Recently, we have talked about what Alzheimer’s is, different types of Alzheimer’s Disease & what causes Alzheimer’s Disease. After laying that groundwork we can finally discuss and review new medications and treatment solutions for Alzheimer’s.
We
will start this series of blogs reviewing Leqembi (lecanemab).
As
in the last blog, I will remind you, I am not a doctor. I am not a
medical professional. I am a person who can take detailed medical
information, research it, and create content & imagery that will make it
easier for you to understand a specific concept. You should NEVER use my
content to make medical decisions for yourself or your loved one. However, you
can take the content I provide to begin conversations with your
doctor.
What is Leqembi?
Leqembi
is a medication that is used to treat early-stage Alzheimer's
Disease. It is an FDA-approved treatment that targets one aspect of the
underlying biology of the disease. Leqembi works by reducing the amount of
amyloid-beta proteins in the brain, which are a key factor in Alzheimer's
Disease
Leqembi
is administered as an intravenous (IV) infusion every two weeks at an infusion
center. Each infusion usually lasts about an hour. Leqembi is
approved for people with mild Alzheimer's disease, which means they have some
memory and thinking problems, but their symptoms are not severe. It can
also be used to treat mild cognitive impairment (MCI) and mild dementia due to
Alzheimer's disease.
It
is important to note that Leqembi is not a cure. I will repeat it to be
clear. Leqembi is NOT a cure for Alzheimer’s Disease. Alzheimer’s Disease
is triggered by multiple conditions such as diabetes, genetics, toxic
environmental exposure, and inflammation. Leqembi was designed to slow
Alzheimer's progression by identifying and attacking beta-amyloid proteins in
the brain.
This
is significant because beta amyloids are one of the hallmarks of Alzheimer’s.
These proteins clump together to form plaques that destroy neurons. Neurons are
the cells that form the brain’s communication system. Leqembi is a
monoclonal antibody that binds to these plaques and breaks them apart.
What is a monoclonal antibody?
Monoclonal
antibodies (mAbs) are laboratory-made proteins that are a type of targeted
therapy used to treat a variety of diseases, including some types of cancer and
COVID-19. Monoclonal antibodies are highly specific because they are derived
from a single clone of cells and are engineered to closely reflect the
structure of naturally produced human proteins. This means that the body
handles them similarly. The body does not metabolize monoclonal antibodies like
it would a synthetic medication.
mAbs
are created in a lab from living sources that produce antibodies, such as
human B cells. Or immunized animals. The first step in the process
is to express a purified antigen, which is often a critical step. The mAbs
are then produced by identical clones of B lymphocytes against a specific
antigen.
How are monoclonal antibodies produced?
The
traditional monoclonal antibody production process usually starts with a
generation of mAb-producing cells (i.e. hybridomas) by fusing myeloma
cells with desired antibody-producing splenocytes (e.g. B cells). These B cells
are typically sourced from humans or animals, usually rodents.
Human
mAbs can be used to target and neutralize specific proteins that induce an
immune response, such as those associated with inflammation in psoriasis and
other autoimmune disorders. Leqembi is an example of a human mAb used to
treat Alzheimer's disease.
Advantages
of using mAbs:
·
Precision - mAbs are more precise than other treatments, which can improve
effectiveness and reduce side effects. For example, monoclonal antibody
therapy can target cancer without damaging healthy cells.
·
Safety - mAbs are safer and less toxic than chemotherapy drugs, which can
improve patient survival and well-being.
·
Quality - mAbs quality is consistent across production batches, which is
important for both therapy and diagnostics.
·
Quantity - mAbs can be produced in large quantities.
·
Other advantages - mAbs also have fewer off-target adverse effects, fewer
drug-drug interactions, and higher specificity.
It
is not uncommon to have an infusion reaction when taking mAbs. It is like
an allergic reaction. Symptoms can include fever, chills, weakness,
headache, nausea, vomiting, diarrhea, low blood pressure, and rashes, and are
more common when the drug is first given. This is your body’s response to
taking a biological medication and will usually subside as you get used to it.
