Novembet 23, 2018

FOR IMMEDIATE RELEASE

News from Florida reports that Willie Johnson, Jr. age 95, wandered away from his home. Another precious life at risk because of a diagnosis of Alzheimer's disease. Wandering is a common aspect of Alzheimer's Disease. The costs and time of first responders who come to the rescue are in the thousands of dollars. Prayers go out to Willie and his family for a safe return.  

Recent news about Retired Supreme Court Justice, Sandra Day O'Connor's dementia diagnosis and health issues with Supreme Court Justice Ruth Bader Ginsburg bring attention to the health concerns of older adults.

At what point, will these concerns be taken seriously, not only for individuals in government holding high offices, but for the general public diagnosed with memory loss. Research confirms that 50% of older adults over the age of 85 have a diagnosis of dementia but are undiagnosed by physicians. 

Poor self-reporting by older adults and a lack of reporting by family members are the reasons physicians cite for not being comfortable making the diagnosis. Should memory testing become part of all annual physicals beginning at age 65 for all adults? Should insurance companies be required to pay for this testing as part of chronic disease prevention, like testing for heart disease and other common diseases? 

Evidence exists that the signs of dementia are present 10 years prior to the diagnosis. Who is watching out for older adults?

Another question is who is watching our government officials responsible for making decisions that effect the United States? Should safeguards for memory testing be in place for all individuals holding public office?  Are government officials immune to the same health concerns as the general population.

Should an age limit of 75, health, and cognitive testing instituted for Supreme Court Justices? Justices experience the same health declines as peers of the same age. Symptoms of dementia and Alzheimer's disease begin 10-12 years prior to a diagnosis. Concerns with walking, balance, and gait are early predictors of dementia. Other diagnoses like heart disease and diabetes contribute to a diagnosis of dementia.

Retired Supreme Court Justice, Sandra Day O'Connor, announced a diagnosis of dementia on October 23^rd. She retired in 2006 at age 76. Current Supreme Court Justice, Ruth Bader Ginsburg, age 85, was hospitalized on November 7^th, diagnosed with 3 rib fractures. Ginsburg fractured 2 ribs in 2012 and has survived two episodes of cancer.  Supreme Court Justice Anthony Kennedy, 81, retired on July 31; current Justice Steven Breyer is 80.

Cognitive functioning declines with age. 50% of adults over the age of 85 have undiagnosed dementia. Older adults are poor-self reporters of memory loss.  Family caregivers do not recognize the signs of dementia. This combination results in doctors failing to diagnose or not wanting to tell a patient that dementia is a likely diagnosis.

Supreme Court Justices hold the highest responsibilities in the United States legal system. What happens when Justices become aware of cognitive difficulties and fail to report to avoid a request to resign?

President Ronald Reagan served as president from 1981 to 1989, taking office at age 70. The announcement of his diagnosis of Alzheimer's Disease was made on November 5, 1994. Based on statistics, symptoms of the disease were likely occurring during his presidency.

Estate planning, elder law, and probate attorneys are directed to follow Rule 1.14 and ABA Ethics Opinion 96-404 when working with clients they suspect may be incompetent. Attorneys are directed to obtain an evaluation and may petition for appointment of a guardian ad litem, guardian, or conservator. Serving as court appointed guardian for incapacitated older adults, I am very familiar with symptoms, diagnosis, and the necessary care oversight to avoid risks.

Public officials have an ethical duty that includes: the duty of care, the duty of loyalty, duty of impartiality, duty of accountability, and duty to preserve the public's trust in government. The duty of loyalty specifically directs that the official is to put the public's interest before their own. Public officials also have a duty of transparency.

Hiding health concerns from the public even though protected by HIPPA, (Health Insurance Portability and Accountability Act), a U.S law to protect patients' medical records and other health information is contradictory to government ethics laws. Government laws should not protect government officials from acting ethically.  

Supreme Court Justices must be held to standards requiring reporting of cognitive declines. An excuse for not reporting may be the response that individuals who experience cognitive decline are unable to notice the decline.  This concept supports required health and memory testing.

Memory and related testing must be required for all Supreme Court Justices beginning at age 65.  Earlier if suspicions exist about cognitive declines.  Annual neuropsychological testing, PET scans of the brain, and bloodwork to confirm if the APOE-4 gene exists provide insight into cognitive deficits.  Repeat testing on an annual basis will track progression of early concerns allowing proactive responses.

According to the Alzheimer's Association, Symptoms vary among people with Alzheimer's dementia, and the differences between typical age-related cognitive changes and early signs of Alzheimer's dementia can be subtle. Typical age-related changes may be as simple as forgetting a name or an appointment but remembering the information later. 

Individuals with mild cognitive impairment are usually able to carry out day to day activities. 32% of individuals with mild cognitive impairment develop Alzheimer's dementia within 5 years with follow up.

These facts support the need for both age limits and annual testing of health and memory for Supreme Court Justices beginning at age 65. At the time memory concerns are confirmed by impartial physicians', resignation is mandatory. The age limit of 75 will eliminate Justices serving beyond the point of potential health concerns resulting in an inability to ethically perform the responsibilities of their position.

The statistics about Alzheimer's disease are sobering. According to the Alzheimer's Association, Alzheimer's disease is the 6th leading cause of death. Today, 5.7 million individuals in the U. S. are diagnosed with Alzheimer's disease. By 2050 this number will rise to 14 million. 

We can no longer ignore the effects of memory loss and chronic disease for individuals like Willie Johnson, Jr., or elected officials. It is time that Alzheimer's disease be recognized as a concern for regular screening by health insurance companies and the healthcare system.