Oanh Meyer is no stranger to Alzheimer’s disease. Her everyday life revolves around caring for those who suffer from the ailment.
Meyer’s office is at the UC Davis Alzheimer’s Disease Center in Sacramento, California. But her care goes beyond the clinic: Her mother was diagnosed with the progressive disease that commonly causes dementia and has no cure.
As a primary caregiver, the University of California, Davis, assistant adjunct professor understands the challenges, barriers and emotional burdens that come with that role — especially for newer immigrants — but are often ignored or dismissed.
WATCHING OVER A FAMILY MEMBER
It was 3 a.m. and Meyer was awakened by a sound in her bedroom — someone was unplugging the nightlights. It was jarring, Meyer recalled.
Her mother’s silhouette began to register in the dark. Anh Le, 84, used to unplug the nightlights, scared the electricity would start a fire.
Another night, the garage alarm awoke Meyer. Le had wandered down to the garage, gone outside and left the door open. Meyer turned off the alarm and walked Le back to her room.
Sometimes she would have to stay outside of Le’s room to make sure her lights didn’t flip back on. Then she’d lie on her bed for an hour or more, taking deep breaths and scrolling through social media to try to fall asleep again to prepare for the upcoming day.
Meyer has always been interested in mental health issues among Asian immigrants. She even started a post-doctoral degree in 2011 at the UC San Francisco with a focus on mental health issues among Asian minorities.
But that’s when Le started showing symptoms of cognitive impairment; she was diagnosed with Alzheimer’s disease in 2014. Two years later, Meyer was living with her mother to take better care of her.
Meyer admitted that it’s stressful being her mother’s primary caregiver. Even though she understands on an academic level that her mother will continue to decline, she finds it difficult to apply that knowledge to her mother’s case with the emotional turmoil such a concession would entail.
“Sometimes I am proud of myself for not being snappy or short,” Meyer said.
Some days the mask slips and she might be a little curt. When that happens, Meyer said she feels guilty and tries to be extra nice to her mother the next day.
“It is hard when you are dealing with it on a day-to-day basis,” she said.
STIGMA, TRAUMA AND LACK OF KNOWLEDGE
Through research and experience as a caregiver, Meyer found that many Vietnamese elders lack knowledge about Alzheimer’s and wait a long time before seeking help or diagnosis.
Sometimes, stigma drives them from treatment; in many cases, there are multiple caregivers, and conflicts can arise when they don’t agree on what to do.
And they aren’t the only ones.
According to a report published this year by the Alzheimer’s Association, most of the current studies on dementia among Asian subgroups are unreliable and more studies are needed to draw significant conclusions about the prevalence of Alzheimer’s and other dementias in Asian Americans and subgroups.
In 2015, Meyer published a research paper documenting the experience of Vietnamese caregivers to help them better understand the context of the battle against Alzheimer’s.
Wartime trauma is one factor that could exacerbate the effects of Alzheimer’s and dementia for Vietnamese immigrants. With their long-term memories intact, Meyer noted, many care recipients repeat traumatic stories about the communist forces coming to attack Vietnam before the fall of Saigon.
She wants to study whether wartime trauma, reinforced by immigrating to a new country, could worsen behavioral symptoms among people with dementia.
In 2018, she published another paper that explores a culturally competent program to help reduce stress for caregivers of Vietnamese loved ones with dementia and Alzheimer’s, as well as to educate them on how to get appropriate medical care and deal with real-life situations as a caregiver, among other topics.
She later began a six-week support program for caregivers based in Sacramento and San Jose.
“For example, caregivers can learn about the protocol when the care recipient refuses to bathe,” Meyer said. They can also learn to manage stress and emotions through breathing exercises and stretching.
Information that many caregivers found useful include the Alzheimer’s Association hotline and the in-home support services for low-income families to help pay for caregiving, Meyer said.
“Once they are in the safe space, they were open in sharing and the stigma is gone,” she said.
YOU’RE NOT ALONE
Dan Truong, a Sacramento resident and a caregiver for his wife, enrolled in the program but was skeptical at first.
“Why should I open my life to people who are strangers?” he recalled thinking.
But he gave it a shot anyway — and was glad he did.
Truong’s wife of 34 years first showed symptoms of Alzheimer’s, such as memory loss, in 2004, in her early 50s.
Truong said he felt depressed after having to quit his job in the food industry to take care of her.
“I have an eight-hour job. How do I deal with that?” Truong said. “For a while, I would just go to work at 8, come home for an hour to have lunch with her and put her to bed, go back to work again and come home at 4. But it was killing me because who knows what she will do from 12 to 4 p.m.”
“I stayed at home, but there is only so much ‘Judge Judy’ you can watch,” he said.
Because Truong’s wife developed separation anxiety, common with Alzheimer’s, she tagged along wherever Truong went. He later found a job with more flexibility and placed his wife in a day care during work.
Truong said the most important realization he came to through the program was knowing he isn’t alone.
“There were others struggling like me,” Truong said. “It’s funny because you can identify the things listed [in the program] just happened to me. That was what compelled me to go back every week.”
Truong made friends at the program who helped form a support network. One participant called him a week ago to update him about her husband and asked whether such and such symptoms happened to him. They spoke for more than an hour.
“It is a relief when you can talk about it,” Truong said. “The stress goes away.”
Having a translator present at the program to provide interpretation for participants was helpful, too, he said.
“There’s a learning curve to this disease because you are not prepared for it,” Truong said.
Meyer invited experts from the Alzheimer’s Association and from social service groups to help with questions at the intervention and passed out cards with contact information.
“I didn’t know these places like in-home long-term care or respite care exist,” Truong said.
What keeps Truong going is the lucid moment his wife has, every now and then. “Sometimes she doesn’t remember me,” Truong said. “She has a blank stare — she is scared of me. But when she realized it was me, she will squeeze my hand really hard.”
For her upcoming projects, Meyer, along with principal investigator Van Ta Park from UCSF, will develop a registry for the Asian Pacific Islanders in California to help researchers address the gap and disparities by studying a population that is typically left out.
Data about Asian Americans usually lumps the subgroups of different ethnicities together, potentially burying issues among subgroups that are often smaller and consist of more newer immigrants. Better detailed data would be able to guide organizations to do more effective outreach in underserved communities.
The registry will gather information from 10,000 API participants. It is expected to launch next year. The National Institute on Aging funded the study. It will be conducted in Cantonese, English, Mandarin, Vietnamese and Korean across Sacramento, Los Angeles and Orange counties, as well as the Bay Area.
In the meantime, Meyer is continuing to research caregivers among the API population. “I think it is the desire to give people the support they need,” she said. “I know how stressful it can be as caregivers and a lot of them are not aware of the services out there.”