Who can take Leqembi?
Now
that we understand what Leqembi is and how it works. Who can take
Leqembi?
In
theory, anyone experiencing mild cognitive impairment or the early stages of
Alzheimer’s Disease. However, to qualify for treatment with Leqembi,
patients must meet the same criteria used in the clinical trials that led to
its approval:
·
Be between the ages of 50 and 90
·
Have a confirmed presence of beta-amyloid plaques in the brain
·
Have mild cognitive impairment (MCI) or mild dementia due to Alzheimer's
disease
·
Have a body mass index (BMI) between 17 and 35
Potential
patients must undergo diagnostic testing to confirm the presence of
beta-amyloids before starting treatment, which is usually done with a PET scan
and/or a spinal tap. Leqembi has not been tested on people with more
advanced Alzheimer's or those without symptoms, so they do not qualify for
treatment.
Side Effects of Leqembi
There
are potential side effects with every medication. No one should be
surprised that there are side effects with Leqembi. The following
information was taken word for word from Eisai and Biogen, the manufacturers
and distributors of Leqembi:
LEQEMBI
can cause serious side effects, including:
·
ARIA (amyloid-related imaging abnormalities). There are usually no signs of
ARIA. In rare cases, it can lead to serious complications
·
ARIA can show up as swelling in parts of the brain or small spots of bleeding
·
Larger areas of bleeding in the brain may occur, but this is uncommon
·
ARIA usually goes away over time
·
Most people with ARIA don’t have any symptoms. However, some people
may notice:
–headache
–confusion
that gets worse
–dizziness
–vision
problems
–nausea
–problems
walking
–seizures
·
Some people have a gene called ApoE4 that may increase the risk of ARIA. Talk
to your healthcare provider about testing to see if you
have this gene
·
Some medicines can increase the risk of larger areas of bleeding in the brain
for people taking LEQEMBI. Talk to your healthcare provider to see if any of
the medicines you’re taking increase this risk
·
Your healthcare provider will check for ARIA with MRI (magnetic resonance
imaging) scans before you start LEQEMBI and during treatment
I
want to be careful to not over-dramatize these side effects. As I have
said in previous Blogs, I am a study buddy for a loved one participating in a
research program with (BAN2401) Leqembi. My loved one has experienced
Aria-E and Aria-H.
The
Aria-H experience was by far the most dramatic of the two. It started
when my loved one woke up from a deep sleep after feeling and hearing what she
described as an explosion in her brain. She said it felt like she had
been hit by a brick. She sat up and placed her hand on top of her head as
you would when something just hit you. When she removed her hand to look
at it, she fully expected to see blood on her hand. But there was no
blood. She got up out of bed, went to the bathroom, made a note in her journal,
laid back down, and went back to sleep.
There
are some important things to point out here:
She
said she felt like she was hit with a brick. However, there are no pain
receptors in the brain. And later she would say that it felt like being hit by
a brick but without pain. I say this to be clear that as traumatizing as
it was, there was no pain.
She
calls it an explosion in her head. She is confident that she heard the
sudden micro hemorrhage take place. And that she heard the blood flow.
I am 100% confident that she did. My loved one is not one to
over-dramatize facts.
But
how big was this hemorrhage? To be classified as a micro hemorrhage it
must be smaller than 5 millimeters in diameter. How big is that?
The size of her micro hemorrhage was between the size of the tip of a pencil
lead and half the diameter of the eraser tip. VERY small.
Despite
the potential of brain swelling and another brain bleed, I stand behind her
choice to continue to take Leqembi. Knowing that any day, I might get a
phone call with her telling me it happened again. Because without this medication,
I believe her cognitive decline will become significant. We are not
giving up on her and her desire to be a volunteer for Alzheimer’s research.
How do I get started?
OK,
so you heard all about the scary potential of experiencing a brain bleed and
potential brain swelling. You understand that by taking no action, you
are guaranteeing continued cognitive decline. And you want to start the
evaluation process to see if you are a good candidate for Leqembi
treatment. How do you get started? There are 2 options:
Schedule
an appointment with your neurologist to learn more.
