are standing by for a mandatory evacuation notice.
Now, imagine doing all of that as the main caregiver of a person with Alzheimer’s disease or dementia — everything changes.
In a 2018 study, family caregivers of persons with Alzheimer’s disease and related dementia, known as ADRD, said that while they had experienced a natural disaster previously, none had done so in a caregiving role.
“The caregiving role affected their ability to prepare for the storm and influenced their decisionmaking regarding evacuation and utilization of recovery resources,” according to the study. “Thus caregivers were confronted by a ‘perfect storm’ of circumstances and uncertainty.”
The study, “A perfect storm: Challenges encountered by family caregivers of persons with Alzheimer’s disease during natural disasters,” was conducted by the College of Social Work at the University of Kentucky and the clinical psychology department at Palo Alto University.
Family caregivers were interviewed about their experience with South Carolina floods in 2015, but researchers have moved to examine best practices for disaster response for the elderly and aging populations since Hurricane Katrina in 2005.
Three months after Katrina, about 6,000 people were reportedly still missing — many of them elderly and suffering from Alzheimer’s disease or dementia. Many of them were evacuated from long-term care facilities in New Orleans and brought to evacuation shelters to ride out the storm’s aftermath, which homehealth caregivers say can make their condition worse.
“Just a traumatic event like a flood, where a person is displaced, can exacerbate symptoms,” said Courtney Hochhalter, owner of Right at Home in Sugar Land. “It impacts every person in an individual way. Sometimes it’s dramatic and the person was fine before. Or something happens (like a hurricane) and they’re impaired quickly. It can be related to any number of things.”
Nearly 15 years after that devastating storm, hurricanes are now stronger, deadlier and happen more often. There have been fewer named storms in 2019 compared to recent seasons, but the death toll from Hurricane Dorian is up to 50 people with 2,500 still missing in the Bahamas.
As more research is being done to identify best practices for the Alzheimer’s and dementia-affected population during natural disasters, Houston Methodist’s neurology and neurosurgery departments are conducting or participating in a number of clinical research trials to treat the diseases and possibly find a cure.
The hospital has eight ongoing clinical trials and six research trials dealing with Alzheimer’s, some of which identify ways to reduce proteins in the brain that contribute to the disease.
“We are basically targeting two different proteins that accumulate in the brain of people with Alzheimer’s — one is amyloid and the other one is tau,” said Dr. Joseph Masdeu, Houston Methodist neurologist and director of the Nantz National Alzheimer Center. “Beta-amyloid protein begins to deposit in the brain very early, before people have any problem with memory — 12-15 years before anybody has symptoms.”
Seven people between the ages of 65 and 80 are being studied in Houston and are part of a 1,500person nationwide clinical trial that started in 2013. The subjects are given medication with antibodies that target the amyloids and reduce them before they show any symptoms of the diseases.
Another trial is studying whether a nicotine patch could have an effect on developing either disease. Data and animal testing has shown positive results, Masdeu said.
“One thing that is very important is that we do not treat people with dementia or Alzheimer’s with the same approach. There is nothing that is ‘one size fits all’ here,” he said. “It’s not only about the diagnosis; it’s about what is going on in your brain and what we can do about it. Each person has to be looked at and studied differently and treated accordingly.”
For more information on Houston Methodist’s clinical trials, contact clinical research coordinator at jmgarrett@houstonmethodist.org.