Ideas. Lessons Learned, and Occasionally, Opinions
When Bill Gates pledged $100 million for research on controlling or curing Alzheimer’s disease in our lifetimes, it focused much-needed attention on this dread disease. At Corgenius, when we teach about preparing for it, signs to watch for, and protocols to follow, we often ask the audience how many have a family member affected by Alzheimer’s. Well over half of the hands in the room go up; often it’s nearly unanimous.
Statistically, 1 in 8 people aged 65 and above have Alzheimer’s disease. Every five years after the 65th birthday the chance of diagnosis doubles. Nearly half of people at age 85 have Alzheimer’s, and one of every three seniors dies with the illness. This epidemic has profound implications for all of us, and especially for financial advisors, who are charged with guiding clients through their elder years in ways that protect their best interests and their financial viability. Here are some resources to help.
For your own education: Our vote for the best recent resource is “In Pursuit of Memory: The Fight Against Alzheimer’s” by Joseph Jebelli. This British neuroscientist has carefully crafted an understandable and comprehensive examination of the history of the disease, causes and characteristics, past and current research, and currently available treatment options. He details the major drug testing failures in the past several years, but ends with hope that in 10 years we reduce Alzheimer’s to a manageable chronic disease like diabetes rather than the debilitating fatal illness is currently is. If you want the best education on the subject and if you appreciated “The Emperor of All Maladies” (which was published in 2010 and examined cancer in the same way), this book is for you.
For your clients with a diagnosis in the family: “The 36-Hour Day: A Family Guide to Caring for People Who Have Alzheimer Disease, Related Dementias, and Memory Loss” by Nancy Mace and Peter Rabins is a comprehensive listing of what to expect from someone with Alzheimer’s disease along with a wealth of information, tips, skills, and language. The authors incorporate humor, compassion, and realism as they help caregivers and family members cope with the progression of cognitive and physical diminishment while maintaining as much communication and life as possible. Give it to clients and their families as a reliable and highly practical guide.
For everyone: The Alzheimer’s Association. This dedicated organization offers a wealth of resources and services for anyone concerned about or affected by Alzheimer’s disease. They provide in-home care consults, tracking programs for those who wander, free brochures you can provide in your office, a trial match so clients or their family members can be enrolled in appropriate clinical trials, and more. Check out what your local chapter has to offer.
Beta amyloid plaques, or build-up of “sticky” proteins on the neurons, is one characteristic of the disease. Not all people who have beta amyloid plaques have Alzheimer’s, but every person with Alzheimer’s has beta amyloid plaques. With the aid of improved brain scan techniques that more accurately detect them plaques, one focus of research is to prevent, slow, or dissolve the proteins.
Many antibodies have been in clinical trials for some time. Crenezumab, for instance, is showing some promise in early-onset Alzheimer’s. But recently another antibody called Solanezumab became the first one proven to show definitive results in slowing beta amyloid plaque build-up on neurons, at least temporarily.
We are still a long way from a cure. There is no drug or treatment, including Solanezumab, which is capable of preventing or curing Alzheimer’s. All we can do is slow the progression of symptoms for anywhere from a few months to a few years. There is no “fix”. Sooner or later the disease takes over again. Yet every step helps.
What can you do?
One relatively less labor-intensive way to support grieving clients is to create a dedicated page on your website to share online resources on coping with loss. We’ve collected some links that we recommend to get you started on your list.
Alliance of Hope provides healing support for people coping with the shock, excruciating grief and complex emotions that accompany the loss of a loved one to suicide. Also, check out The American Foundation for Suicide Prevention. They provide education and prevention, but also provide support groups and after-care when a suicide occurs.
The Trevor Project is designed for the LGTBQ community. It focuses on prevention, providing a suicide hotline, as well as information, education, and support after a suicide occurs. Suicide rates are much higher in this community.
Grief Share provides in-person support meetings in a number of places around the country. They describe themselves as “a friendly, caring group of people who will walk alongside you through one of life’s most difficult experiences.” They offer the option of a daily “encouragement email”.
The Caring App is aimed at caregivers who provide home care to family. Whether young or elderly, dementia or other physical or mental conditions, this app serves as a how-to-guide that recommends high quality, low-cost products, services, and strategies.
Compassionate Friends is a national organization organizes support groups around the country for parents whose child has died. All leaders have been through it themselves, and the group offers comfort, acknowledgment, and hope.
Family Caregiver Alliance (FCA) an unmoderated email-based support group and participants must register. Many people caring for a loved one who is disabled, ill, or living with dementia, find support and understanding in the conversations with others in similar situations. For support specific to Alzheimer’s, check out the Alzheimer’s Association at www.alz.org
We hope your clients find these resources helpful and healing as they go through their journey, generating gratitude and loyalty to you. If you know of other resources that your clients have benefitted from, please email us at firstname.lastname@example.org and we will be sure to share them.
When I was a young widow, there was no such thing as a support group to help me through. There was no such thing as online resources. There were no retreats for widowed people to share their experience. I sometimes thought I recognized the sadness in another person’s face, but I didn’t dare ask if we had a common thread of grief between us. Despite all the well-intentioned people who loved me, I felt alone and lost. I had to figure out this grief thing by myself and find some way to put the pieces back together, heal, and refashion my life.
No widow should grieve alone -- nor do they have to. While there is now a wide variety of places to help widows get counsel, sympathy and share their feelings, one of the most healing is the non-profit organization Soaring Spirits International. Founded by a young widow, Michele Neff-Hernandez, the group offers Camp Widow®, a weekend this program for widowed persons rebuilding their lives, in different parts of the country as well as a variety of other resources. The value this organization offers is inspiring and I am now a member of their Advisory Board and I teach at their events.
