Amy Goyer moved back to Phoenix to look after her father, Robert, when he began to show signs of Alzheimer's. He is just one of 5 million Americans living with the disease. (Sarah Brodzinski)

Alzheimer's Cases Rise, But Hope Remains

May 18, 2013 (All Things Considered) — More than 5 million Americans currently have Alzheimer's disease, and the number is only going to increase -- in part, due to aging baby boomers. But researchers say increased awareness and early detection is helping patients live with the disease.

More than 5 million Americans are currently living with Alzheimer's disease, and the National Institute on Aging estimates that that number is going to triple by 2050 — in part due to aging baby boomers.

The cost of coping with the disease — currently estimated at $215 billion — is projected to rise to half a trillion dollars by 2050. That amount will likely tax our overburdened health care system, the economy and the families of those affected.

Amy Goyer realized her 84-year-old father Robert's health was deteriorating one night while watching a movie with him.

"He asked me the name of the movie like 20 times within a half-hour, and I thought, 'This is not normal for him,' " Goyer tells NPR's Jacki Lyden.

It wasn't normal; it was Alzheimer's. As her father's condition worsened, Goyer made the decision to return home to Phoenix to take care of him.

"As time progressed, he was having trouble managing the finances; the paperwork was overwhelming," she says. "He would get incredibly stressed out ... [and] little things about his memory kept getting worse and worse."

Goyer is no stranger to caregiving; she's worked at AARP for 19 years giving advice as a home and family expert. When she first began taking care of her dad, she decided to start a blog, which then turned into a web video series.

In the series, Goyer offers advice to caregivers like herself, who are struggling to take care of their loved ones.

"It's very challenging, and there are times I get very exhausted," she says. "And I just feel like the biggest enemy of caregivers is sleep deprivation because you just do not have the energy to deal with the emotional aspects of it and ... just doing, doing, doing."

Because her mother is at home, too, recovering from a stroke, Goyer often has to help both parents get up in the morning and go to the bathroom, do all of their personal grooming and put on their pajamas at night. She also must make sure they have all their medications throughout the day.

Goyer does have some help, but caring for someone with Alzheimer's can be staggering. She says one of the most difficult aspects of the disease is what's been described as "the long goodbye."

"Over time, it's like he's being robbed of who he is," she says. "And my dad is probably the most optimistic person you'd ever know, and he still has that, which is wonderful for us. But there are times when he gets very cranky because he doesn't know what's going on."

Given her family history of Alzheimer's — her grandmother had it as well — Goyer says she fears getting the disease herself.

"I think about it all the time, but it's hard when I'm focusing on caring for my parents to think about that for myself," she says. "All I can do is anything that will prevent the onset of the disease. But I sure would like to have a lot more tools in my toolkit to fight it."

A Search For Answers

Alzheimer's is a disease that can last a really long time and cost a lot of money — so much money, in fact, that the U.S. government is paying attention with new legislation.

In 2011, Obama signed the National Alzheimer's Project Act into law. Currently, about $500 million per year goes to Alzheimer's research, and the new law includes an additional $100 million toward treatment, research, medicine and diagnostic tools.

Dr. Dorene Rentz, a neuropsychologist and co-director of Harvard Medical School's Center for Alzheimer's Research and Treatment, has been studying Alzheimer's patients for three decades. In 2005, the breakthrough was the discovery of something called amyloid plaque in the brains of patients with Alzheimer's. Not all people with the plaque go on to develop the disease, however.

"Unfortunately, we've come to discover that many older individuals who are still normal have these changes of amyloid plaque," Rentz tells Lyden.

She says doctors believe an abundance of what's called fibular amyloid may trigger Alzheimer's, but that's not always the case. Some people can walk around with a "head full of fibular amyloid," she says, and live normal lives.

In patients already diagnosed with Alzheimer's, even if amyloid plaque is removed, the neurons may be too damaged for memory loss to be reversed. If diagnosed earlier, there might be some hope.

Rentz and a colleague at Harvard are launching a nationwide clinical trial this fall to see what happens in the brains of people who have amyloid plaque, but not Alzheimer's. The object of the study is to see if doctors can remove the amyloid and prevent them from getting symptoms of Alzheimer's.

Living With Alzheimer's

In 40 years, there will be 13.8 million people in the U.S. alone living with Alzheimer's.

Over her 30-year career working with the disease, Rentz says, people she had diagnosed with Alzheimer's were devastated because there wasn't much that could be done. Things have changed, however, as technology and awareness has improved.