Schedule
an appointment with an Alzheimer’s Research facility.
How much does it cost?
The
answer to that question is difficult to answer because there are so many
factors to be considered. The Japanese drugmaker Eisai set the list price for
Leqembi, at $26,500 per year in the United States. However, the
actual cost for patients will vary depending on their insurance
coverage. For example, Medicare beneficiaries are responsible for 20% of
the cost after meeting their Part B deductible, which means the out-of-pocket
cost for Medicare enrollees is $5,300 per year. Other factors that may
affect the cost include Medicare supplemental or other secondary insurance,
Medicare Advantage plans, and Medicaid.
In
addition to the cost of the drug itself, there are also associated expenses for
diagnosing and monitoring patients, such as PET scans, MRI scans, and clinical
visits.
Is it worth it?
It
is for my loved one. Despite experiencing brain swelling and a brain
bleed, she won’t stop as long as it is available.
I
know that if I am diagnosed with mild cognitive impairment or Alzheimer’s
disease, I would take it or a similar mAB as a multi-step treatment
protocol. I would work with an Alzheimer’s Disease researcher to be sure
every bit of information is captured.
Is
it worth it to you? Only you can decide.
As our loved ones age, many prefer to remain in the comfort and familiarity of their own homes. This desire for independence, however, comes with the responsibility of ensuring their living environment is safe and secure. By taking proactive steps to prevent accidents and address potential hazards, we can help our older family members maintain their independence while minimizing risks.Conducting a Home Safety AuditThe first step in creating a safe living environment is to perform a thorough home safety audit. This involves carefully examining every room and area of the house, paying close attention to potential hazards that could lead to accidents or injuries.Stairs and WalkwaysStart by inspecting the stairs and walkways. Ensure that handrails are securely fastened and extend the full length of the staircase. Look for any loose carpeting or floorboards that could cause tripping. Remove throw rugs or use non-slip backing to prevent slipping.Bathroom SafetyThe bathroom is a common site for accidents. Install grab bars near the toilet and in the shower or bathtub to provide support. Consider adding a shower chair and a non-slip mat to reduce the risk of falls. Ensure the bathroom is well-lit and easily accessible, especially during nighttime hours.LightingAdequate lighting is crucial for preventing accidents. Install bright lights in hallways, stairways, and bathrooms. Consider using motion-sensor lights for nighttime navigation. Ensure that light switches are easily accessible and clearly visible.Emergency PreparednessBeing prepared for emergencies is essential for older adults living independently.Emergency Contact ListCreate a comprehensive list of emergency contact numbers and place it near every phone in the house. Include numbers for:Emergency services (911)Poison Control (1-800-222-1222)Healthcare providersFamily members or trusted friendsPersonal Emergency Response SystemsFor added security, consider investing in a personal emergency response system. These devices, worn as necklaces or bracelets, allow the user to quickly call for help in case of a fall or other emergency.Fall Prevention StrategiesFalls are a significant concern for older adults. Implementing fall prevention strategies can greatly reduce the risk of injury.Regular Health Check-upsEncourage your loved one to have regular check-ups with their healthcare provider. These visits can include fall risk assessments and recommendations for exercise programs designed to improve balance and strength.Proper FootwearEnsure that your loved one wears appropriate footwear inside the house. Non-slip slippers or shoes with rubber soles can provide better traction on smooth surfaces.Mobility AidsIf your loved one uses a cane or walker, make sure they use it consistently and correctly. Ensure that these aids are in good condition and properly adjusted to the user's height.Fire SafetyProtecting against fire hazards is another crucial aspect of home safety for older adults.Smoke AlarmsInstall smoke alarms on every level of the home, including inside and outside sleeping areas. Check the batteries regularly and replace them as needed.Escape PlanDevelop and practice a fire escape plan with your loved one. Ensure that all exits are clear and easily accessible.Medication ManagementProper medication management is essential for preventing accidental poisoning and ensuring that prescribed treatments are followed correctly.Organized StorageKeep medications in a well-organized, easily accessible location. Consider using a pill organizer to help track daily doses.Medication ReviewRegularly review medications with a healthcare provider to ensure they are still necessary and to check for potential interactions.Creating a Support NetworkWhile these safety measures are crucial, it's equally important to establish a support network for your loved one.Regular Check-insSet up a system for regular check-ins, either in person or by phone. This not only provides social interaction but also allows you to monitor their well-being.Community ResourcesResearch local community resources that can provide additional support, such as meal delivery services, transportation assistance, or social programs for seniors.Professional Home Care ServicesIf your loved one requires more extensive assistance, consider professional home care services. Companies like Caring Mission can provide individualized care plans tailored to your loved one's specific needs, ensuring they receive the support they require while maintaining their independence.By implementing these safety measures and creating a strong support system, we can help our older loved ones continue to live independently in their own homes with greater peace of mind. Remember, home safety is an ongoing process that may require periodic reassessment as needs change over time. With careful planning and attention to detail, we can create a safe and comfortable living environment that promotes both independence and well-being for our aging family members.
