Overwhelming Face of Dementia

Rooted in tradition · Exploring the future Vol. 47 · Issue #3 Tuesday, Jan 22, 2013 Loyalist College · Belleville, ON · Canada Simple shot could save a life Number of people getting flu vaccinations needs to improve, say health experts By Justin Tang With the worst of the flu season behind us, two local health experts admit that influenza vaccination uptake has much room for improvement. This year’s flu season has seen more people affected and more severely than a typical season, thanks to a newer sub- type of Influenza A called H3N2 Victoria. Officials in eastern Ontario, including Kingston Frontenac Lennox & Adding- ton Public Health, have seen increased numbers in cases of pneumonia and complications in people with heart disease from the flu, and in several cases, death. “If you exclude 2009, when we had the pandemic H1N1, this is probably the heaviest year we’ve had in a decade,” says Dr. Gerald Evans, chair of the division of infectious diseases and professor of medicine, biomedical and molecular sciences and pathology and molecular medicine at Queen’s University in Kingston, Ont. Evans is also medical director of infec- tion prevention and control at Kingston General Hospital and the Hotel Dieu Hospital. An estimated 2,000 to 3,000 people die in Canada each year as a result of influenza. Evans says he expects to see similar numbers this year as well. Hastings and Prince Edward counties experienced similarly high levels of se- verity, but the counties’ medical officer of health says the outbreak was predictable — and is in decline. Photo by Evan Campbell “Once an outbreak has started, we know it’s going to peak in three or four Gemel Smith of the Owen Sound Attack smokes Belleville Bulls player Stephen Silas into the boards in the end of the second period at Yardmen Arena on Sat- weeks and then come down again,” says urday in Belleville. The hit stirred up the players, causing a fight to break out. For story and photo, see page 3. Dr. Richard Schabas. Schabas also served as Ontario’s chief medical officer of health from 1987 to 1997. “What we never know until it actually happens is how severe it’s going to be.” Experts use the flu season in the south- ern hemisphere, which occurs during the Overwhelming face of dementia winter months of July, August and Sep- tember, to predict the strains that might By Marta Iwanek falling under that umbrella and being occur six months later in the northern ‘So for me, I didn’t recognize it because I always the most common disease to cause it. hemisphere. For 16 years, Beth Harder’s father, No matter the diagnosis, whether just “The dominant strain of last year has Brian Skinner, learned to live with Par- thought that dementia was related to someone dementia or something more specific, been replaced by the Influenza A H3N2 kinson’s disease. It wasn’t easy, but with who was a very old person. What I’ve since learned she says people can all still receive help Victoria, so there is less immunity,” says the help of medication, he was still able from the Alzheimer’s Society. Some of Schabas. “Although it’s a good match with to hunt, fish and spend time with his is that dementia takes many, many forms. It affects the services offered are one-on-one the vaccine, the end result has been we’ve friends and family. client support groups, meetings for seen quite a bit of flu.” This past year, however, really everybody differently.’ caregivers, tax and legal sessions and The Australian flu season saw a large changed for him. In March 2012, he Beth Harder community information meetings, number of people with the Influenza was diagnosed with dementia. like the Forget-Me-Not information H3N2 strain — the same influenza that “And it was the dementia that sessions. would later raise attention across Canada Belleville-Hastings-Quinte area there dementia, explains Kristel Nicholas, overwhelmed him and overwhelmed Dr. Andy Quinn, who practises and lead the State of New York to declare are about 2,500 cases, according to the education and support co-ordinator all of us,” says Harder as her eyes in Tweed, regularly volunteers a state of emergency. 2011 census. at the Alzheimer Society of Belleville- water. She sits in a boardroom in the with the Alzheimer’s Society to “It was a beautiful prediction of what’s There are over 70 types of Hastings-Quinte, with Alzheimer’s Belleville Police Force Station where provide the sessions. He sees a lot of happened here,” says Evans, pointing out she now works as a sergeant. Her father misunderstanding on what a diagnosis that the intercontinental sharing of in- spent 32 years as an OPP officer in the means. “A lot of people see it sort of formation helps vaccinologists pinpoint then Belleville detachment, serving as a dead end street and that’s not which strains should be targeted. in the community he grew up in and the case,” he says. “Most people with Influenza vaccination rates in Ontario loved. dementia do very, very well for long were 32 per cent in 2011, slightly lower At first, Harder denied the dementia. periods of time, but in order for that than the 36 per cent average among the She saw no memory loss or confusion in to happen, they need help.” He says general population nationwide. her father, as she knew dementia to be. an early diagnosis to get treatment as Evans expects the rate to be higher this And her father was only 67, she adds. early as possible is very important for year, but only by a margin. “So for me, I didn’t recognize it not just patients, but their caregivers as “Immunization up until the outbreak because I always thought that dementia well, so they can get the support they of flu this season was similar to last year, was related to someone who was a very need established. but since then there has been a significant old person,” says Harder. “What I’ve However, out of the near 2,500 increase in the number of people wanting since learned is that dementia takes people in the area with dementia, only to get the flu shot.” many, many forms. It affects everybody about 600 are connected with the local The low numbers aren’t the biggest differently.” Alzheimer Society, says Nicholas. “So issue for Schabas, whose health unit ag- It was only when her brother, who we know these people are out there, gressively promotes vaccination in Octo- would visit every third weekend from but they’re not coming to us,” she ber and November before the flu season Calgary, accepted the diagnosis that says. “So if because of fear or stigma takes off. Timing, he stresses, is key. she did too. people resist going to the doctor with “Giving people the idea that it’s okay to Her father went from a happy-go- their concerns, it reduces the chances wait until the flu is all over the news is the lucky man to someone who was upset of the medications being effective for wrong message. We don’t indulge in that.” or agitated easily. “All that laughter them, because they’ve waited so much A vocal critic of the federal govern- that he had just wasn’t there,” she says. longer.” There are still different support ment’s handling of the H1N1 pandemic, “It would come through every now and options as the disease progresses, but Schabas draws comparison to the present then, but his personality changed and less than in the early stages, she adds. outbreak: that response is often too little, it was the dementia that changed that.” The local Alzheimer Society is too late. He died on Nov. 9, 2012 in hospital. expecting 200 walkers and has a goal “Level of interest and response are That’s why this Sunday, Jan. 27, of raising $70,000 this year. Last year, a driven by how active the disease is. By Harder is walking in memory of her record $54,000 was raised. that time, you’re at the peak of outbreak father at the Alzheimer Society of When Harder was struggling to care — you’ve missed your chance to do any- Belleville-Hastings-Quinte’s Walk for for her father, she reached out to the thing about it.” Memories, to raise money for other Community Care Access Centre and The 2009 H1N1 outbreak gave public families in the community who have Alzheimer Society and says she can’t health officials the chance to evaluate been affected by dementia. thank them enough as well as the their pandemic response plans, an op- “What’s interesting about our fundraiser hospital community for the support portunity that Evans maintains was not and what makes it unique from a lot of they gave her father. “When they were squandered. Policies contemplating bor- different fundraisers is that all of the taking care of whatever it is that I der shutdowns were discarded — the flu money stays here locally,” says Ashley needed, it allowed me to take care of moves much too fast — and pandemic Matheson, fund development co-ordinator my dad,” she says. supplies and storehouses of medical at the Alzheimer Society. The organization Harder is also collecting pledges for equipment were improved. receives 25 per cent of its funding from the walk. “It doesn’t matter if it’s $10,” The forethought has already paid the government, but the rest comes from she says.

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