"People are more educated and many people are coming earlier to get tested because they are experiencing memory loss," she says.

Even when a patient's clinical profile indicates early signs of a neurodegenerative disease like Alzheimer's, Rentz says, she gives them hope because there are things that can be done.

"Because they're not yet fully devastated in this disease, we can actually give them some FDA-approved medications that are good in keeping people stable for a while," she says.

Rentz says she also encourages a healthy diet and intellectual stimulation, what's called "optimal aging." She says this helps people with early signs of Alzheimer's — who often tend to withdraw — to stay engaged and active.

Goyer won't let her parents withdraw. She's providing a happy, nurturing environment, getting her parents as engaged as possible and having fun.

"I'm not just trying to keep my parents alive; I'm trying to have a good life with them and live my life at the same time," she says. "There's still a lot of fun and a lot of surprises and just a lot of love. My parents are just very sweet individuals and I'm very lucky in that way."

There might not be a cure for Alzheimer's, but that doesn't mean there isn't hope.

Copyright 2013 NPR. To see more, visit http://www.npr.org/.

Amy Goyer moved back to Phoenix to look after her father, Robert, when he began to show signs of Alzheimer's. He is just one of 5 million Americans living with the disease. (Sarah Brodzinski)

Prominent Pakistani Politician Shot, Killed On Re-Election Eve

May 18, 2013 — The PTI party chairman, Imran Khan, blamed Zahra Shahid Hussain's death on a rival party. Police told Pakistan's Dawn newspaper that she was killed during an armed robbery.

On the eve of a re-vote, a prominent Pakistani politician was shot and killed on Saturday.

Pakistan's Dawn newspaper reports that Zahra Shahid Hussain, who was the senior vice-president of Pakistan's Movement for Justice (PTI), was shot in the head during "an attempted robbery incident."

"According to police," Dawn reports, "robbers tried to steal Hussain's hand bag and opened gun fire upon resistance by the PTI leader outside her residence in Defence Housing Authority Phase-4."

Imran Khan, the celebrated former cricket player and the chairman of the PTI, blamed Hussain's death on Altaf Hussain, the leader of the rival MQM party.

"I hold Altaf Hussain directly responsible for the murder as he had openly threatened PTI workers and leaders through public broadcasts," Khan said in a tweet. He continued: "Zara Apa's murder has further strengthened PTI's resolve to stand up against criminals and terrorists!"

Pakistan's Tribune adds:

"Shortly after the incident, the MQM chief issued a statement of his own where he condemned the murder and demanded that the government immediately arrest the culprits and accord them the most severe punishment as per law.

"Imran said Zara apa, as she was known to all within the party, was an old and senior Party leader who was a mentor to the PTI youth and a committed ideological leader of the Party.

"'I am totally shocked and deeply saddened and still cannot believe anyone would kill such a gentle lady.'"

Pakistan had ordered a re-vote in 30 Karachi polling stations after reports of irregularities. The PTI party was among those complaining of voting irregularities.

As NPR's Julie McCarthy has reported, Hussain's PTI party has become a "third force in Pakistani politics."

Copyright 2013 NPR. To see more, visit http://www.npr.org/.

Amanda Knox enters an Italian court on Oct. 3, 2011, just before being acquitted of murdering her British roommate, Meredith Kercher. (AP)

'Waiting To Be Heard' No More, Amanda Knox Speaks Out

May 18, 2013 (All Things Considered) — Less than two months into her study abroad program in Italy, Amanda Knox was accused and eventually convicted of murdering her roommate, Meredith Kercher. After her conviction was overturned, Knox returned home to Seattle -- and now faces a potential retrial. Knox tells her story in a new memoir.

When 20-year-old Amanda Knox left for Italy in August 2007, it was supposed to be a carefree year studying abroad.

No one could have foreseen it ending in her being accused, tried and convicted in the murder of her roommate, Meredith Kercher.

The case, and Knox, became an international media sensation.

"I think that there was a lot of fantasy projected onto me," she tells weekends on All Things Considered host Jacki Lyden. "And that resulted in a re-appropriation and re-characterization of who I am."

Following a controversial trial led by a prosecutor accused of misdoings, Knox and her onetime boyfriend, Raffaele Sollecito, spent four years in prison before an Italian appeals court overturned the ruling.

Also convicted in Kercher's murder was a man named Rudy Guede. In his case, extensive DNA evidence linked him to the crime.

Knox returned home to Seattle, but in March 2013, the Italian Supreme Court annulled her acquittal and ordered a new review of the case.

