The makeup of the Brick Township Council, once traditionally Democratic, is now officially all-Republican after the New Year’s Day organization meeting.
“We’re not Republicans or Democrats here,” said Councilman Anthony Matthews, who was tapped to serve as council president this year. “We are representatives of the people. I feel like I’m the manager of an allstar team. We do not hide, we do not run. We make ourselves accessible to the people of Brick Township.”
Republican Mayor Stephen C. Acropolis was sworn in to his first full four-year term as mayor, flanked by his mother, wife, children, grandchildren and other members of his large family.
“How about the ones on the bus outside,” Councilman Joseph Sangiovanni joked before state Sen. Andrew W. Ciesla administered the oath to Acropolis.
“To be re-elected is like being born again,” Acropolis said. “I renew my commitment to you, the people of Brick Township. It seems like only yesterday I was sitting in the basement of this building going through a nominating process for council. I still remember my first reorganization meeting in 1994. Our position of trust is not one to be taken lightly or for granted. It is always about performance. If you don’t perform, you’ll be out in the blink of an eye.”
Acropolis was first elected mayor in November 2007 to fill the unexpired term of former longtime Democratic Mayor Joseph C. Scarpelli. Scarpelli resigned in December 2006 and pleaded guilty to accepting bribes one month later. He was released from federal prison in May after serving a 15-month term.
Ciesla also swore in Councilmen Joseph Sangiovanni and Daniel Toth to their second full terms and newcomer Dominick Brando to his first term on the council.
“I’ve been waiting 58 days for New Year’s Day,” Brando said when roll was called. “I’m here.”
Council members voted unanimously to select Matthews to serve as council president, and Toth to serve as council vice president.
“Councilman Toth has been not only a friend and hard worker, he makes our lives a little easier,” Matthews said. “I don’t think there’s enough lassos in Brick Township to slow him down. There is no one who researches a topic like Councilman Toth. I think his middle name is Google.”
Acropolis noted the council’s accomplishments over the past several years. Since the Republican majority on the Township Council took over in 2005, the Traders Cove site is now a township park and marina, traf- fic has eased at the Chambers Bridge Road and Route 70 intersection due to traffic pattern changes, progress has been made on the cleanup of the French’s Landfill site, and a “historic” shared services agreement with Toms River was put in place, he said.
“We will continue to make government smaller,” Acropolis said. “Brick Township is ahead of the curve with regards to shared services.”
But the work is far from over, he said.
“I pretty much wear my emotions and my opinions on my sleeve,” Acropolis said. “We don’t pull any punches here. The number one goal is to continue to bring Brick Township together as a town. One community. People helping people.”
Acropolis choked up briefly when he thanked his family for their support over the years.
“Can you imagine what my children have gone through since 1994?” he said. “I just have a special place in my heart for my family, who have always been there. I’ve always said public service should just be about that, public service, not self-service. I am humbled and honored to be your mayor.”
Matthews thanked Acropolis for “hanging in there” during difficult times.
“I say this with the utmost respect,” he told Acropolis. “You are a crazy man. You choose to stay here and decided to lead this community through tough times.”
Matthews also presented Sangiovanni with a plaque for his year as council president.
“We as a team went through a lot,” Sangiovanni said. “We did a lot more than we ever thought we could get done in one year. It wasn’t all smiles and it wasn’t always laughter.”
Sangiovanni noted the layoffs of 42 township workers just a year ago, to close a nearly $4 million budget deficit predicted for the 2009 municipal budget.
“We had some tough decisions,” he said. “Nobody likes layoffs. But tough decisions call for tough leaders. We cut the budget by $3 million. Unheard of. Nobody ever cut the budget in Brick Township.”
Longtime Democratic Councilwoman Kathy Russell, who lost a bid for a fourth term in November, did not attend the meeting.
New Year’s Day started off on a low note, with a markedly reduced employee roster, following the layoffs of 42 workers on New Year’s Eve.
2009 ended with Mayor Stephen C. Acropolis preparing to be sworn in to his first full term.
The Bulletin has selected what we consider to be the top 10 local stories of 2009, in order of importance. Let us know what you think we might have missed.
Acropolis wins in landslide
1. Republican Stephen C. Acropolis won a decisive victory over former Democratic Councilman Gregory Kavanagh. Acropolis had a nearly 6,000-vote margin over his Democratic opponent.
It was a vote of confidence for the mayor, who was first elected in November 2007 to fill the unexpired term of former Democratic Mayor Joseph C. Scarpelli. Scarpelli, who was elected to an unprecedented four terms, went down in disgrace after pleading guilty to accepting bribes and spent time in prison.
Control of the Township Council and administration is now firmly in Republican hands. All four of the Democratic council candidates, including veteran Councilwoman Kathy Russell, went down in defeat. Councilmen Joseph Sangiovanni and Daniel Toth were easily re-elected to their second terms. Dominick Brando, who failed to win a council seat in 2005, was elected to his first term.
2. Scarpelli released from prison
Former Democratic Mayor Joseph C. Scarpelli walked out of a halfway house in Brooklyn, N.Y., on May 15, after serving nearly 15 months in a minimum-security federal prison in Fort Dix. Scarpelli admitted at his plea hearing in January 2008 that while he was mayor, he took cash payments, totaling at least $5,000 from 1998 to late 2003. Scarpelli also admitted he accepted the cash payments knowing the payments were intended to influence him to help the developer obtain township approvals for potential applications.
3. School referendum goes down
Voters let the Board of Education know they didn’t think much of the $172.9 million referendum when they overwhelmingly rejected all four ballot questions Sept. 30.
The school district would have received $57 million in state grants if all of the questions had been approved. The most costly question on the ballot — $90.8 million renovation of Brick Township High School — garnered fewer “no” votes than any of the other questions. The other questions dealt with safety and security upgrades at all elementary and middle schools; replacing heating and air-conditioning systems, boilers and lighting in all of the schools and the installation of solar panels in the two middle schools; and an expansion to the Primary Learning Center on Chambers Bridge Road.
School officials are waiting for the results of an online survey offered to residents to see how they will proceed. A preliminary, scaled-down referendum of $92,462,845 is being considered, with a taxpayer share of $59,126,336, and a state share of $333,336,509, according to board documents. The district plans to be “more specific” with information in the next referendum and emphasize the savings the district could reap once improvements are made, Superintendent of Schools Walter J. Hrycenko has said.
4. Uproar over new football coach
Hundreds turned out at the May 14 Board of Education meeting to protest the hiring of Patrick Dowling as Brick Township High School’s second football coach in the school’s 51-year history.
espite last-minute appeals by legendary
coach Warren H. Wolf, who served as coach for 51 seasons, parents and students, the board voted unanimously to hire Dowling. Many questioned Dowling’s record as a head coach, the number of schools he coached at, his lack of familiarity with the Brick Township High School football tradition and his lack of ties to Brick Township. Dowling ended his first season as coach with a 4- 6 record. It remains to be seen if the board will rehire him for 2010. All coaching appointments in the district are made on an annual basis.
5. Beaches take a hit from November nor’easter
A two-day nor’easter that struck in mid-November took its toll on Brick’s three oceanfront beaches, with 15-foot waves reaching almost up to the dune lines. Township officials estimated the damage from the event at $1,940,660. Brick submitted paper for damages to the Ocean county Office of Emergency management shortly after the storm, Mayor Stephen C. Acropolis said.
6. Federal Nuclear Regulatory Commission gives Oyster Creek nuclear plant a new lease on life
The NRC on April 8 relicensed the controversial plant in Lacey Township for another 20 years, much to the dismay of a coalition of citizen groups, who claim the aging plant is unsafe.
A July 12 unplanned shutdown tipped Oyster Creek into the NRC’s “white” performance indicator. NRC regulations allow nuclear plants no more than three unplanned shutdowns for every 7,000 hours of operation. Oyster Creek’s number of unplanned shutdowns, also known as scrams, was 2.7 during the first quarter of 2009.
NRC officials announced on Oct. 26 it would step up oversight on the plant because of the number of unplanned shutdowns. Oyster Creek, which went on line on Dec. 23, 1969, is the oldest nuclear plant in the nation.
7. Traders Cove gets big boost from state
The township is slowly recouping the $8 million purchase cost of the Traders Cove site on Mantoloking Road. Acting DEP Commissioner Mark Mauriello came to Traders Cove on June 25 to present Mayor Stephen C. Acropolis with two checks — one for $3.4 million as partial reimbursement for the site acquisition costs and a $1 million check for redevelopment costs. The site, now known as the Traders Cove Marina and Park, is still in the process of being redeveloped. But it was open to the public this summer for fishing, crabbing and picnics.
8. Brick budget total drops for first time in history
The municipal budget dropped nearly $3 million in 2009. Much of the savings came from the layoffs of 42 employees at the end of 2008 and attrition, as township officials struggled to cope with a 4-percent state cap on municipal expenditures, declining revenue and the loss of an additional 4173,531 in state aid. Democratic Councilwoman Kathy Russell cast the lone vote against the budget’s adoption. Russell said the $75,651,524 budget left a “dangerously low” amount of surplus for the remainder of the year. Russell had voted yes to introduce the budget in March.
9. Traffic improvements
After years of maneuvering through traffic-choked Brick, motorists found it easier to make their way through the Chambers Bridge Road and Route 70 intersection in 2009. A change in the traffic pattern eliminated left-hand turns from Chambers Bridge Road onto Route 70 east or west. Traffic on Chambers Bridge Road is now able to travel north and south simultaneously, which increased the time for green lights and allowed more cars to travel through the intersections before the lights changed. Drivers who want to access Route 70 east from southbound Chambers Bridge Road now go to the intersection of Chambers Bridge Road and Route 70. Motorists who want to get on Route 70 west from northbound Chambers Bridge Road use the U-turn on Ovation Way.
The traffic changes were the result of extensive traffic studies conducted by Birdsall Engineering, which examined traffic flow counts on Route 70, Chambers Bridge Road, Cedar Bridge Avenue and Brick Boulevard.
10. Snowstorm buries Brick in 2 feet of snow
The two-day storm during Dec. 19 and Dec. 20 challenged public works crews to clear Brick’s 1,762 roads of snow. Both Public Works Director Glen Campbell and Mayor Stephen C. Acropolis said workers were hampered by the number of parked cars on streets in some areas, which made it difficult to plow.
Acropolis plans to ask the Township Council to consider regulations that would require cars to be taken off the streets during snowstorms.
The mayor estimated the storm’s cleanup costs at between $200,00 and $250,000.
It’s the time of year to reflect on how the world has changed in the past year, and even the past decade.
Imagine, then, how much it has changed in the past 50 years: the Internet, cell phones, four wars, landing a man on the moon and the election of the first African American president.
But there’s one thing that hasn’t changed in 50 years: the dedication of the Brick Elks to honor veterans and help the less fortunate.
The Brick Elks Lodge opened its doors for the first time on Nov. 28, 1959, on Brick Boulevard with 233 members.
The membership grew to over 600 members during the first decade. The lodge moved to its current home on Old Hooper Road on June 15, 1972, and the Brick Elks Lodge now has 1,065 members.
A ceremony to commemorate the lodge’s 50th anniversary was held on Nov. 28, and current Exalted Ruler Philip DiGuglielmo along with longtime members Leroy “Whitey” Wutsch and Ralph Comppen sat down this past week to reflect on all they have seen the Brick Elks accomplish over the decades. All three have served as Elks members since the mid-1960s.
“When you become an Elk, you become one of two things: you become dedicated or you become a card carrier,” Wutsch said. “The three of us here have been Elks for over 30 years. We’ve become dedicated. It’s part of our lives. We enjoy giving. We enjoy doing.”
The Brick Elks are active in both local and regional projects. One of the regional projects that the membership immediately singled out is their support for Camp Moore for special-needs children in Pompton Lakes. Local members make a trip to the camp each year to cook dinner for the children there.
The Brick Lodge has been part of a statewide Elks initiative for several patriotic projects over the past 50 years.
The projects included donating money to restore the Statue of Liberty, building the Vietnam Veterans Memorial in Holmdel, and working to return the Battleship New Jersey to the state, where it eventually became a museum in Camden.
“We cater to veterans,” Wutsch said.
On the local level, the Brick Elks sponsor a Little League team and Boy Scout troop. Other programs they support include Vest-A-Cop, which provides bulletproof vests for local police officers, and Kids Night Out to promote anti-drug awareness among youths. This past year they gave out 142 food baskets to needy Brick families on Thanksgiving and Christmas.
The Brick Elks Lodge members are also proud of their ability to provide scholarships for local students. One boy and one girl from each Brick high school receive a scholarship worth a minimum of $1,000 every year. But Wutsch said they typically give out $10,000 each year in scholarship money.
For all their work on the local level, the Brick Elks received the Key to the City from Mayor Stephen Acropolis on their anniversary date, along with a proclamation that decreed Nov. 29 as Brick Elks Day throughout the township. A follow-up resolution honoring the Elks’ achievements in the community was issued by the council.
It was an honor that DiGuglielmo said he was “proud” to accept on the lodge’s behalf.
“It’s nice to be recognized, since we work with the township,” he said.
“We have a good relationship with the township,” Wutsch said. “We cooperate with them fully and they cooperate with us, and we both benefit.”
The Elks Lodge also holds a number of annual events. There is a Flag Day service held at the lodge every year.
“The Elks always honor the flag,” Wutsch said.
Wutsch also cited the history of the Elks nationally in aiding veterans. The very first veterans hospital in the nation was built and run by Elks during World War I. The hospital was turned over to the federal government at the close of the war, he said.
And the Elks continue to honor veterans at the lodge’s annual party in November, DiGuglielmo said.
“A lot of time we go to their homes and bring them gifts,” Comppen said.
Lodge members also take veterans to baseball games at the Lakewood BlueClaws’ minor league baseball stadium as well.
The Elks always honor their own with an annual event and a remembrance ceremony on the first Sunday in December for members who passed away in the preceding year.
“There’s a lot of unfortunate people out there,” Comppen said. “If we don’t do it [help them], who will? You do not have to donate a lot of time. The more people who do it, the less each person has to do.”
“This is a centralized location for people who like to volunteer and help others,” Wutsch said.
For more information about the Brick Elks, call 732-920-0750.
Mildred “Muney” Davis is described by her son as a “real lady”: she taught her son to hold doors open and she never used four-letter words.
She worked for her husband Lou’s business, and volunteered her time for the Jewish Chronic Disease Hospital in Brooklyn, and was president of the volunteer organization of the Mildred Davis Unit, not named after her.
But once she moved from Brooklyn to a new residence in Manhattan in the 1970s, things weren’t quite so familiar to her. She would begin to pretend she recognized business associates when in fact she didn’t know who they were, she would get lost even though she was one block away from home, she put too much dish detergent in the dishwasher and caused a flood, and the proper, well-to-do woman cursed at a woman wearing a fur coat.
Although the disease was fairly unknown at the time, Muney Davis was eventually diagnosed with Alzheimer’s disease when she was in her 60s.
Her son, Robert Davis, recalled instances when the family noticed something was wrong but assumed it was just old age, as many people did back then. The North Brunswick Township councilman said that she would ask a question and then ask the same thing a few minutes later. During a cruise, she was confused several times about where she was. She was misplacing items around the house.
“In the beginning, you kind of lose patience when someone asks you the same thing over and over again,” Robert Davis said regretfully. “But you have no idea.”
Muney Davis was tested at Mount Sinai Hospital in New York and was diagnosed with the most common form of dementia. However, the doctor told Lou Davis, “Your wife has Alzheimer’s and there is absolutely nothing we can do about it. It just gets worse,” Robert Davis said.
“The doctor gave my father absolutely no help,” Robert Davis said. “The most frustrating thing is, there is nothing you can do. It literally is a death sentence. The person goes from being an active person in society to pretty much a vegetative state.”
Lou Davis’ cousin was a top neurologist and psychologist in New York and prescribed different experimental medications for Muney, but nothing worked. Instead, Robert Davis watched his mother get progressively worse.
“She needed someone with her all the time. She would forget things. Her personality changed,” he said. “I think the most difficult thing is that here you have active people who are always out there doing things and all of a sudden they’re sliding into dementia.”
Muney Davis eventually became bed-ridden and had to be fed intravenously. Her husband had taken out an insurance plan years before that allowed her to have round-the-clock nursing, but the cost of her overall care was $1.5 million, Robert Davis said.
Yet despite all of the medical attention, Muney Davis passed away 18 years after her initial diagnosis, at the age of 82. Albert Einstein Hospital in New York performed an autopsy on her brain, but it was determined there was nothing significant that could be used in Alzheimer’s research.
“We did it because we felt if there was something they could find that did help somebody else, then the death of my mother wouldn’t be in vain,” Robert Davis said.
Robert Davis said that the caregivers suffer the brunt of the disease because they need to be with a patient 24/7. He said his father would come home every night and talk to his wife, and if she would utter just a word or two, he would think there was improvement. He refused to put her in a nursing home, although the couple’s two children made the difficult decision to move her to a facility a few years before she passed away so that she could receive the constant care she needed.
“It is very hard for a person to accept that,” Robert Davis said of watching a loved one decline, especially seeing his mother for over a decade not being able to recognize people. “It is affecting them physically, but mentally it affects the caregivers and family and friends.”
Lou Davis, who had never given up hope for his wife’s improvement, lived for nineand a-half years after she passed. His son called him “tough” and one of the strongest people he knows.
Another person Robert Davis called his “pillar of strength” is his own wife, Linda, who was also in pain from watching her mother-in-law suffer.
Linda Davis said her relationship with the Davises was better than her relationship with her own parents, and said she was always treated like a daughter instead of an in-law.
“Eventually you look at what’s the quality of life and you know this was a very vibrant, active, involved woman … and to see her decline, to see her finally in a home in the fetal position, it hurts,” Linda Davis said. “As much as I loved her, I had to let her go. She was just existing.”
Linda Davis said the family was also very concerned about Lou Davis, because of the energy and time he put into caring for his wife.
However, to cope with his situation, the elder Davis had joined the New York chapter of the Alzheimer’s Association and helped raise over a million dollars for research.
Robert Davis is now involved with the Greater New Jersey chapter.
Robert and his sister, Barbara, are also participating in The National Cell Repository for Alzheimer’s Disease study through the Department of Medical & Molecular Genetics at Indiana University School of Medicine. Blood samples are being used to obtain DNA and cell lines for research purposes, though it is not a diagnosis of Alzheimer’s, and half-hour memory tests are given. Family history is provided as well because the study requires that two relatives have had the disease; Robert Davis said he believes his mother’s sister had it as well.
“We all forget things but when you have someone in your family, it’s definitely in the back of your mind,” he said, “but you can’t worry about it. You’ll drive yourself crazy.”
The Davises advise others to get tested right away if something is suspected, to find facilities for patients so that caregivers can rest, for all family members to be involved and share the responsibility, and for those affected directly or indirectly to attend support groups. Alzheimer’s patients die twice: the first time, when they lose all sense of themselves and their surroundings, is the most painful.
The second time, when they pass on, is a relief.
Teri Tumbleson, of Sayreville, said that was the best advice she was given when her mother, Santa Restivo, was diagnosed seven years ago with the mentally debilitating disease.
Tumbleson said her mother, who was 74 at the time, had been doing “silly things” her family would laugh off prior to her diagnosis, such as putting too much soap detergent in the washer, or donating a lot of money to different charities.
However, when the situation came into question, Restivo was taken to a neurologist in March 2002 and through a process of elimination, mainly by ruling out a carotid sonogram, MRI and EEG as negative, she was diagnosed with Alzheimer’s.
Restivo continued under the care of the neurologist for the next year-and-a-half, and was given memory tests to check what state and county she lived in, what floor she was on, the season and month, and what time it was.
Tumbleson said her mother only scored 14 correct out of 20 questions.
“I was extremely upset because I couldn’t believe how bad she was at that point.
The neurologist prescribed a host of medications, including Exelon to slow the dementia symptoms, Lexapro to calm her bouts of crying, Seroquel to help her sleep, and something to quell her dizziness.
“There is really no solid proof that any of these medications do what they say, but I wouldn’t take the chance [of not using them],” Tumbleson said.
In the meantime, Restivo was getting worse, asking to “go home” to her childhood home in Brooklyn, walking outside and upstairs of her Sayreville home late at night thinking she was going to her upstairs bedroom in Brooklyn, forgetting she ate and consuming portions such as 10 bananas or a loaf of bread, placing dirty knives and forks in a plastic bag in a clothing drawer, hallucinating, and acting out in an agitated manner.
“It used to bother me. I would think, why doesn’t my mom realize and say what she has to say. … I used to think, if it were me I would tell everyone what was happening.… It frustrated me that she didn’t know this. It made me angry,” Tumbleson said of her initial reaction.
But then, she realized that she could not blame the former stay-at-home, quiet mother who had changed into a loud woman who would curse and yell; instead, she had to blame the disease.
Then, in March 2003, Restivo went to see a geriatric psychiatrist at the University of Medicine & Dentistry of New Jersey University Behavioral Healthcare.
She was referred to the Carrier Clinic in Belle Mead for two weeks. While her relatives were not allowed to see or call her, she was detoxified of all her medications and given new prescriptions.
She was prescribed Exelon, and also Respitrol, Zoloft and Depakote to calm her.
After the end of those two weeks in May, Restivo was discharged and placed at The Chelsea Senior Living Facility in East Brunswick. Tumbleson was so impressed with the facility, she said if something happens to her, she wants to be placed there.
She said her mother loved it too, calling it her “apartment,” and thinking it was her “job” because in the beginning she helped push wheelchairs and serve food.
The recreation director there kept the patients active: they played card games, drew pictures, sat in the garden and took bus trips.
However, as time went on, Tumbleson said her mother began coloring out of the lines and stopped writing her whole name.
Restivo began to revert back to her childhood, looking for her mother, wanting to cook dinner for her husband and asking for her young kids.
