Details coming soon!

"The soul comes to the end of its long journey and naked and alone draws near to the divine"        --- from the film, Fearless ---

     To first hear that your mother or father or anyone you love has Alzheimer's leaves an empty feeling in the pit of your stomach. There are currently more than 4.5 million families in the United States who have received just this kind of news, and I don't think very many of them have really known quite what to do with it. It's very difficult to have a family member or a close friend suffer from an incurable disease.   It's hard to know just what to say sometimes, how to help them, how to be with them.   For those who know someone with Alzheimer's, this is no exception.

     What helps, though, is being willing to risk getting close enough to them to really understand what it means to have Alzheimer's. This takes courage. But if we are willing to do this we make ourselves more available to the person -- we can walk in their shoes, and in doing so, we open ourselves to the possibility of discovering those precious and intimate moments of closeness and connectedness that make our lives truly meaningful. It also makes the help we give that much more effective. With this in mind, I would like to take you on a journey of discovery about Alzheimer's -- to help you get really close to it -- to help you learn about the impact Alzheimer's has on those who suffer from it and the effect it has on families, caregivers, and ourselves.

     From a physical point of view, Alzheimer's is a disease characterized by the destruction and degeneration of tissue in the brain. Its toll on the human spirit, however, is even more devastating.   Alzheimer's slowly robs its hosts of their memory, their ability to think, and ultimately, the very sense of their own existence. Alzheimer's is a disease for which there is no cure -- only medicines that can slow the progression of its symptoms or postpone its inevitable conclusion. This point of view is well known. From another perspective, however, Alzheimer's is a psychiatric disorder -- a mental illness -- one that triggers a wide array of emotional and behavioral problems. These types of problems can be treated with medicines, but they can also be treated with counseling and psychotherapy, and this perspective is much less well known.    

     Counseling people with Alzheimer's? Can you do that? For many Alzheimer's victims, the answer is an emphatic "Yes!"   Understanding Alzheimer's from a psychological model (and not strictly from a medical one) opens up possibilities for new and expanded ways of relating to those afflicted with this illness. New intervention possibilities like these are not only available to the professional and paraprofessional care provider, but they are also available to family members, friends, or anyone who provides care for someone with this disorder. Everyone in the individual's family and social support system can learn to communicate better with the Alzheimer's sufferer. It takes knowledge and understanding and being able to identify and relate to the problems of Alzheimer's as they arise.

     Making the distinction between Alzheimer's as a medical illness and Alzheimer's as a mental disorder is essential. From a medical perspective, Alzheimer's is a disease, like cancer, heart disease, or emphysema. As a disease, it progresses, its symptoms worsen, and eventually, it's fatal.   Alzheimer's as a disease implies that it is a medical problem with medical solutions.   Increasingly, we hear of "breakthrough research" on the genetic and biochemical links with Alzheimer's. We also hear announcements of new image-scanning methods to better identify the illness or new drugs to treat its accelerating symptoms. These discoveries are important, but regarding what is known and generally applied in the treatment of Alzheimer's, its treatment has essentially been relegated to medical staff prescribing and recommending medical interventions.  

      In addition to being classified as a medical disease, though, Alzheimer's is a mental illness, just like schizophrenia, depression, or anxiety disorder. Alzheimer's as a mental disorder implies, however, that in addition to medical interventions, there are also psychiatric and psychological treatment interventions available. In addition to high-tech detection methods and new medicines to treat the spread of the disease, the symptoms of Alzheimer's can also be treated through psychological methods that include individual counseling, group interventions, interventions designed to change the person's physical surroundings, and through medicines and educational strategies to improve the person's ability to cope with the emotional distress and cognitive loss. This is the focus of At Wit's End. This book is intended to be a simple, straightforward, and easy-to-read summary of what is currently known about this devastating disorder, as free as possible from technical jargon and impractical detail.  

