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“STANDING IN THE GAP”. An education and outreach program on memory loss, dementia and Alzheimer’s disease for African Americans. “STANDING IN THE GAP”. Standing in the Gap is a reference to each individual’s moral responsibility to be of service to others in need.

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standing in the gap

An education and outreach program on memory loss, dementia and

Alzheimer’s disease for African Americans

standing in the gap1

Standing in the Gap is a reference to each individual’s moral responsibility to be of service to others in need.

african americans who are we
African Americans: Who are we?

The term “African American” refers to people having origins in any of the Black race groups of Africa, as well as people of African descent from Caribbean Islands and parts of South America.

Each of these groups has distinct cultural and social identities.

african americans who are we2
African Americans: Who are we?
  • Today, African Americans represent close to 13% of the population.
  • There are 2.7 million African Americans age 65 and over
  • By the year 2050, it is projected that this number will increase to 8.6 million.
illness and survival
Illness and Survival

Many African Americans perceive their success on the individual, familial and cultural levels in terms of enduring a lifetime of oppressive and discriminatory actions. In spite of these actions, African American elders passed on values, beliefs and wisdom to their families.

illness and survival1
Illness and Survival

Lives can be seen as successful, but it is believed that the price of enduring such pressure is experiencing mental and/or physical health problems.

cultural beliefs associated with memory loss and dementia
Cultural Beliefs Associated with Memory Loss and Dementia


Combination of worry and stress thought by many to cause damage to the brain. It is believed that one can actually overuse one’s mind to the detriment of the brain. That is, “thinking too much” or “too much head work.”

cultural beliefs associated with memory loss and dementia1
Cultural Beliefs Associated with Memory Loss and Dementia

Falling Out

Presents as a loss of consciousness and a physical collapse.

cultural beliefs associated with memory loss and dementia2
Cultural Beliefs Associated with Memory Loss and Dementia

High Blood

Is a condition in which the blood is not flowing normally through the body.

It is thicker or sweeter and therefore, believed to be stagnating in the higher area (head, chest) of the body.

When the pressure of “too much blood” occurs you develop memory problems.

culture memory loss and dementia
Culture, Memory Loss and Dementia
  • “I just thought it was a part of getting older.”
  • “She had suffered such a lifetime of worries and my father was not very good to her.”
  • “My mom was the backbone of the family. Everyone looked up to her. She took on everybody else’s problems. It was the pressure.”
standing in the gap2
  • What is senility?
  • What is dementia?
  • What is Alzheimer’s disease?
what is senility oh she s just senile
What is Senility?“Oh, she’s just senile”
  • Senility is not a medical term. Senile means “of, or relating to advanced age.”
  • Senility does not refer to dementia.
  • Dementia is NOT normal aging.
what is dementia
What is Dementia?

Dementia is an umbrella term that refers to a general loss of abilities involving memory and judgment, language and abstract thinking as well as changes in personality.

irreversible causes of dementia
Irreversible Causes of Dementia
  • Alzheimer’s disease
  • Vascular dementia
  • Parkinson’s disease
  • Huntington’s disease
  • Pick’s disease
  • Creutzfeldt-Jakob disease
  • Lewy Body dementia
  • AIDS and at least 70 other conditions
alzheimer s disease
Alzheimer’s Disease
  • Alzheimer’s disease is the most common form of dementia.
  • It occurs gradually over time as it attacks the brain.
  • The course of the disease can range from 8 years to as many as 20 years.
  • Alzheimer’s disease is irreversible.
alzheimer s disease1
Alzheimer’s Disease

Causes a steady decline in the ability to:

  • Remember and learn
  • Think and reason
  • Communicate and respond
  • Live independently
10 warning signs
10 Warning Signs
  • Recent memory loss that affects performance at work or at home
  • Misplacing things
  • Problems with language
  • Confusion about time and place
  • Poor or decreased judgment
10 warning signs1
10 Warning Signs
  • Problems with abstract thinking
  • Difficulty performing familiar tasks
  • Changes in mood or behavior
  • Changes in personality
  • Loss of initiative
the silent epidemic
The Silent Epidemic

Alzheimer’s disease is more prevalent among African Americans than among whites – with estimates ranging from 14 – 100 percent higher.

the silent epidemic1
The Silent Epidemic
  • There is a greater familial risk of Alzheimer’s in African Americans.
  • Genetic and environmental factors may work differently to cause Alzheimer’s disease in African Americans.
the silent epidemic2
A person with a history of either high blood pressure or high cholesterol is twice as likely to develop Alzheimer’s disease.