Tumbleson also said when the sun went down, all of the patients would begin to whine, cry, yell and try to leave, which was known as “sundowning.”
“It’s just a heartbreaking thing,” she said. “You never go back up. You know there is no cure and you’re never going to get better. You stay at a plateau and then drop down.”
The spiral downward led to Restivo’s admittance to a nursing home in Matawan in 2006: she stopped using the bathroom, she was falling out of bed and she eventually needed a wheelchair.
During this time she was also going through hospice.
“She wasn’t hurting, but who was hurt most was the people around her,” her daughter said. “But she’s my mom. She took care of me growing up, so I can take care of her now.”
The Alzheimer’s progressed quickly: Restivo couldn’t chew and finally stopped breathing.
She passed away in April 2007 at the age of 79.
Tumbleson said the experience has taught her a lot about Alzheimer’s, and that despite dealing with her father’s heart problems, her grandmother’s stroke and her mother’s-in-law lung and breast cancer, Alzheimer’s is the toughest to deal with.
“I’ve gone through things but [Alzheimer’s] has to be the most terrible disease that there is. It could last 20 years, it could last two years, you never know. Everything just gradually stops.”
Tumbleson said she learned that anyone with an inkling of a problem should get tested; that all doctors should be informed of a family history of Alzheimer’s; that a geriatric doctor should be sought to deal with the elderly instead of a general practitioner; that a living will and power of attorney documents are necessary before the patient declines; that family members must make sure that Alzheimer’s patients are not overmedicated; that patients are spoken to because despite not being able to respond, they most likely can feel your presence and hear your words; and that caregivers need their own time to rejuvenate themselves for their own health and well-being.
She also recommended the resource book “The 36-Hour Day” by Nancy L. Mace and Peter V. Rabins.
Tumbleson said that she does not feel any guilt because she knows her mother is with her father in a better place, and because she knows she did everything she could to help her mother.
“I knew that wasn’t a life because she wouldn’t want to live like that. I don’t want to live like that,” she said.
Yet thoughts do linger with Tumbleson about the future of her relatives, because her aunt, father-in-law and possibly her grandfather have suffered from it.
“The only thing that bothers me to this day is when I forget things. Will I get this?” she said rhetorically. “They have to find something for this because way too many people have this disease.”
10 warning signs of Alzheimer’s disease
1. Memory loss
Forgetting recently learned information. A
person begins to forget more often and is
unable to recall the information later.
2. Difficulty performing familiar tasks
Finding it hard to plan or complete everyday
tasks. Individuals may lose track of the steps
involved in preparing a meal, etc.
3. Problems with language
Forgetting simple words or substituting
unusual words, making their speech or
writing hard to understand.
4. Disorientation to time and place
Can become lost in their own neighborhoods.
5. Poor or decreased judgment
May dress inappropriately, wearing several layers
on a warm day or little clothing in the cold.
6. Problems with abstract thinking
May have unusual difficulty performing
complex mental tasks, like forgetting what
numbers are and how they are used.
7. Misplacing things
May put things in unusual places — an iron in
the freezer or a wristwatch in the sugar bowl.
8. Changes in mood or behavior
May show rapid mood swings — from calm to
anger — for no apparent reason.
9. Changes in personality
May become extremely confused, suspicious,
fearful or dependent on a family member.
10. Loss of initiative
May become very passive, sitting in front of
the TV for hours, sleeping more than usual or
not wanting to do usual activities.
As the most common form of dementia, accounting for about 70 percent of all cases, Alzheimer’s disease affects 5.3 million people. This loss or decline of memory and other cognitive abilities is newly diagnosed every 70 seconds, and has become the sixth-leading cause of death across all ages and the fifth-leading cause of death for those over age 65.
With Alzheimer’s disease, information transfers at synapses, or the connections where healthy nerve cells in the brain, begin to fail. Starting with 100 billion of these nerve cells, or neurons, Alzheimer’s patients eventually lose these synapses, and their brains show dead and dying neurons.
Normal memory loss includes forgetting part of an experience, remembering events later on, being able to follow written or spoken direction, being able to use notes and being able to care for oneself.
The difference with Alzheimer’s is that a person forgets whole experiences, rarely recovers the memory later on, is gradually unable to follow directions or use notes, and is eventually unable to care for themselves.
As damage spreads, individuals experience confusion, misplace items, have disorganized thinking and impaired judgment, have trouble expressing themselves, experience disorientation in time, space and location, have difficulty remembering names and recent events, suffer from apathy and depression, have a loss of initiative, and have trouble speaking, swallowing and walking.