If you have a client who is widowed, I encourage you to tell them about Soaring Spirits. Suggest they chat on its forum, get a pen-pal, read the blog posts of other widowed people, find a regional meeting, check out the long list of recommended resources, register for Camp Widow, gain hope, and know that they are not alone.
And there are other ways you can help, too.
You have the financial expertise to help your clients, now raise the bar in other areas by learning how to do more to support a client through difficult life transitions. Serve your clients well through the toughest times of their lives, and you help them as well as your business.
When a client or colleague receives serious diagnosis or needs to undergo surgery, chemotherapy, or other treatments, people often rally around with support. They offer to bring food, provide rides to doctor’s appointments, watch the kids, etc. While grateful for all the offers, most people are still overwhelmed by trying to keep their network informed of medical progress, juggling responsibilities at work, and coordinating the needed help, all in the midst of the intense emotional and physical drain of the situation.
You can help alleviate that stress. There are several ways you can provide support that is different than what most people do. For example,
Spare your client or colleague the legwork by providing resources like these. Depending on your relationship, you may even wish to participate in offering practical help to the family. Regardless, let them know you care by providing concrete assistance at a tough time
Too much wisdom is lost every day in this country because we devalue our elders. When we highly value them, and take the time to listen and learn from the wealth of their life experience, it can be eye-opening, informative, and quite a delight for the storyteller and listener alike.
My sister and I recently embarked on a project to capture more of my Mom’s life story before it was lost to us. Over a period of several visits we asked her many things - what it was like growing up in a household with six brothers, what stood out about her Mom’s death from cancer at the too-young age of 52, her happiest and most troublesome memories, how people who knew her as a young woman would describe her, and what she hopes people will remember about her after she dies. Together we laughed, cried, and grew closer. We also learned many things we had never known. For example, we were surprised to find out that she’d had two dogs as a teenager, and she was not very fond of Frank Sinatra, even though all of her friends and classmates swooned over him!
In addition to passing on wisdom and life lessons, these stories are important for another reason. As we age, we are increasingly susceptible to the diseases that cause dementia, including Alzheimer’s disease. When people have Alzheimer’s, they lose their short-term memory first. Family members who gather long-term memories build a way to maintain their relationships, because even if their beloved elder can’t remember what she had for lunch, she may well remember that dog or the kind of music she loved in high school.
So, as you meet with clients to close out the year, encourage them to take time over the holiday season with the older generation, asking for their wisdom and life lessons, and gathering their stories and memories. Your clients will often learn things they never knew before, and may deepen their relationship with parents or grandparents. In the process, they may find themselves wiser, more tolerant, and with greater appreciation for those who comprise their heritage.
Of course, if your clients ARE the older generation, encourage the same thing in reverse. Recommend that they write or record their own memories and stories, along with the wisdom, hard-won lessons, and messages they wish to pass on to their families. The compilation could be a welcome gift of lasting value. Regardless of which direction the information flows, it is an exercise your clients will likely never regret. While you’re at it, perhaps you can do it in your family as well. Give the gift of time, curiosity, memory, and wisdom this holiday season. It costs so little, yet it is priceless.
We have an unprecedented crisis happening in our country. Every day, 115 people die of an opioid overdose. From 1999 to 2016, 350,000 people have died. A recent survey by the AP and Center for Public Affairs Research found that 1 in 10 Americans know a relative or close family member who died of an opioid overdose. In April, the Surgeon General issued the first national health advisory since 2005, urging families and friends of addicts to carry naloxone, the drug that can reverse the acute effects of an overdose and give a greater chance of survival.
Clearly, we have a huge public health problem with more people dying per day due to opioids than were dying of AIDS at the height of that epidemic. Just as we found the will and resources to combat AIDS over 30 years ago, we need to do it now for opioids.
In addition to scope, there is another aspect of these two epidemics that is similar. When people died of AIDS, their family members were often reluctant to tell others the cause of death because of the stigma. The same is true with the opioid crisis, leaving families unsupported and isolated. It’s bad enough that our society knows so little about how to effectively support the survivors of a loved one’s death; with a stigmatized death, the situation is exponentially worse.
Many people don’t realize that opioid addicts generally begin taking the drugs to relieve intense pain from a medical condition, not to get high. Yet one of the ways opioids work is to increase the levels of dopamine in the body, resulting in a feeling of euphoria while relieving some of the pain. Even if all the pain is not relieved, that which remains seems tolerable because of the underlying “high”.
Addiction begins when the drug rewires the reward centers of the brain, causing the person to perceive anything less than the euphoria as being painful and creating a physiological craving for more of the drug. Tolerance requires higher doses, the euphoria increases, the drug continues to affect the brain, and the addict sinks into an ever-deepening need for opioids just to feel normal. For those who try to reduce or quit, withdrawal symptoms are intense, and they often give up, relapsing into drug abuse to eliminate the pain. It reaches the point where an addict will do anything to get the next hit.
How to Help
After an overdose death, the grief is profound. The family loses a beloved family member. They lose the future they hoped for with that person and the unique place that person held in the family structure. They have exhausted themselves with worry and attempts to help. There are feelings of guilt and inadequacy that the loved one couldn’t be saved. These reactions are combined with anger at the lack of resources for addiction and resentment towards the addict who wasn’t able to kick the habit despite whatever help the family could offer. At the same time, rather than the outpouring of support they would receive if their loved one died of something like cancer, the support is muted, tentative, or absent, replaced by judgment or simply the would-be comforter’s inability to know what to say.
Here are a few suggestions on how you can help a client, friend or family member dealing with this kind of loss: