Questions to ask when a loved one is suffering from Alzheimer's or dementia

It starts slowly, almost imperceptibly. Keys lost. The forgotten birthday Use the wrong word or lose the thread in the middle of a conversation. These are often considered as typical signs of aging, but in some people they may be the earliest signs of a more serious phenomenon: the development of dementia or Alzheimer's disease. When a doctor is diagnosing dementia or Alzheimer's disease with your loved one, you need to ask many questions to understand his current condition and prepare yourself appropriately for the progression of this progressive disease.

1. Is it Alzheimer's disease or another type of dementia?

There are many types of cognitive decline that people may experience. "Dementia is just a generic term," says Dr. Susann Varano, a geriatrician at Maplewood Senior Living, a retirement home corporation in Westport, Connecticut. "If a doctor says" you have dementia, "it's the same as saying" you have cancer. "She adds that it's essential to determine exactly the type of dementia that he's having. "Is it Lewy body dementia? Is it vascular? Is it a fronto-temporal disorder? Is it mixed dementia? Is it Alzheimer's disease? Although all dementia affects the brain and cognitive functions, "each of these types of dementia has a different pathway, some accelerate more than others, and some have different symptoms, so it's very important to get the diagnosis of dementia. "

[See: 11 Things Seniors Should Look for in a Health Provider.]

2. What else could it be?

According to Varano, doctors often meet a senior who complains of memory problems and automatically assumes dementia. The doctor can begin to treat him as such without the diligence required to dismiss other culprits. "Alzheimer's disease is a diagnosis of exclusion. Therefore, to be fair to the patient and to the caregiver, you have to exclude certain things, "and your doctors should evaluate reversible dementia and pseudodementia, she says. Other diseases, conditions, and side effects of medications can sometimes mimic some of the symptoms of dementia or Alzheimer's disease.

For example, "did this person evaluate her thyroid and B12 levels?", She asks, because disturbances in these areas can lead to memory loss. Could it be Parkinson's disease, another common disease in the elderly and sometimes exhibiting symptoms similar to those of dementia. "It's common to have an elderly person with urinary incontinence, dementia, and door disruptions. This triad is in itself a hydrocephalus at normal pressure, an accumulation of cerebrospinal fluid that causes an increase in pressure in the brain. It is more common in the elderly, but it is reversible with the right treatment.

Depression is also often misdiagnosed as dementia "because depression in the elderly is extraordinarily common," says Varano. These two conditions share many symptoms, including loss of concentration, lack of motivation, loss of interest, apathy, psychomotor delay, and sleep disturbances. "You see that under both conditions and rather than jumping up and giving someone an Aricept (a cognition enhancing drug used to treat Alzheimer's disease, usually called donepezil), it's extremely helpful to know their history and geriatric screening to detect underlying depression. "Said Varano.

A lack of restorative sleep (insomnia, difficulty staying asleep, sleep apnea or morning waking) can lead to symptoms such as agitation, darkening of the mind, increased car accidents and decreased ability to sleep. focus, sometimes confused with dementia. "When a person presents these symptoms, the doctor should ask him about snoring and sleep apnea or waking up twice or more a night to go to the bathroom," a disorder called nocturia. "A lot of people think that's the normal biology of aging, but that's not the case – it's a condition, and it's treatable," Varano says.

And through all of this, it's important to stay calm, she says. "Do not panic. Do not assume that because you are old and have forgotten something, you have Alzheimer's disease. But on the other hand, it's important to pay attention to clues and not waste a lot of time negating. "Some people see deficits (cognitive) and think it's normal aging. They do not want to be told that their father or mother has Alzheimer's disease because they do not want it, but it is important that your well-being loved be examined early in the symptoms because it is the best time to slow the progression of the disease. disease. "Face your fears and get an accurate diagnosis," she says.

3. How will the disease evolve?

Once you have identified an appropriate diagnosis, it is important to know what awaits your loved one in the weeks, months and years to come. Varano says that you want to know: "What is the typical course of this disease so that I can prepare myself emotionally, financially and physically".

