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Posts Tagged ‘alzheimer’s’

Brains Don’t Last Forever

Thursday, May 19th, 2011

–by Nigel S. Lockyer, Director

The Prime Minister of Canada (who now has a majority government for the next four years) plans to emphasize among other things brain research. TRIUMF is already involved in brain research, especially Parkinson’s, Alzheimer’s, and some aspects of addiction and depression. Our nuclear-medicine division supports and collaborates with a superb team of researchers at Pacific Parkinson’s Research Centre (based at UBC) and have done so for over 20 years. Recently it has expanded into Alzheimer’s. Neurodegenerative diseases are special in that none of them have cures or simple diagnostic processes. Major discoveries and progress are being made, thank goodness, but complete understanding, let alone cures, is elusive.

Behind all this rhetoric about the value of brain research is an age-old public policy question: fund new breakthroughs (i.e., brain research) or fund distribution & implementation of existing ones (i.e., build new, modern centres for the growing population of mentally diseased, ageing people). Not an easy choice.

Since my father has recently been admitted to a Long Term Care Facility in Guelph, Ontario, Canada, the difficulty of this choice has become acutely evident. His new facility is one where the doors are always locked, a necessary measure to protect the residents from themselves…many wander and would get lost or hurt off the grounds. About 75% are in wheelchairs with head and neck motion constrained, and the majority suffer from some form of dementia.

However, it is a pleasant and brightly lit place. For Mother’s Day they held a concert called “Rowdy Country Tunes” sung by a local guitarist (I am guessing he was 75 years young). It was mostly Elvis Presley tunes, and the auditorium looked from the back like a drive-in movie except it was wheelchairs parked wall-to-wall replacing the cars.

The staff and volunteers are totally dedicated in their attempts to provide a stimulating and nurturing environment for residents who struggle daily with tasks such as finding their own rooms, eating, controlling verbal outbursts, or even making eye contact. Simple games such as pushing a beach ball back and forth can be a challenge.

The most popular game it seems is trying to get out of the locked floor. The exit is always crowded with wheelchair escapees. The most often heard phrase is “How do I get out of here?” My dad told me recently that he can’t get out because he cannot get past all of the wheelchairs. I replied, “Yeah, Dad, the traffic is rough here.” However, if you open the door, expect a stampede! This game, they all seem to understand.

Each resident has a private or semi-private room. However, the great symmetry of the hallways and building, perhaps a good thing in physics, is not good for finding your room. When I was in my dad’s room, inevitably several residents would wander into his room and look shocked that we were in “their” room. All a part of the character of the place, all a part of what our brains and bodies do in the final chapters of our lives.

On the second evening of my recent visit, during the well-choreographed recreational time, I sat with my dad and about a dozen residents while they listened to country music (Hank Williams seems to appeal to this group) and played catch with the beach ball. I sat with this group for about an hour and then it was time to leave. One person was staring at me, since I was obviously (at least, I hope) not a full member of the club, and so I said, “Good night.” About 90% of the room replied with “Good night!” I was floored. They were all fully aware of my presence and wanted to connect with me. I had had no idea. It was quite a touching moment and I realized though they might all appear to be immobilized, or suffering from Alzheimer’s, they sometimes, maybe just sometimes, they just want to communicate. That is when you realize that these are the moments all family members wait for—those special times when there is a fleeting glimpse of the person they once were. That is what keeps us all going.

Health care of this type is highly people intensive and expensive. In my view, Canada does a good job in this area. Employees (and many volunteers) in these facilities are dedicated, caring, cheery, loving, and tender. It is really just amazing.

Physicists work on advanced medical technologies all the time, from PET scanners, medical isotopes, and accelerators for cancer therapy to MRI, contrast imaging, laser surgery, and so on. Yet I had to ask myself what we as a field could do to help these special old folks. My first thought was better technology—more breakthroughs, better tools, better understanding of the progress of ageing. But while this is necessary, there seems to be no substitute at the moment for personalized care….one on one for the people who really are there right now.

As a lab director, I often think about how politicians make decisions on what to fund: What events affect their inner priorities? My guess is that much of it is personal experience. Next time you see a politician, just think that it is they who have to choose between funding brain research or the multitude of long-term care facilities for our aging populations. It is not that easy to choose…help people now or potential help in the future…but we surely need more brain research.

A few people agree. Check out the cool building in Las Vegas by the Canadian-American architect Frank Gehry. What is it? It’s the Cleveland Clinic’s Lou Ruvo Center for Brain Health, of course!

Frank Gehry designed Lou Ruvo Center for Brain Health

Canadian architect Frank Gehry designed the Lou Ruvo Center for Brain Health in Las Vegas