When a senior is ready to leave the hospital after surgery, illness, or another medical event, the transition to home or another care setting can be overwhelming for both the patient and their family. This is where discharge planners play a crucial role in ensuring a smooth, safe, and well-coordinated discharge process. At Assisted Living Locators North Pittsburgh, we work closely with discharge planners to help seniors and their families navigate the complexities of post-hospital care and find the right long-term living arrangements.What Is a Discharge Planner?A discharge planner is typically a nurse, social worker, or case manager within a hospital setting. Their main responsibility is to ensure that patients are prepared to leave the hospital and transition to the next stage of their recovery or care. For seniors, this often involves coordinating care and resources to support them as they move back home, to a rehabilitation center, or to an assisted living or long-term care facility.The Key Responsibilities of a Discharge PlannerAssessing Post-Hospital Care Needs:Discharge planners work with doctors and nurses to assess a patient's medical needs after leaving the hospital. For seniors, this might include ongoing therapies, medications, or specialized care for chronic conditions.Coordinating Care and Services:After assessing the patient's needs, discharge planners arrange services such as in-home care, physical therapy, and transportation to medical appointments. For seniors who can no longer live independently, discharge planners can help identify more supportive living arrangements like assisted living communities.Education and Guidance:Discharge planners provide families with vital information about medications, treatments, and care requirements. They also educate families on recognizing warning signs of potential health issues and offer guidance on how to best support their loved one during recovery.Linking Patients to Resources:Many seniors require additional support post-discharge. Discharge planners connect families with local resources, such as senior care services, financial assistance programs, and transportation options.Navigating Insurance and Paperwork:Managing healthcare can be daunting, especially when it comes to insurance and coverage for post-hospital services. Discharge planners help families navigate insurance claims and ensure that all necessary paperwork is completed to secure ongoing care.How Assisted Living Locators North Pittsburgh Works with Discharge PlannersAt Assisted Living Locators North Pittsburgh, we understand the critical role that discharge planners play in ensuring that seniors receive the appropriate care after leaving the hospital. We collaborate closely with discharge planners to provide families with personalized, comprehensive support as they consider long-term care options. Here's how we can help:Identifying the Best Senior Care Options:Discharge planners often work with seniors who can no longer safely return home due to their need for more extensive care or a supportive environment. We step in to help families explore the wide range of senior living options, from independent living to assisted living, memory care, or skilled nursing facilities.Providing Guidance on Senior Care Communities:Assisted Living Locators North Pittsburgh helps families navigate senior care communities that meet the medical, social, and emotional needs of their loved ones. We ensure that seniors find the right place to call home, with the support and services they require for a high quality of life.Personalized Support During Transitions:We provide hands-on support during the transition from the hospital to a senior living community, ensuring a smooth process. Whether it's arranging tours of local communities, helping with paperwork, or providing guidance on what to expect, we make the transition as stress-free as possible for both seniors and their families.Ongoing Advocacy and Support:Even after the move to a senior living community, our commitment continues. We check in regularly to ensure that the senior is settling in well and receiving the care they need, and we are always available to address any concerns.ConclusionDischarge planners are invaluable in ensuring that seniors receive the care and resources they need after leaving the hospital. At Assisted Living Locators North Pittsburgh, we work alongside these professionals to ensure that families find the best long-term care solutions for their loved ones. Together, we ensure that seniors transition smoothly from the hospital to a senior living community where they can continue to thrive.If your loved one is preparing for hospital discharge and you're exploring senior care options, Assisted Living Locators North Pittsburgh is here to help. Contact us today for expert guidance and personalized support in finding the perfect senior living solution.