High blood pressure and high cholesterol occur more frequently in African Americans.

African Americans have a 60 percent higher risk of type 2 diabetes – a condition that contributes to vascular disease.

African Americans have a higher rate of vascular dementia than whiteAmericans.

The Silent Epidemic
alzheimer s disease stages mild
Can still take care of their personal needs and may still be in the workforce

Has trouble with finding names for common items

Loses things more often

May begin to ask the same question over and over

Gets lost easily in places well known

Personality changes may occur

Loses interest in things once enjoyed

Alzheimer’s Disease Stages - Mild
alzheimer s disease stages moderate
Displays anxiety or depression

Experiences difficulty with simple activities

Paces excessively

May hallucinate or become paranoid

Requires close supervision

Becomes more confused about recent events

Argues more than usual

May wander

Alzheimer’s Disease Stages - Moderate
alzheimer s disease stages severe
No longer able to communicate

Unable to recognize themselves when they look into the mirror

Can not care for themselves

Unable to recognize family members

May be bed-bound and become totally debilitated

Alzheimer’s Disease Stages - Severe
diagnosing alzheimer s disease
Physical examination

Laboratory tests

Patient history

Memory and thinking tests

Diagnosing Alzheimer’s Disease
diagnosing alzheimer s disease1
Diagnosing Alzheimer’s Disease

Patient history should include the following:

  • Medical history
  • Focused history
  • Family history
  • Social and cultural history
diagnosing alzheimer s disease2
Diagnosing Alzheimer’s Disease

Medical History –

Physicians should ask about relevant diseases: mental disorders, history of head trauma, review information about infections or illnesses such as pneumonia, diabetes, urinary tract infections or chronic renal failure.

diagnosing alzheimer s disease3
DiagnosingAlzheimer’s Disease

Medical History -

The review of all medications is a critical component of the assessment because drug toxicity is the most common cause of dementia-like symptoms that can be resolved.

A wide range of drugs have been associated with cognitive changes. Patients should bring all medications to the appointment including, over the counter pills.

diagnosing alzheimer s disease4
Diagnosing Alzheimer’s Disease

Focused History –

It must identify signs and symptoms such as difficulty learning and retaining new information, handling complex tasks, reasoning ability, spatial ability and orientation, language and exhibits behavior problems.

diagnosing alzheimer s disease5
Diagnosing Alzheimer’s Disease

Family History –

Physician should inquire about a family history of Alzheimer’s disease especially early onset or other rare genetic conditions that might lead to dementia.

diagnosing alzheimer s disease6
Diagnosing Alzheimer's Disease

Social and Cultural History

diagnosing alzheimer s disease7
Diagnosing Alzheimer’s Disease

Social and Cultural History –

Include information about recent life events and social support networks, literacy, socioeconomic, ethnic and cultural background. These factors may affect performance on mental status examinations.

diagnosing alzheimer s disease8
Diagnosing Alzheimer’s Disease

Physical Examination –

Standard medical principles should be used to guide a physical examination as a part of the assessment process.

diagnosing alzheimer s disease9
Diagnosing Alzheimer’s Disease

Mental Status Examination -

Used to develop a picture along with functional performance; provides baseline data for monitoring over time; and can document multiple cognitive impairments.

diagnosing alzheimer s disease10
Diagnosing Alzheimer’s Disease

Mental Status Examination -

Factors such as age, primary language, educational level and cultural influences should be taken into consideration in the interpretation of mental status scores.