Memory loss is diagnosed by a physician, who can suggest a neuropsychological examination to check memory, language function, problem solving and visuospatial skills. An MRI scan of the brain tests for causes of cognitive impairment such as a thyroid or vitamin B12 abnormality.
Once diagnosed, there are several stages of memory loss:
Stage one is no impairment, where function is normal.
Stage 2 is a very mild decline that could be memory lapses due to normal age-related changes.
Stage 3 of mild cognitive decline could be early-onset Alzheimer’s where memory or concentration problems are detected by a medical doctor, such as trouble remembering names or words, forgetting material that was just read, misplacing a valuable object or having trouble planning or organizing.
Stage 4’s moderate cognitive decline includes forgetfulness of recent events, impaired arithmetic ability, difficulty performing complex tasks, forgetting one’s own personal history and becoming moody or withdrawn.
In Stage 5, there is a moderately severe cognitive decline where patients cannot recall their own address or phone number, become confused about where they are or what day it is, have trouble with less challenging arithmetic and need help choosing proper clothing, but can still remember significant details and do not require assistance with daily functions.
Stage 6 represents a severe cognitive decline in mid-stage Alzheimer’s. A person may lose awareness of his or her surroundings or personal history, have trouble remembering names, need help dressing properly and need help with the restroom.
Stage 7 is severe Alzheimer’s, where patients lose the ability to respond, carry on a conversation and control movement. They need help with much of their daily personal care and could lose the ability to smile and sit up without support. Muscles grow rigid, and swallowing becomes impaired.
Those patients with highly advanced stages of the disease lose their ability to communicate, fail to recognize loved ones and become bed-bound and reliant on 24/7 care.
They tend to wander or become lost, which is why the Alzheimer’s Association has set up a registry program database for emergency responders, and the Comfort Zone computerization tracking system to monitor patients in their homes and along perimeters.
Yet many patients must move into a nursing home or professional care facility to further protect their safety.
The greatest risk factor is advancing age, as most sufferers of the disease are over age 65. Inheriting one or two forms of the three common forms of a specific gene that provides the blueprint for a protein that carries cholesterol in the bloodstream increases the risk of developing Alzheimer’s but does not guarantee it.
“Younger-onset” or “early onset” Alzheimer’s does occur in less than 5 percent of cases, and is caused by rare genetic variations.
African Americans are affected more, as are women because women tend to live longer than men. White females have the highest death rates, while there are lower death rates in non-Hispanic blacks and those of Hispanic origin.
In New Jersey, the estimated number of people with Alzheimer’s in 2000 was between 101,000 and 200,000, with New York, Pennsylvania, Florida, Illinois, Texas and California reaching up to 499,000 cases. By 2025, the estimated number in New Jersey remains about the same, with less than a 24-percent increase rate, while numbers in Florida and California could exceed 500,000 patients. The Midwest typically has fewer than 50,000 patients. Across the United States, the upper Midwest could see increases of anywhere from 81 percent to 127 percent.
Patricia Lombreglia, the president and CEO of the Alzheimer’s Association Greater New Jersey Chapter, said that since the greatest risk factor for Alzheimer’s is age, the statistics reflect a high number of diagnoses in Florida because of the elderly population there and a low number of diagnoses in the Midwest because of a lower population density.
By next year, the overall number of new cases is expected to increase from 411,000 in 2000 to 454,000, and the estimates are 615,000 by 2010 and 959,000 by 2050.
By 2030, 7.7 million people over age 65 will have it, a more than 50-percent increase than those 65 and older currently suffering. By 2050, there could be up to 16 million Alzheimer’s patients over age 65 unless medical breakthroughs prevent or treat the disease; if not, more than 60 percent of Alzheimer’s patients will be over 85 years old.
Across the board the mortality rate tends to be high because severe dementia frequently causes complications such as immobility, swallowing disorders and malnutrition, which can increase the risk of developing pneumonia, which is the most commonly identified cause of death among elderly Alzheimer’s patients.
In relation, in New Jersey, as of 2005 statistics, there were 1,815 deaths, or about 17.6 deaths per 100,000 patients.
On a more positive note, there have been five new drugs approved by the U.S. Food and Drug Administration to slow the worsening of symptoms for up to a year for about half the patients prescribed them.
Yet studies have shown that using available treatment options, integrating coexisting conditions into the treatment plan and using counseling, activity and support group services can improve quality of life while dealing with the disease.
