"People don't talk about what dementia really means, or what Alzheimer's really is. It's just, it's scary and frightening and alien — and it's part of who we are. Like, why can't we talk about it?"
Seated in her firm's office on the 38th floor of the U.S. Bancorp Tower in Portland, Victoria Blachly paused for just a moment.
"Then again, I'm a litigator, so I talk about everything," she quipped. "Too much."
Blachly, who has lived in Tigard since graduating law school in 1997, is a partner at Samuels Yoelin Kantor LLP, one of Portland's oldest law firms. The firm is sending a team to participate in the Walk to End Alzheimer's at the Portland International Raceway on Sunday, Sept. 10.
For Blachly, who sits on the board of the Oregon chapter of the Alzheimer's Association, the cause is close to her heart — and a part of her job.
"What I personally do, and all that I do, is fiduciary litigation," she said. "So that's people fighting about wills and trusts, it's people fighting about capacity, undue influence, will contests — drama litigation is what I deal with."
That line of work means Blachly is very familiar with dementia and other age-related mental health conditions. Legal challenges not infrequently arise over whether a person is mentally fit to make decisions about their own finances and assets, or whether someone is taking advantage of another person's medical condition, a form of exploitation often described as "elder abuse."
"What I do for a living professionally is I see the worst of what happens when you have dementia or brain-related illnesses, and how people take advantage of that," Blachly said. "So I wanted to be involved with something that had a much more positive focus."
"Unfortunately, there is a lot of misunderstanding about what (dementia) is," said Dr. Allison Lindauer, who works at the Layton Aging & Alzheimer's Disease Center at Oregon Health & Science University Hospital and also sits on the Alzheimer's Association board.
As defined on the Alzheimer's Association website, "dementia" is "a general term for a decline in mental ability severe enough to interfere with daily life." Alzheimer's disease is one of many different dementias.
Like many mental conditions and disorders, dementia's effects can be described along a spectrum.
People suffering a severe form of dementia, like late-stage Alzheimer's disease, may experience long- and short-term memory loss that can be entirely debilitating, rendering them unable to recognize or remember loved ones and family members, and eventually inhibiting their ability to perform basic functions, including walking, eating and communicating.
But many dementias are much more mild, with their sufferers perhaps forgetting words or misplacing items, among other symptoms, while still being able to work and socialize as they did before their diagnosis. The disease tends to be progressive, worsening with advancing age in those who experience symptoms. Noticeable but minor changes in behavior, memory or capacity are sometimes described as a "mild cognitive impairment," which may or may not advance to the level of dementia.
"There has to be several different factors present," Lindauer explained of a dementia diagnosis. "You have to have a change in thinking — so a short-term memory loss. And then you have to have some type of functional change, like not being able to pay your bills, or take your medication, or drive your car."
She added, "With Alzheimer's disease, there tends to be a very early, subtle phase. … As time progresses, the changes become much more apparent."
Blachly recounted one case in which an elderly woman's nephew used a dementia diagnosis from a doctor to seize control of her finances, even though the woman's form of dementia was very mild, Blachly said. In another case she recalled, a woman with mild dementia agreed to move into an assisted living facility in Washington to be near family, but she later decided she wanted to move back to the East Coast, only to find herself barred from leaving the state on the grounds she was incapacitated.
"I mean, you cannot take away this woman's civil rights just because there are hearsay medical records that say she has dementia," Blachly said, her voice rising with passion.
Blachly said she thinks of elder abuse similarly to domestic violence: It's an issue that may be more common than people realize, because it frequently goes unreported, and people may not even realize when it is being committed.
"It used to be that nobody talked about domestic violence. It didn't really happen, right, like it was the dirty little secret. And then there was a paradigm shift and the laws caught up with the morality of 'no, this is unacceptable,'" Blachly said. "And my hope is that with elder abuse, that's where we're getting to as well, is that people are talking about it more and they're realizing that just because it's family, this is not a tolerable situation and that there should be consequences to it."
What Blachly hopes to accomplish through her involvement with the Alzheimer's Association, she said, is to spread the word about elder abuse and dementia. She wants people to understand what they are and how to deal with them.
"Awareness is the key issue," she said. "Let's talk about it. Let's talk about how we can help people that are dealing with it. Let's talk about how we can empower the caregivers so that they have knowledge that they can deal with it. It's really just putting a light on this."
Caregivers for those with dementia run a higher risk of experiencing health problems themselves, according to Lindauer, who also sits on the Alzheimer's Association board.
"There's a great deal of stress, and there's a great deal of what we call burden," Lindauer said.
People who provide care for dementia sufferers need to be cognizant of the strain it places on themselves and take time away from it, Lindauer said.
But like Blachly, Lindauer said she thinks people tend to be uncomfortable talking about dementia, and through her work, she knows many people don't understand it.
"It's a very subtle, progressive disease," said Lindauer, adding, "Unfortunately, I think there is still a great deal of stigma around it — which there shouldn't be."
Like Samuels Yoelin Kantor, the Layton Center is sending a team to participate in the Walk to End Alzheimer's on Sunday, Sept. 10, at Portland International Raceway. Teams raise money for the Alzheimer's Association to support research into Alzheimer's treatment and prevention.
"It's such an uplifting event," said Blachly, who will be walking for the second year in a row. "Just the energy was amazing and empowering for a disease that is so brutal and that there is no cure for — to be part of an event that is actually inspiring is priceless."
She also noted the event is a good one for businesses to participate in.
"It's a fantastic way for businesses to have a collaborative, team-building event that I would encourage other businesses to do," Blachly said. "We found that, you know, the walk itself is an easy walk, which is nice — but that kind of support and collaboration is really important, and it's an easy way to have that kind of team-building event."
Along with trying to raise awareness through the Alzheimer's Association, Blachly also encourages people she addresses to designate power of attorney — someone with the authority to manage a person's affairs if they become incapable of doing so — and to contact Oregon's abuse hotline at 1-855-503-7233 if they believe a vulnerable adult (or a child) is being abused.
By Mark Miller
Assistant Editor, The Times
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