     About one in three of us will eventually provide care for someone with Alzheimer's. Given the tremendous amount of care required to safeguard the medical well-being and mental health stability of people with Alzheimer's, At Wit's End is intended to offer new options for clinicians, for family members, and for the many other caregivers who assist, support, and help to ease the impact of this quiet killer. The stress of providing care to a person with Alzheimer's can be considerable, but caring for someone with Alzheimer's can also be extremely rewarding. I have talked with many care providers whose pride in what they are doing far outweighs the challenges with which they struggle. For me, it's been the joy of helping Alzheimer's sufferers and their families hold on to the value they place on living.   At Wit's End has been written to enhance your knowledge about the psychiatric and psychological aspects of Alzheimer's as it helps you discover a wealth of effective interventions too infrequently utilized.

      There are many excellent books on Alzheimer's -- ones that address the medical, financial, legal, and daily care needs of those afflicted with the disease. There are excellent sources of information on a variety of issues related to managing guardianship, powers of attorney, living wills, life and healthcare insurance, and on making choices about assisted-living facilities, nursing homes, in-home care, and safety preparation of the person's living environment. These are all important areas of concern, and I have tried to provide a wealth of references to help you learn more about them. There has also been a great deal written about the self-preservation needs of family members and other caregivers who have been left with the disheartening and often daunting task of managing the afflicted person's waning competencies. References to these excellent sources of information are also included.  

     The thrust of At Wit's End, however, is on the psychological life of the Alzheimer's sufferer. It focuses on the whole person and their social, psychological, emotional, physical, and spiritual life.  Part I:   What is Alzheimer's? covers the basics of the disorder, how it can be distinguished from normal aging, and how it is similar to and different from other medical conditions that mimic its symptoms.  Part II:   Ways to Measure Alzheimer's deals with a variety of assessment methods that are commonly used to gauge the extent and progression of the disease. These include methods of measuring how the disorder affects changes in functional abilities and how the issue of competence to complete tasks of daily living is viewed by the psychiatric and legal communities.  

     Part III:   Disturbances in Mood and Perception covers the array of emotional and behavioral problems frequently encountered in Alzheimer's -- things like anxiety and agitation, depression, anger and impatience, inappropriate expressions of sexuality, wandering, and other troubling behavioral conditions. In this section, special attention is given to the issue of geriatric depression and its reciprocal relationship with Alzheimer's.   Also examined in this section is how Alzheimer's affects distortions in rational thinking and psychotic disturbances in sensory perceptions. Finally, in Part IV: Psychiatric and Psychological Treatment Approaches , I discuss traditional and alternative medicines that are available to treat the disease itself and the emotional and intellectual symptoms commonly stemming from the disorder. I also discuss changes that can be made to the afflicted person's physical surroundings, simple and common-sense ways of enhancing communication, new ways of improving coping abilities, fun learning activities useful in stimulating and maintaining the afflicted person's thinking and emotional stability, and finally, ways of preventing the disease.

     My hope is that reading this book will be just the beginning of your continued learning about Alzheimer's. The more you know and share about Alzheimer's as a medical illness and as a mental health disorder, the more the suffering from this devastating disease can be abated.

Warm Wishes,

George Kraus, Ph.D.

"At Wit's End: Plain Talk on Alzheimer's for Families and Clinicians" was recently chosen for the 17th Edition of outstanding University Press Books as selected for Public and Secondary School Libraries. This selection is made by a committee of Librarians from the American Association of School Librarians and the Library Committee of the Public Library Association.

"At Wit's End: Plain Talk on Alzheimer's for Families and Clinicians" appears on the list of suggested textbooks by the American Psychological Association - Division 20: Adult Development and Aging for use by educators offering programs and courses on the psychology of older adults.

Audio Preview of "At Wit's End" (MP3 format)

To hear Dr. Kraus' radio interview at WYSO, just click below!

WYSO Interview (MP3 format)

If you would like to read newspaper articles about At Wit's End, click below!

Dayton Daily News Article:
Understanding Alzheimer's

Xenia Daily Gazette/Greene Memorial Hospital Article:
Understanding Alzheimer's

Xenia Daily Gazette Article:
Wright State University Professor
Releases Book on Alzheimer's