Last posted by Melonee Hurt | tennessean.com
Anyone with aging parents will tell you they experience a moment of panic every time a parent forgets where they left their phone, or misses an appointment. It seems today that dementia and Alzheimer’s disease are almost inevitable as we live much later in life than generations before.
According to the Alzheimer’s Association, of the top 10 leading causes of death in the United States, Alzheimer’s disease is the only one that cannot be prevented, slowed or cured. It’s the same disease that affects 1 in 10 people over the age of 65.
Alzheimer’s is a degenerative brain disease and the most common cause of dementia. A recent Forbes.com story reported that by the time a person is 85, the odds of developing Alzheimer’s Disease are about one in two.
Tiffany Cloud-Mann, vice president of programs and outreach for the Mid South Chapter of the Alzheimer’s Association, said she sees one common misconception about dementia.
“I work with families needing help, and one of the biggest things I see is people assuming these changes in their loved ones are normal,” she said. “There are some normal things that happen to us as we age, but dementia isn’t a normal part of it.”
Her top two warning signs that something beyond normal aging is happening are: 1. Noticing your loved one having trouble with familiar tasks; and 2. Memory loss that disrupts daily life.
“If you notice your loved one starting to have trouble doing things they used to be able to do without even thinking about it, that is a warning sign,” she said. “As we age, our brains might not work as sharply as they once did, but when a loved one can’t pay their bills, for example, and it happens regularly, that is a sign something more serious is going on.”
Talk about it
If the warning signs are present, knowing what to do next can be difficult.
Cloud-Mann advises getting a conversation started with your loved one without even using the “A” word.
“If your loved one is acting differently than they normally do, just ask them if they have noticed it,” she said. “Don’t assume it’s dementia. It could be a brain tumor, or it could be a vitamin deficiency. The important thing is opening up those lines of communication.”
People covered under Medicare who are over 65 have an annual well check included in their insurance coverage. Cloud-Mann encourages families to take advantage of that and communicate to the physician any changes you may be noticing with you or your loved one’s memory.
William Halford is a board-certified family medicine physician with Williamson Medical Group in Franklin who sees aging patients and their loved ones regularly who are dealing with different stages of memory loss from normal day-to-day forgetfulness to Alzheimer’s and other forms of dementia.
“I think we all begin to notice our memory isn’t quite as good as it used to be, but I think that’s a normal part of aging,” Halford said. “When it becomes clear someone is developing abnormal levels of memory loss and confusion, the sooner you intervene, the better.”
Halford said even though he will ask a patient how their memory is, often times they downplay any problems. It’s the spouse or caregiver who will speak up and mention changes they have noticed.
“It’s generally another family member who will say they noticed Mom or Dad is asking the same question over and over again or getting lost, turning the stove on and forgetting it or waking up in the middle of the night and thinking it’s morning. Those are all common scenarios I hear,” he said.
Easy, effective evaluation
Halford said he has a mini mental status exam he can do in his office that is a series of questions generated by a well-known geriatric researcher. The test allows a physician to do a rapid assessment of those suspecting memory problems.
“I will give a patient three objects that we name, and I will tell them that in five minutes I am going to ask them to name those same objects again,” he said. “Then I will ask the patient to tell me: What day of the week is it? Where are we right now? What’s your home address? I give them a two-part command and ask them to follow it. The score you get from this assessment tells us a lot about a person’s memory or lack thereof.”
Serious memory issues could require follow-up visits with a neurologist or other physician who can do further testing on the brain to gain more information about what might be going on.
Initial options for care
If a loved one is suffering from dementia or Alzheimer’s, the No. 1 action family members or caregivers must take is to keep them safe. Maybe that means taking car keys away or hiring someone to help cook meals and do simple tasks around the house.
But it doesn’t mean that you have to remove your loved one from their home, where statistics show 9 out of 10 people over age 65 say they would prefer to stay for as long as possible.
Phil Bongiorno is the executive director for the Home Care Association of America (HCAOA), and he said home care, which is different from home health care, is an option for anyone with a loved one who isn’t ready for an assisted living facility, but needs some extra help.
The HCAOA is a nonprofit trade association representing in-home personal care service companies that help people with everything from basic companionship to personal hygiene and light meals to monitoring medications and ensuring they are being taken correctly.
Bongiorno said before hiring an in-home caregiver for your loved one, there are a few things you need to know.
“Members of our association are employed caregivers, not independent contractors,” he said. “Part of our standards are that you have to be a W-2 employer who has a care plan and monitors caregivers. We know elder abuse is on the rise, but you will not see any of our companies in the news. We are setting higher standards, so it’s important when looking for a caregiver, you go to an agency that employs their caregivers.”
He added that all too often family members try to administer all of the care their loved one might need. Many times, those family members are still in the workforce.
“Families need to know there are professional caregivers who can really offer them some peace of mind,” he said. “I had someone tell me recently (that) after hiring a home caregiver, she was able to be a daughter again. When you become a caregiver, you lose that sense of being their child. We help that parent-child relationship continue. “
10 early warning signs and symptoms of Alzheimer’s Disease
The Alzheimer’s Association recommends you speak with your physician if you notice any of these signs.
1. Memory loss that disrupts daily life. Beyond just casual forgetfulness, this is forgetting recently learned information, important dates or events, or asking the same questions repeatedly.
2. Challenges in planning or solving problems. Some examples are difficulties in following a familiar recipe or keeping track of monthly bills, or if a person takes much longer to do things than before.
3. Difficulty completing familiar tasks at home, work or at leisure. This could be trouble driving to a familiar location, managing a budget at work or remembering the rules of a favorite game.
4. Confusion with time or place. People with Alzheimer’s can lose track of dates, seasons or the passage of time. They may forget where they are or how they got there.
5. Trouble understanding visual images and spatial relationships. For some, vision problems can be a warning sign. There may be difficulty reading, judging distance or determining color, which can cause problems with driving.
6. New problems with words — speaking or writing. Problems joining or following a conversation can be a warning sign, such as stopping in the middle of a conversation and not knowing how to continue, or repeating themselves.
7. Misplacing things and losing the ability to retrace steps. Putting things in unusual places or losing something and being unable to go back through their steps to find them again is a common warning sign.
8. Decreased or poor judgement. People with Alzheimer’s may experience changes in judgement or decision making, including dealing with money or keeping themselves clean.
9. Withdrawal from work or social activities. Removing themselves from hobbies, social activities, work projects or sports, trouble keeping up with a favorite sports team or completing a favorite hobby or the avoidance of being social because of these changes.
10. Changes in mood or personality. The mood or personality of a person with Alzheimer’s can change and they can become confused, depressed, fearful or anxious. They may be easily upset in places where they are out of their comfort zone.