Alzheimer's and Dementia Counseling and Education: call Cindy Keith of M.I.N.D. in Memory Care at (814)-235-0691, or e-mail at firstname.lastname@example.org
Moving In Nurturing Directions
Tuesday, January 31, 2006
NEWSPAPER ARTICLE BY CINDY KEITH
WHAT SHOULD WE DO ABOUT MOM?
Since Dad died 2 years ago, Mom has been more forgetful and is missing important appointments despite having put them on the calendar. She just doesn't seem to be herself and lately, I've noticed that she's forgotten conversations with me about recent family events. She's had two fender-benders in the past year, the last one resulting in a nasty bump on her head. I don't think she's taking her medicines properly because I find pills lying around the house, but she resists my efforts to monitor them and tells me her doctor is keeping tabs on her. She's pretty adept at covering up her mistakes, but I sense she's worried too since I've heard her joke to her sister in Ohio that she thinks she's getting "Old Timer's Disease." My siblings live in different parts of the country, and none of us want to admit this is happening, but now I'm really concerned about her safety. We don't know what to do next.
This is a common scenario being played out in every city across the country. None of us want to think of the possibility of a devastating diagnosis like Alzheimer's or some other type of dementia, and how each family deals with the problems and questions that arise will be as diverse and individual as each family is unique.
Your objective will be to maintain Mom's dignity, health, happiness and safety, and she first needs to be thoroughly evaluated by her physician. A "dementia work-up" would include a history along with blood tests to rule out a problem that can mimic dementia. Depression, thyroid disorder, vitamin B12 deficiency, and medication reactions are just a few of the possibilities which can be treated successfully. Memory tests such as a mini-mental state exam, including a clock-drawing test are important and should be done for a baseline evaluation, as well as in follow-up to monitor memory status. PET and CT scans or an MRI can show abnormalities in the brain such as strokes, lesions or excess fluid, all of which could account for her symptoms. Someone should accompany her to these appointments, and her doctor should be informed about the family's concerns.
In any case, a durable healthcare power of attorney must be appointed in order to access medical information or make medical decisions for her, if needed.
Waiting for the crisis to happen before acting is being "reactive" where "proactive" would be finding some answers to try to prevent a crisis. Since people don't know what they don't know, accessing those professionals who can provide answers will give families some control over what may happen. It will never be easy or comfortable to find the answers, but meeting your objective may depend on what you do before the crisis. Future articles on this topic will address some of the specific challenges faced by families dealing with dementia.
Cindy Keith, RN, BS, of M.I.N.D. in Memory Care can be reached at 814-235-0691
Sunday, January 15, 2006
SENATOR HILLARY RODHAM CLINTON AS CO-CHAIR
Senator Hillary Rodham Clinton was appointed co-chair of the Congressional Task Force on Alzheimer's Disease last year. Because of the increasing numbers of people who are going to be diagnosed with some type of dementia, the government recognizes the importance of increased research and awareness of dementia. Senator Clinton feels one key issue to be addressed now is in working to find solutions to alleviate the tremendous burdens assumed by the caregivers of people with dementia. She urges people to contact their senators and representatives and urge them to support the Lifespan Respite Care Act. Among other things, this Act would help to develop a statewide system for caregivers regardless of their age, disability or Medicaid status. It would also provide more information to people about respite care services. Senator Clinton says that this bill "picks up where the National Family Caregiver Support Program leaves off."
SOME ENCOURAGING NEWS ! !
There are many studies on dementia being performed and published on an on-going basis. Some good news coming out of those studies is that progress is being made in tracking down some pathways for Alzheimer's and other dementias--which may lead to ways to prevent the disease. Scientists are working on a vaccine for Alzheimer's and it looks promising in the animal testing stages now. Some of the drugs currently on the market are being shown to slow the progression of dementia, including some of the cholesterol-lowering drugs. Another study looks at the possibility of Alzheimer's being a neuroendocrine disorder, meaning it may be linked to abnormalities in how the brain handles insulin. It may be a few years until these studies lead to effective treatments for people, but we need to focus on how much is now being discovered, and work together to see that these important studies receive the funding and the support they need.
Tuesday, January 10, 2006
People who are diagnosed with some type of dementia before the age of 60, often in their 40's or 50's, sometimes spend years attempting to find the correct diagnosis for their declining abilities. Some physicians will quickly dismiss their fears of having Alzheimer's disease or some other type of dementia as "you're much too young to have that" without ever ordering the tests that may help confirm that very diagnosis. Their complaints of mood swings, personality changes, increasing forgetfulness and even gait changes are usually attributed to depression, stress, or working too hard. There are some indications from studies that an inability to accurately draw the intersecting pentagons or do the clock-drawing on the mini-mental state exam are a better indication of some type of dementia, than the final score on the test itself. In other words, a person may score high on the test, but still not be able to accurately draw the required pentagons or clock face. My advice to anyone suspecting a type of dementia, is to find a doctor who will listen and perform the tests needed. If the score on the MMSE is high or "normal," but the drawing is incorrect, I would push for brain scans to look for changes there.
People with early-onset dementia often have more insight into their situation than do people who were diagnosed later in life, and also face many more challenges dealing with family dynamics. Their diagnosis may come at a time when they are still rearing children, have jobs that require extensive travel, and they often have not had time to accumulate any "retirement" savings to help with expenses.
The good news is that even after the diagnosis of dementia, these people can still lead productive lives, and can still contribute to their families and support groups. Knowing what their future brings, people with early-onset dementia can plan more effectively for it. It will never be easy, but educating families and friends can make a world of difference.
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