Bob's Last Marathon

Lena shares her sense of optimism as she recounts how the response to Alzheimer’s disease and related dementias has evolved from little discussion, poor resources, and stigmatizing to general recognition—and dare we say acceptance—of their significance within our aging population. She announces the transfer of all assets—content and branding—to the Penn Memory Center, where work will continue in m...

What happens when we reach the end of our journey, when we are confronted with grief and loss, while the burden of caregiving is relieved? In this episode, two caregivers share their stories: Judith Johanson, in her multiple roles at the Alzheimer’s Disease Research Center and Gerontology Research Unit, and Katie Brandt, Director of Caregiver Support Services and Public Relations for the Frontotem...

With the availability of anti-amyloid therapies, accurate diagnosis and staging of Alzheimer’s disease becomes ever more important, as does the need to monitor response to treatment. Faster, less expensive, and more accessible blood-based biomarkers, a long-standing goal for the medical research community, are now on the horizon. Dr. Steven E. Arnold, Massachusetts General Hospital, explains why a...

The somewhat complex logistics for both the clinic and the patient in administering Leqembi (lecanemab), the first fully FDA-approved drug for Alzheimer’s disease in over 20 years, are summarized in this second of two excerpts from a recent roundtable. Dr. Steven E. Arnold and Dr. David A. Wolk highlight some of the risk factors, including genetic risk factors. They postulate that Alzheimer’s dise...

Decades of research have helped elucidate the roles of amyloid plaques and tau tangles in Alzheimer’s disease, identify biomarkers of underlying pathology, and guide the development of new therapies. In this first of two excerpts from a recent roundtable, Dr. Steven E. Arnold, Massachusetts General Hospital, and Dr. David A. Wolk, Penn Memory Center, review our current understanding of amyloid and...

Caregiver stress and burnout are not uncommon, as caregiving for someone with dementia is a journey that demands resilience, compassion, and understanding. Felicia Greenfield, MSW, LCSW, describes a case study and urges our listeners to navigate caregiving while prioritizing mental health and well-being. She recommends a combination of self-care practices—such as meditation, exercise, spending tim...

Dementia can pose challenges by changing the way a person communicates. Repetition, confusion, and inappropriate language are just a few examples of what caregivers may face. Today, we would like to share some curated content from past episodes that our audience has found to be the most useful—in developing techniques, and perhaps a fresh perspective, to connect with our loved ones in the face of...

Alex Morris talks about the need to acknowledge changes within the person with dementia, and the modifications that can help loved ones remain comfortable and engaged. She also stresses the importance of reducing the burden on the caregiver by sharing some of the planning and hosting of events. Tips for improving conversation are also offered.

Holidays are meant to be a time of joy, celebration, and tradition, but they can also be stressful and hectic. Caring for a person living with dementia can bring additional holiday stress to a caregiver. How your loved one participates in your holiday rituals will need to be adjusted. Stefanie Bonigut, MSW, shares tips and strategies that can help a caregiver make the holidays as manageable and as...

Hearing news about a diagnosis, can be a devastating, confusing, and difficult experience. To help our listeners find the way to helpful information, and look for guidance on getting started, we’ve curated content that our audience has found to be the most useful—in understanding the basics about dementia care, learning about lifestyle practices we can adopt to slow the disease, putting together a...

Felicia Greenfield, Penn Memory Center, presents an overview of the new nationwide model—Guiding an Improved Dementia Experience (or GUIDE)—announced by CMS recently. The goals of GUIDE include: (a) improving quality of life for people living with dementia by addressing their behavioral health and functional needs, coordinating their care for dementia and co-occurring conditions, and improving tra...

Felicia Greenfield, Penn Memory Center, shares her learnings from the 2023 annual Alzheimer’s Association International Conference. She presents findings from the Penn Memory Center’s Time Together program, designed to offer opportunities for older adults to interact with college students while giving care partners a break. She summarizes sessions on improving outcomes for caregivers and ways to t...

