About six years ago, Theresa Sitar of Joliet noticed that her husband, Steve, was growing a bit forgetful. Today, he can no longer remember his home address, and the Alzheimer’s disease with which he was diagnosed 5 1/2 years ago necessitates round-the-clock care.
“At first you always think it will get better,” Sitar said. “But it doesn’t. It’s progressive. Last year, he wandered out of the house and went about 10 blocks to McDonald’s. The police brought him home.”
Fortunately, Steve, 77, suffered no permanent harm, though he was hospitalized for two weeks shortly afterward with pneumonia. During his illness, Theresa came to the difficult conclusion that she was no longer able to care for her husband at home. “I knew I wouldn’t be able to lift him out of bed (if he returned home),” she said.
Theresa Sitar chose to seek long-term nursing care for the man who once oversaw a thriving greenhouse business. Sitar selected the Deerbrook Care Centre in Joliet, a long-term nursing facility that is on the leading edge of care for Alzheimer’s patients.
Sitar became aware of Deerbrook when an aunt resided at the 217-bed center. About 61 of those beds are reserved for people suffering from Alzheimer’s or dementia; the others are for residents who are elderly, physically impaired or recovering from illness such as a stroke.
“The people here really care for him. The workers are terrific,” Sitar said recently as she visited with her husband in a large room dubbed the Clubhouse.
In this sunny activity room, patients in the early stages of Alzheimer’s visit with family members or participate in singing or dancing to songs from their youth. One resident smiled broadly in the room’s center as she sang and performed a little soft-shoe to the song “I’m Forever Blowing Bubbles.” One of the ironies of Alzheimer’s, staffers say, is that its victims often recall very clearly things from their distant past but cannot remember events that happened just minutes ago.
Deerbrook’s Alzheimer’s patients live in a wing apart from other patients. A door to the early-stage Alzheimer’s wing stays locked unless pushed against for at least nine seconds, providing a safe environment for residents who still are mobile but can’t be trusted not to wander, according to Arlene Albert, executive assistant to the center’s administrator. Studies have shown that Alzheimer’s patients usually don’t concentrate long enough to open such a door, she said, though it can be opened by staff in case of a fire.
The idea of a wing exclusively for Alzheimer’s patients is a new one, said Wanda Mattix, a geriatric nurse who works as a consultant at Deerbrook and also coordinates a support group at Silver Cross Hospital in Joliet for families of Alzheimer’s patients.
“Specialized care units are just coming into the forefront,” she said. “Providing for the needs of Alzheimer’s patients is difficult, and the disease can be difficult for other residents to witness.”
Because Alzheimer’s patients are not part of the center’s general population, they can receive care tailored to their specific needs, Mattix said. Alzheimer’s patients often don’t adhere to schedules for sleeping or eating and don’t require the quiet environment that other elderly patients may need.
Lapses in judgment caused by the disease make it hard to maintain their dignity, she added. “If (patients) disrobe on the unit, for example, staff can help them get dressed, but everyone else (among patients) is going to be oblivious to it,” Mattix said.
Deerbrook also provides different levels of activities and medical care depending on the extent of impairment. “They’ve developed a continuum of care,” from the very earliest to the very latest stage, explained Anna Ortigara, director of residential care services at Rush Alzheimer’s Disease Center in Chicago, affiliated with Rush-Presbyterian-St. Luke’s Medical Center. The Rush center studies the causes of the disease and therapies that may lead to prevention or a cure.
At the Clubhouse where Steve Sitar visited with his wife, patients can still engage in group activities, such as singing. As the disease progresses, patients lose the ability to connect with others or their environment, and another wing at Deerbrook is set aside for about 20 patients in the late stages of Alzheimer’s. Many of these patients are wheelchair-bound and unable to talk. As they sit around a long table, several fidget with colorful objects placed in front of them. Staff members coax them to touch these objects to maintain the mental capacity that remains.
Although these activities may not seem like much, they keep patients from withdrawing completely into themselves, said Carolyn Tait, director of the Alzheimer’s unit.
“We feel strongly about providing activities for patients, no matter how late-stage their illness is,” she said.
The staff gauges the success of the activities by noting patients’ reactions–if they smile, for example, or fiddle with an object, it shows they’re making a connection, she said.
Ortigara praised the practice of working with late-stage Alzheimer’s patients. “Even those (in the late stage) should not be warehoused,” she said, noting that only about 10 percent of long-term care facilities nationwide provide continuing care for Alzheimer’s patients.
The cost of care at Deerbrook runs about $2,000 a month, not including the cost of doctor visits and medications, and is covered by patients’ own funds, private insurance, Medicare or Medicaid. The center provides an 8-to-1 staff-to-patient ratio and also operates a telephone information line for family and friends of patients and anyone else who has questions.
The illness is especially hard on the caregivers, Albert said. “They tell me that they lose their loved one not once, but twice,” she said. “They lose them when they begin no longer to be the person they were, and then they lose them when the end comes.”
Lois Demos, the niece of a Deerbrook patient, said that families often feel guilty about turning to a nursing home for care of their loved one. “People sometimes have the attitude that a nursing home is a dumping ground,” she said. “But (being at) home isn’t always the best answer. People like to think that, but it isn’t the case.”
Demos’ 98-year-old aunt, Edith Hanson, has been at Deerbrook since July, when she moved from another, larger facility. She said she has noted an improvement in her aunt since the move.
“Everything has gotten better since she’s been here,” Demos said. “Her memory is improved.”
Still, the devastating effects of the disease on its victims and on their families cannot be underestimated. Although Theresa Sitar knows the center provides better care than she could at home, she said that every time she visits her husband, “he still says he wants to come home.”
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For information on Alzheimer’s Disease, call Deerbrook’s information line at 815-744-5585.