As we grow older, our needs and priorities evolve, often making our living spaces feel less suitable than they once were. For seniors, the comfort of home becomes even more essential, yet the task of organizing and maintaining a home can become overwhelming. At A Call to Order Professional Organizers, we understand the emotional and physical challenges that seniors face. Our mission is to provide compassionate, expert assistance to help seniors feel at home, wherever they choose to live. Through our personalized services, we strive to create spaces that are not only organized but also nurturing and comfortable.Understanding Seniors' Needs1. Emotional Attachment to BelongingsFor many seniors, their homes are filled with a lifetime of memories and cherished belongings. Each item tells a story and holds sentimental value. The thought of sorting through these possessions can be daunting and emotionally taxing.Tips for Respectful Decluttering:Listen with Empathy: Take the time to listen to the stories behind the items. This shows respect for their memories and makes the process less about discarding and more about cherishing.Gentle Guidance: Encourage seniors to keep items that bring joy and consider donating or gifting those that don't. Highlight the positive impact of giving items a new life.Memory Preservation: Offer creative solutions to preserve memories, such as creating photo albums or digital archives of beloved items that can't be kept.2. Safety and AccessibilityAs mobility becomes a concern, its crucial to ensure that a seniors living space is safe and easily accessible. Organizing with a focus on safety can prevent accidents and make daily tasks more manageable.Strategies for a Safe Home:Clear Pathways: Ensure that hallways and living areas are free from clutter to reduce the risk of falls.Accessible Storage: Place frequently used items within easy reach to minimize the need for bending or stretching.Adaptive Solutions: Incorporate adaptive equipment and furniture arrangements that cater to mobility issues, such as grab bars in the bathroom and stable seating options.Creating a Sense of Home1. Personalized SpacesA home should reflect the personality and preferences of its inhabitants. For seniors, maintaining a sense of identity through their living environment is vital for emotional well-being.Personalization Tips:Favorite Items: Make sure that favorite belongings, like a beloved armchair or treasured photographs, are prominently displayed and easily accessible.Comfort Zones: Create cozy areas where seniors can relax, read, or engage in hobbies. A well-placed chair by a window, a dedicated crafting table, or a garden nook can enhance their quality of life.Warm Aesthetics: Use colors, textures, and decorations that evoke warmth and comfort. Familiar and favorite colors can make a space feel more inviting and homely.2. Encouraging IndependenceHelping seniors maintain their independence is crucial for their self-esteem and happiness. An organized home can empower them to perform daily tasks more efficiently and confidently.Empowering Through Organization:Logical Layouts: Arrange items in a logical order that matches their routines. For example, keep kitchen utensils near the stove and daily medications by the bedside.Simplify Systems: Implement simple organizational systems that are easy to maintain. Clear labels, color-coded bins, and straightforward filing systems can reduce confusion and make upkeep manageable.Regular Check-ins: Offer ongoing support to adjust the organization as needs change. Regular visits can help keep the home functional and address any new challenges that arise.At A Call to Order Professional Organizers, our commitment goes beyond mere organization. We aim to create environments where seniors feel safe, comfortable, and truly at home. By understanding their unique needs and providing compassionate, personalized support, we help transform living spaces into nurturing havens. Our approach ensures that every senior we assist not only enjoys an organized home but also experiences an enhanced quality of life filled with joy, dignity, and independence. If you or a loved one is facing the challenges of aging in place, we are here to help you feel at home, every step of the way.