diagnosing alzheimer s disease11
Diagnosing Alzheimer’s Disease

Laboratory Tests –

Complete Blood Count (CBC),

electrolyte panel, screening for metabolic panel,

thyroid gland function, B-12 and folate levels,

tests for syphilis and depending on history for HIV antibodies, urinalysis, ECG, chest X-ray, CT and an EEG.

diagnosing alzheimer s disease12
Diagnosing Alzheimer's Disease

African Americans tend to be diagnosed at a later stage of Alzheimer’s disease – limiting the effectiveness of treatments that depend upon early action.

the importance of early diagnosis
The Importance of Early Diagnosis

Early diagnosis may help the person with dementia:

  • Educate him/herself on the disease
  • Learn to manage the disease
  • Participate in their own care planning
  • Make legal and financial arrangements
disease management1
Disease Management

Currently, there is no cure for the disease, but there are 5 drugs on the market that may help reduce some of the symptoms associated with the disease. They are:

  • Cognex (tacrine)
  • Aricept (donepezil)
  • Exelon (rivastigmine)
  • Reminyl (galantamine)
  • Namenda (memantine)
disease management2
Disease Management

African Americans are seriously underrepresented in current clinical trials of potential treatments for Alzheimer’s disease.

This has occurred even though evidence of genetic differences and response to drugs varies significantly by race and ethnicity.

disease management3
Disease Management
  • Physical exercise
  • Calm and well-structured environment
  • Proper nutrition
  • Pleasurable social activities
  • Adequate sleep
  • Identify what activities cause problem behaviors
caring for the person with dementia
Caring for the Person with Dementia

The person with dementia is not:

  • Faking or trying to get on your nerves
  • Trying to drive you crazy
  • Seeking attention
  • The recipient of a hex or a curse
caring for the person with dementia1
Caring for the Person with Dementia


  • Difficult behaviors are the result of the disease
  • Persons with dementia are not able to learn new information or “just try a little harder”
  • You, not they, will have to change
  • Your relationship will change
  • Denial, anger and depression are normal reactions
now what do i do the lord never puts more on us than we can handle
Now, what do I do?The Lord never puts more on us than we can handle
  • Contact the local chapter of the Alzheimer’s Association.

“There is no time like the present”

  • Learn more about the disease.

“What you don’t know can hurt you”

  • Talk to family members, friends or clergy.

“This is the first day of the rest of your life”

  • Take advantage of community resources.

“It is always darkest before the dawn”

standing in the gap3

The Alzheimer’s Association is the largest national voluntary organization dedicated to conquering Alzheimer’s disease through research and to providing information and support to people with Alzheimer’s disease, their families and caregivers.

Information and Referral

Care Consultation

Educational Programs

Support Groups

Alzheimer’s Association Safe Return™

Core Services
information and referral1
Information and Referral

Information and Referral services provide information about Alzheimer’s disease, services provided by the chapter and community resources. Service delivery may include Helplines, the Contact Center, information packets, Web sites or resource libraries.

care consultation

Assists the person with the disease and/or their families by providing information and making appropriate referrals, supportive listening, assessment of needs, developing an action plan or problem solving. This can be done by telephone, e-mail or in person.

Care Consultation
educational programs1

Provide individuals with knowledge and skills necessary to enhance the quality of care for a person with dementia. May be carried out through caregiver conferences, community programs, in-service trainings for professionals, newsletters or using videos.

Educational Programs
support groups

Learning that you are not in this alone can be beneficial. Supports groups are regularly scheduled in-person or virtual gatherings of persons with Alzheimer’s disease, family, friends or caregivers who interact around issues relating to Alzheimer’s disease. Groups have social, educational and/or support components and are lead by a trained individual.

Support Groups
safe return

Is an identification program that assists in the safe and timely return of individuals with Alzheimer’s disease who wander or become lost.

Safe Return provides family support, wandering awareness and ongoing education and training opportunities to emergency personnel as well as to the lay community.

Safe Return™
what can you do
What Can You Do?
  • Become an advocate – Make your voice heard. You can make a difference.
  • Volunteer with the local chapter of the Alzheimer’s Association.
  • Help others learn about Alzheimer’s disease and available resources.
  • Stand in the Gap!
www alz org