“There is a prolonged functionality when [medications are] given at the earliest point in the diagnosis,” Lombreglia said.
Also, since the health of the brain is closely linked to the overall health of the heart and blood vessels, some data indicate that managing high cholesterol, type 2 diabetes, high blood pressure and weight gain may help avoid or delay cognitive decline. Other evidence cites regular physical exercise and a low-fat diet rich in fruits and vegetables, as well as mental stimulation, may support brain health.
For those affected by the caregiving aspect of Alzheimer’s, Lombreglia said a wealth of information and support is available, such as resource connections, a 24-hour helpline, care consultations, training for support group facilitators, a respite care assistance program and health and wellness promotion.
“It is important [caregivers] take care of themselves, getting a break and understanding how stress works and the need to recharge their batteries,” Lombreglia said.
She said that coping with Alzheimer’s is “very much like any other type of grieving process,” but Alzheimer’s is worse because of the slow, gradual progression of the disease.
The Alzheimer’s Association Greater New Jersey Chapter offers caregiver support groups each month in various towns.
“People don’t realize how ravaging and horrific this disease is as it progresses. It is a total loss of self,” she said.
There is currently no cure for Alzheimer’s, and there is no treatment available to slow or stop the deterioration of brain cells. Yet research is constantly being conducted on ways to prevent, treat and cure the disease. One important component of the research is clinical drug trials for medicines that attempt to halt the progression of the disease.
“There is a lot of really promising medical research going on right now,” Lombreglia said.
There is also a study being conducted to determine the hereditary nature of Alzheimer’s. The National Cell Repository for Alzheimer’s disease study through the Department of Medical and Molecular Genetics at Indiana University School of Medicine studies blood samples of people who have two relatives diagnosed with Alzheimer’s to obtain DNA and cell lines for research purposes. There are also memory tests given, and questions asked about family history. For information, call 1-800- 526-2839 or email AlzStudy@iupui.edu.
However, a major obstacle Alzheimer’s patients face is the lack of funding for research. Therefore, the Greater New Jersey Chapter holds several fundraisers throughout the year. In May there will be the “Legendary Links Golf Raffle,” where courses are donated for threesomes and foursomes to play. On June 19 there will be a Polo charity classic at the Hillsborough Country Club. And every year from September to November, nationwide, the “Memory Walk” is held to raise money and awareness.
The chapter will also hold a professional education and research conference April 15 and 16 in Somerset to discuss cutting-edge research, treatments and care options geared toward physicians, nurses, social workers, hospitals, nursing homes and assisted living facilities.
“We really do feel there is more momentum, more understanding of this disease than there ever has been,” Lombreglia said.
For more information, call the chapter’s helpline at 1-800-883-1180 or visit www.alznj.org.
For more information about Alzheimer’s in general, visit www.alz.org or call 1-800- 272-3900.
Contact Jennifer Amato at
Meridian Health, which is comprised of Jersey Shore University Medical Center, Ocean Medical Center, Riverview Medical Center and K. Hovnanian Children’s Hospital, is temporarily modifying its hospital visitation policy to include recommendations to restrict visitors under the age of 18.
Since the beginning of the H1N1 influenza pandemic, these hospitals have encouraged preventative measures such as frequent hand washing and asking visitors to refrain from hospital visitation if they are experiencing any illness.
These additional age-specific guidelines are based on recommendations recently issued by the New Jersey Hospital Association, New Jersey Department of Health and Senior Services and the Centers for Disease Control, and follow similar approaches taken by hospitals across the nation.
For the duration of the flu season, families and visitors are asked to observe the following:
• Not to bring children under the age of 18 to visit the hospital. No individuals under the age of 18 are recommended to visit the hospital unless they are a patient or in special circumstances that have been identified and approved by the hospital.
• Those feeling ill (experiencing respiratory illness or any flu-like symptoms such as a fever, cough, sore throat, fatigue, nausea, vomiting or diarrhea) should not visit friends or loved ones.
• Visitors should limit their movement within the hospital and use waterless soap/hand sanitizer provided throughout the hospital when entering and exiting a patient’s room and limit touching surfaces within the room.
• Follow the team’s guidance and instruction on the proper use of personal protective equipment, such as masks, prior to entering the room of a patient with respiratory illness.
• Visitors coming to the emergency departments and experiencing respiratory illness or flu-like symptoms, are asked to wear a surgical mask while in the waiting areas. Masks are available at the entrance of the emergency departments.
For further information on the H1N1 virus or the seasonal flu, visit meridianhealth. com/H1N1 or flu.gov.