Dr. Steven Arnold offers a comprehensive overview of the expanding role of biomarkers in the diagnosis and monitoring of Alzheimer's disease and related dementias. Dr. Arnold notes that with new, highly sensitive and specific lab reagents and technologies, we can now detect the extremely low levels of tau, amyloid, and some other brain proteins that are produced in Alzheimer’s disease and leak out...

Felicia Greenfield, LCSW and Executive Director of Penn Memory Center, explains the importance of getting a diagnosis when cognitive impairment is suspected, the process of getting a diagnosis, and the steps that can be taken after diagnosis. She suggests that understanding what lies ahead, securing resources for support, financial planning, and creating a safe environment are just a few examples...

Lena tells the story of how a series of events, over the course of years, finally brought her and Bob to the doctor’s office for Bob to be tested. She recalls how the diagnosis, painful as it was, opened the door to getting support and receiving the care that Bob needed to live well despite the many challenges they faced together. In her words, “As I watch people around me put off their testing, I...

Noting that non-pharmacological approaches to care are considered the gold standard in caring for people living with dementia today, Felicia Greenfield explains the concept of person-centered care, what it is, and how to go about delivering it. Felicia cites the seminal work on dementia by scholar Tom Kitwood, who highlights relationship, uniqueness, and embodiment as the elements of personhood, o...

Dr. Steven Arnold explains the underlying causes of dementia, some of which are treatable, and outlines the process for arriving at a diagnosis. He offers an overview of recent developments in anti-amyloid immunotherapies. He puts amyloid and tau—and the presence of plaques and tangles—in perspective as he explains what we know about Alzheimer’s disease today. According to Dr. Arnold, data from am...

Dr. Jason Karlawish talks about living with dementia and disabling cognitive impairments in the context of today’s public policies that places the burden of care on the American family, and points out gaps in today’s public policies that must be remedied. He explains the concept of custodial care, and how long-term care services and supports are not included in Medicare. He speaks about the need t...

The resolved male caregiver, who may sometimes be described as “rigid as a pillar,” is highlighted in this podcast by psychologist Dr. Barry J. Jacobs. Dr. Jacobs explains how male caregivers who keep their feelings buried inside tend to struggle more and eventually burn out, while others who allow themselves to experience their own feelings and understand these internal signals can prevail. He of...

Dr. Arnold offers an overview of current understanding of Alzheimer’s disease, and lifestyle changes that can lower risks of disease or slow progression. He suggests that risk factors such as hearing loss, head injuries, cardiovascular risk factors and tobacco use all increase our risk of developing dementia and probably drive progression. He also points out increasing evidence that depression, lo...

Finding ways to stay socially connected can be challenging at any age—but it may be especially difficult for people living with dementia. Felicia Greenfield describes the Time Together program, pioneered at Penn Memory Center, which matches older adults living with dementia with college students, with the goal of filling the gap when meaningful social engagement is hard to find, and offering respi...

Dr. Sara Manning Peskin, author of A Molecule Away from Madness: Tales of the Hijacked Brain, reviews what we know about our familial risk of Alzheimer's disease. She points out that Alzheimer’s disease is usually the result of complex genetic and environmental factors, some of which we still don’t even understand. Environmental factors such as education, diet, and head trauma also contribute to t...

Katie Brandt narrates her personal journey as a young wife and mother navigating through early onset dementia of her husband Mike, who was diagnosed with frontotemporal dementia at age 29. She shares practical tips on mitigating financial challenges using federal and local programs to create a financial safety net until she was ready to return to work. She spoke of the value of an elder care attor...

Dr. Stephen Gomperts gives an overview of the Lewy body dementias, the second most common neurodegenerative dementia after Alzheimer’s, affecting some 1.4 million Americans. He explains that there are two clinically distinct but related diseases: dementia with Lewy bodies, also known as DLB, and Parkinson’s dementia. He explains the clinical features, the diagnostic process, and treatment strategi...

Highlights from the 2022 Alzheimer’s Association International Conference offer insights into facets of dementia care and moves toward solutions for risk reduction, more accurate diagnosis and treatment. Katie Brandt describes an ongoing study at Mass General Hospital showing how education and support can improve readiness for advance care planning. Also of interest are social determinants of heal...