In California, more and more families are facing a difficult situation: the level of care needed for elderly parents has exceeded what family members can safely provide. The next steps may involve high costs and significant decisions, leaving many families with little time to prepare.
This pressure begins long before the elderly move into long-term care facilities. When dementia alters daily life within a family, relatives may find themselves limited in available care systems.
Dr. Dayan Goodenowe, an expert in dementia and longevity research, and the founder of Prodrome Science, recently appeared on EpochTV’s California Insider program. He explained why so many families reach this point and what steps should be taken before health deterioration escalates into a crisis.
“When you pass away due to dementia, you cannot even depart as your true self. You can’t spend your final moments with family. You can’t depart with your knowledge. Dementia not only takes your life, but effectively steals your death,” Goodenowe said, highlighting how dementia has now surpassed cancer as the most feared diagnosis.
Since Americans began paying more attention to taking B vitamins two to three decades ago, the incidence of dementia has stabilized and even slightly declined; however, the annual diagnosis still reaches as high as 700,000, with the proportion of patients increasing due to population aging.
“Age remains the primary factor leading to dementia,” Goodenowe believes. “People need to realize that developing dementia is not like getting a bacterial or viral infection…we are not discussing fighting a disease – we are exploring the restoration of brain function and cognitive abilities, crucial when patients can enjoy family time for longer, or even return from a nursing home to be with loved ones.”
From diagnosis to death, dementia progresses much faster than people imagine, averaging only five years. At a certain stage, families may no longer provide sufficient care, leading patients to require long-term care facilities. In California, costs vary based on the room type, ranging from $8,000 to $20,000 per month, typically not covered by health insurance unless long-term care insurance is in place or patients are eligible for government benefits.
Once patients enter dementia care units, they usually have one to two more years before passing away. Goodenowe explained, “When you step into a dementia care unit, you see many people in wheelchairs. Thus, dementia is accompanied by the loss of physical function – limited mobility or muscle loss, leading to a decline in bodily functions and their premature departure.”
“We indeed lack long-term care facilities,” Goodenowe said. It is not only a housing issue but also involves caregivers, meals, and all supportive services. “We really need to reach a point where we can start improving their health before they develop dementia.”
Many people equate Alzheimer’s disease with dementia, but Goodenowe explained that there are various types of dementia, including vascular dementia, Lewy body dementia, and frontotemporal dementia. There is also the phenomenon of “chemo brain” where nearly 90% of women undergoing breast cancer radiation and chemotherapy experience cognitive decline. Similarly, those undergoing heart or liver surgery may also face cognitive impairments.
The good news is that the recovery of brain structure and function is highly repeatable. Goodenowe pointed out that good nutrition, mental and psychological care, a sense of belonging, life goals, along with moderate challenges, can effectively prevent and delay dementia.
To restore cellular function and structure in the brain, one must restore cellular activity. Goodenowe said, maintaining and restoring overall health is key and hinges on the four “M”s.
The first is membranes, with abundant epidemiological data demonstrating the role of nutrition in maintaining membranes.
The second “M” is mitochondria. He likened the human body to a hybrid electric car, with mitochondria as the battery. Carbohydrates consumed by the body are burned to produce energy, charging the battery. Each cell contains thousands of mitochondria, and essential B vitamins such as thiamine, riboflavin, niacin, alpha-lipoic acid, and coenzyme Q10 are critical molecules in maintaining their normal functions.
The third “M” is methyltransferase, supporting muscle synthesis of creatine for cell membrane synthesis of phosphatidylcholine. Pathological changes in the cerebral cortex of dementia patients, such as neurofibrillary tangles, are caused by defects in methyltransferase.
The fourth “M” is muscles. Maintaining muscle mass is a primary measure in preventing diabetes. Preserving skeletal muscle mass makes it almost impossible to develop diabetes.
“We need to ensure that the cells in our body can fulfill their designed functions. By achieving this, we can achieve myelin sheath regeneration, restore and maintain cognitive function,” Goodenowe said.
The Prodrome Science, founded by Goodenowe, focuses on disease prevention strategies and has rehabilitation centers in Moose Jaw, Saskatchewan, Canada, and Temecula, Riverside County, Southern California.
He recalled a mother who was ready to enter hospice care, only weeks away from needing end-of-life morphine, when her daughter questioned, “Has my mom really deteriorated to this point? What can I do?” So, she picked up her mother from the nursing home and drove to the Prodrome Science center in Moose Jaw.
Upon arrival, the mother didn’t recognize her daughter, couldn’t brew coffee, or dress herself; within weeks, she started to regain her memory, remembered her daughter and grandchildren, and could make coffee again.
Goodenowe explained that the three-month rehabilitation treatment at the center is essentially biochemical engineering but also involves placing patients back in a caring and stimulating environment. He said, “It’s like if you break a leg, I can’t just put a cast on you and have you sit on the couch. You need to get up and move around; you need to use your leg. If you don’t use your leg, it won’t heal.”
“When we start repairing the brain, you also need to engage the brain: you need to go shopping, do things, stay active. You need to do something,” he said. The mother returned home years ago, living with her daughter, and accompanying grandchildren to soccer practice.
For Goodenowe, the primary goal is to help patients recover to a level where they can function at home. “We get caregivers and dementia patients together to talk because when you care for someone long-term, you start doing everything for them, creating a dependency. Fundamentally, the caregivers are our service users… their health often deteriorates rapidly, unable to cope with everything anymore.”
That daughter not only saved her mother’s life but also the entire family and established meaningful parent-child relationships. Goodenowe emphasized that this is not a unique case but that they are confident they can “reliably” restore the brain’s structure and function.
“And we just heap elderly people as if they were goods. We place them in large long-term care facilities and then completely forget about them,” he said. “The primary goal is to give them life goals. Just as your life needs goals, you need to feel needed, valued; you need to find a way to make a contribution.”
Goodenowe further elaborated on the role of the mind: “We have all seen stories where a spouse, after the death of their partner, basically loses the will to continue living and passes away soon afterwards. If a person has no reason to live, no amount of medication, nutrition, or scientific means can keep them alive; consciously or unconsciously, they will find a way to die.”
“Establishing life goals is paramount,” he said. “Once you start to love someone, they will feel worthy of love; once they feel worthy of living, they will break out of their shell.”
Hence, Goodenowe and his team established the Senior Engage Program in Moose Jaw: from 11 a.m. to 4 p.m. daily, local seniors are provided with free meals and community services, visiting not only homes but also long-term care facilities to enjoy hot meals and engage in conversations. “When people start to rejuvenate, you will see amazing changes.”
“I always tell everyone, no one should retire. They just need to switch jobs. Just as you should never stop working, you should never stop contributing. Once you stop working, it’s basically setting a deadline for your death,” Goodenowe said. “When you reach 90, start considering your next job. You should think, ‘Okay, what am I going to do next year?’ You should plan for it.”
Goodenowe stated that people must establish challenging goals and immerse themselves in specific environments.
In terms of physical exercise, he said, “Most people only need to walk a few hundred yards a day, but if you start walking miles or running, you create a reserve of capability; weightlifting is the same. You need to ‘trick’ the body, making it believe you are living in an environment that requires this intensity.”
“The body will adapt to this demand, and the brain will adapt as well, enhancing the brain’s resilience,” he summarized. “Part of cultivating resilience is setting challenges for the body and brain that you can overcome. That’s the key. Rehabilitation requires both an environment and practical physiological ability – nutrition is what really operates here… it’s not really complicated.” (To be continued)