It is uncertain what that will mean for Knox.

Now 25, Knox tells her story in her new memoir, Waiting to be Heard.

Interview Highlights

On why she didn't leave Perugia or call the American Embassy in the days after Kercher's murder

"It never occurred to me to worry that I would be a suspect. I didn't do it. And I was very much making myself available to the police so that I could help. But what's important is I thought my innocence was obvious. And even when they were screaming at me in my interrogation and calling me a liar, like, I could not believe what was happening to me was happening. I very much did not understand the kind of danger that I was in."

On her conviction

"After my conviction, I was devastated. I had never believed that I would be convicted. And so all of that time after my conviction, leading up to my acquittal, I was afraid to hope. Not even my innocence had saved me, and so I was afraid that my innocence would never save me."

On whether she has reached out to the Kercher family

"No, I haven't reached out to them personally. It's been a very complicated question for me about what is the right way to approach them. What I did do is I read John Kercher's book and it definitely confirmed to me that they are grieving intensely from this incredibly horrible thing that happened to their daughter. And I can tell that they are unconvinced of my innocence and that is this huge wall that I'm not sure how to confront."

On the Italian Supreme Court ordering a retrial

"It's looming over me — this horrendous thing that just never ends. I do not think that I will be convicted because there just simply is not that evidence. I just simply did not do it. I feel like I'm having to prove my innocence as opposed to have the prosecution prove my guilt."

Copyright 2013 NPR. To see more, visit http://www.npr.org/.

Three-Minute-Fiction ( )

Three-Minute Fiction Reading: 'Plum Baby'

May 18, 2013 (All Things Considered) — NPR's Susan Stamberg reads an excerpt of one of the best submissions for Round 11 of our short story contest. She reads Plum Baby by Carmiel Banasky of Portland, Ore.

NPR's Susan Stamberg reads an excerpt of one of the best submissions for Round 11 of our short story contest. She reads Plum Baby by Carmiel Banasky of Portland, Ore. You can read the full story below and find other stories on our Three-Minute Fiction page or on Facebook.

Copyright 2013 NPR. To see more, visit http://www.npr.org/.

Students fill out applications during a job fair at the University of Illinois Springfield in February. Fed up with working for free, some interns are suing their employers. (AP)

Internships: Low-Paid, Unpaid Or Just Plain Illegal?

May 18, 2013 (All Things Considered) — Fed up with working for free, some interns are suing their employers. Last week, a judge ruled that interns could not sue the Hearst Corp. as a class action, which could be a legal setback for young workers tired of exploitative unpaid internships.

Summer is almost here, and with it comes the army of interns marching into countless American workplaces. Yet what was once an opportunity for the inexperienced is becoming a front-line labor issue.

More and more, unpaid and low-paid interns are feeling their labor is being exploited. Some are even willing to push back — with lawsuits.

One of the most high profile intern-versus-employer lawsuits suffered a setback last week that could have implications for other cases. A judge in New York ruled that a group of 3,000 unpaid interns could not sue the Hearst Corp. as a class, but would have to file individual cases against the company.

"It is important, and it is a setback in the sense that it becomes harder for groups of interns to get together, and it makes it less likely that lawyers will take those cases," Ross Perlin says.

Perlin knows the plight of the unpaid intern well. A former intern himself, Perlin was inspired by his experiences to write his first book, Intern Nation: How to Earn Nothing and Learn Little in the Brave New Economy.

"The internship has become virtually a requirement for getting into the white-collar workforce, certainly. It's something that the majority of students at four-year colleges do at least once before they graduate. Many do it two, three, four more times," Perlin says.

"An estimated quarter or third of all internships are unpaid, many more are low-paid as well," he adds. "So those are the ones we're really focusing on because there are thousands of internships each year in the U.S. that are illegal according to the law."

Perlin offers a few red flags to look out for when deciding on an internship program. "If they're asking for somebody who has deep experience with Photoshop, can design websites, and has lots of other experience, and then they're saying, 'Oh, sorry, we're actually not going to be able to pay.' "

If a company's offering school credit, Perlin says, that should also raise a red flag because school credit is given out by schools. "That really shouldn't come into play unless there is a real relationship between an employer and a given college," he says.

Of course, good internships aren't illegal or exploitative. If the company has an established intern-training program, has a designated intern coordinator and details the skills interns will learn, Perlin says, chances are that intern will have a good experience.

Copyright 2013 NPR. To see more, visit http://www.npr.org/.