To help you determine your next steps, for example, if you are going to transfer your loved one to a long-term care facility or a long-term care facility, you need to know what to expect. Megan Carnarius, a registered nurse, founder of Memory Care Consulting and author of "A More In-Depth Perspective on Alzheimer's Disease and Other Dementias: Practical Tools with Spiritual Clarification," explains that it may involve talking to a lawyer for organize your documents, what needs to be done. done well before a diagnosis of dementia is made because "you usually can not write a power of attorney if a person has this diagnosis". Some lawyers will not be comfortable doing so if they are worried about the patient's competence. Therefore, "If families suspect the person is becoming confused and they need to go to a doctor for a diagnosis, they should already have taken care of their financial and legal concerns."

Carnarius says that you should also ask the doctor who makes the diagnosis if you need to consult a geriatric specialist for further evaluation or treatment, and to find out if the doctor you are working with includes the current treatment options for patients with dementia. She says that not all doctors are comfortable with the treatment of a patient with dementia and that you should know it in advance.

Varano adds that you may want to seek help at a specialized geriatric assessment clinic to confirm the diagnosis and connect you with additional resources. "This clinic usually has social workers and case managers who will provide all the resources available for the situation."

[See: 14 Ways Caregivers Can Care for Themselves.]

In the same vein, Carnarius recommends asking "your doctor if there are research clinics or universities nearby where the person could participate in studies if he wishes. This could provide access to advanced treatment that could slow the progression of the disease. and help researchers find better treatments and maybe even cure one day.

Finally, make sure that your doctor regularly checks the status of your loved one with a standardized tool such as the mini mental status exam, a common test of cognitive function, can help objectively determine if the Your loved one's illness has progressed and it's time to look for others. Help me. Other signs of disease progression include difficulty swallowing or walking, and when these symptoms appear, you should definitely be examined.

4. Does my loved one understand what is happening?

According to Carnarius, "about 50% of people diagnosed with dementia have no idea what they are" and do not realize that their cognitive skills are compromised. This can lead to frustrating exchanges when family members try to impose the reality of the situation on the person with Alzheimer's disease or dementia. "Many people waste a lot of time, frustrate and mystify their loved ones by trying to force them to understand that they have memory loss instead of just moving forward," and finding non-confrontational strategies to work with. the person who will result more. positive interactions.

Dr. Zaldy Tan, Medical Director of the UCLA Alzheimer's and Dementia Care Program and Geriatrician of the UCLA Medical Center, shares the opinion that it is important for loved ones to realize that patients with Alzheimer's disease or dementia "can not learn new information. I do not think they need to fix all the mistakes, "for example, when the patient insists that a long-dead parent comes for them. Sometimes it's better to give up.

5. What do I need to know as a caregiver?

Caregivers are so often asked to care for loved ones with dementia, and it would take a complete article to deal with the most basic details. But just say it early, it's important to ask what is expected of you as a caregiver as your loved one's dementia progresses. Ask your doctor what resources are available locally to help you as a caregiver in your efforts. Tan organizes a Boot Camp program for Alzheimer's Caregivers at UCLA, which brings together the core of a caregiver's knowledge in a one-day program. Find out if similar programs exist near you.

While you want to take care of your loved one, it's important to remember that you need to take care of yourself and Tan also says it's important that caregivers do not take things personally. Sometimes, when patients are having a bad day or are confused or frightened, they can become combative or say harsh things, such as "I've always loved your brother or sister," which triggers a reaction at home. caregiver. It's important to remember that "it's the disease that speaks, not the person," says Tan, so do your best to let such interactions take place behind you. Asking for help from a support group made up of other carers can be very helpful in managing this aspect of dementia care. Discover the resources available locally, both to learn to be a caregiver and to take care of yourself as you take on this important and often difficult responsibility.

[See: 9 Strategies to Reduce Falls for People With Dementia.]

6. What should be my next steps?

You will also have to take into account the evolution of the living situation of your loved one. Depending on the state of progress of the dementia, they may not be able to live autonomously any longer. You must therefore determine when it is time to transfer them to a long-term care facility, a long-term care facility, another facility can specifically take care of them as their illness progresses. This can be a difficult decision that requires a lot of work. You should therefore start as soon as possible to study your options and try to find the place that best suits the situation of your loved one. "In the end, it's all about safety," says Tan. "You do not want them to fall or choke on their food," so as soon as you can, start looking for the right place so that when the time comes to move your loved one, you're all ready .

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Questions to ask when a loved one is suffering from Alzheimer's or dementia originally appeared on usnews.com