http://www.latimes.com/health/la-na-adv-latino-alzheimers-20101121,0,7488446.story
Angelica Reyes-Servin with her father, Arturo Reyes, 69, who has Alzheimer's. The family lives in Chicago. (Antonio Perez, Chicago Tribune / November 11, 2010)
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Reporting from Chicago —Arturo Reyes sat quietly as his family talked about traveling to Mexico over the holidays.
Suddenly, he broke into the conversation. "We cannot do it; we are illegal," his daughter Angelica Reyes-Servin remembers him saying. "If we leave, we may never get back again."
The room fell silent. Reyes and his family, who crossed the border from Mexico to Arizona more than three decades ago, have been U.S. citizens for more than 20 years.
"It was then I realized my father is sick," Reyes-Servin said. "He's not himself anymore."
Reyes, 69, has Alzheimer's disease.
Alzheimer's exacts a heavy toll among Latino Americans, who tend to get the condition almost seven years earlier than white Americans, according to research from the University of Pennsylvania and UC San Francisco.
Limited access to medical care and health insurance, lower levels of education and income, and higher rates of high blood pressure and diabetes contribute to above-average risks for Alzheimer's among Latino seniors, experts say.
The Alzheimer's Assn. calls the situation "a looming but unrecognized public health crisis" and predicts that Alzheimer's and related dementias could afflict 1.3 million older Latinos by 2050, up from about 200,000 currently.
In Chicago, a push to respond is being led by Constantina Mizis, a Mexican immigrant who founded the Latino Alzheimer's & Memory Disorders Alliance, one of the few organizations of its kind in the country.
With a Mexican mother and a Greek father, Mizis says she has always lived between two cultures, aware of differences in traditions and beliefs. It's a lesson she's bringing to medical professionals who reach out to Latinos with memory problems.
Such efforts have to be undertaken with sensitivity, says Mizis, explaining that some Mexicans from rural areas believe Alzheimer's is punishment for sins of youth. Others think of cognitive difficulties as "just part of age" — something that families have to accept without asking for assistance.
But cognitive lapses can occur because of treatable medical issues, including depression, thyroid problems and the side effects of medication, according to Freddy Ortiz, coordinator of the memory disorders clinic at Olive View- UCLA Medical Center.
Although no medication can reverse Alzheimer's, some drugs can offer short-term relief of symptoms, and some services, such as adult day care, can ease caregivers' stress.
In many Latino families, however, adult day care is considered a type of warehouse. "They believe that if you leave someone there you have abandoned this person," Mizis said.
For Luisa Echevarria's Cuban mother, Nora, dementia was associated with mental illness and a source of shame.
"We had to be very careful not to use the words 'Alzheimer's' or 'dementia' around her," said Luisa Echevarria, community relations director for Univision and its TeleFutura TV network in Chicago. "If we did, she would scream and say, 'There's nothing wrong with me; it's you who are crazy.' "
Echevarria remembers a lunch with her parents when her mother suddenly started speaking in gibberish, her eyes dark with panic. Soon after, Nora began picking fights with her husband.
Echevarria realized her mother needed medical help but felt torn. "You don't want to doubt your mother — the person you trust more than anybody, the person you go to for everything," she said. "It was a very hard time because I felt I was betraying her."
At a hospital for evaluation, Nora flirted with the doctor while joking about tasks she could not complete, such as naming her age or drawing a box. "She was a queen at disguising her disabilities," Echevarria said.
Nora now lives in a small, Latino-oriented assisted-living facility in Miami, near her husband and a large circle of family members.
"She is still my mother," Echevarria said. "Alzheimer's places you in a different reality, but it doesn't change who you are."
Education can be a complicating factor. People who have not had much education, including many Latino immigrants, tend to score lower on memory tests, and adjustments are needed to account for that, said Maria Marquine, a neuropsychologist at Rush University Medical Center in Chicago.
Language, too, can be a concern even when tests are translated into Spanish. Consider that car is carro in some Latino groups but auto and automovil in others, Marquine said. If the translation used in a memory test is unfamiliar, a senior's score could be affected.
For Arturo Reyes' family, his 2002 Alzheimer's diagnosis was an introduction to a strange new world.
"We had never been around anybody who had Alzheimer's," said his daughter Laura, who lives with her parents. "We didn't know anything about it."
She remembers finding her father in the kitchen opening all the drawers in search of silverware. Then came a call from his factory supervisor. Reyes had been standing in the middle of the factory floor, unsure what to do next.
Now, Laura worries about their mother, who insists on doing everything for her husband. She is not sure whether her father knows what has happened to him.
Not long ago, her mother asked him if he realized he forgot things.
The old man shook his head. "I don't know, I don't know," he repeated. "I don't know."
ATC Says - More serious research needs to be done and the results made public on the Genetic Differences between the races and the drawbacks and risks associated with mixing. Science has shown that these differences do indeed exist and until we can have an intelligent discussion about this matter without the label of racist being hurled upon us which the multiculturalists love to label us with, our children will continue to suffer the maladies of our own feel-good political correctness!
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