Warning Signs and Treatment of Alzheimer's Disease
If You Think Your Mom or Dad Has Dementia
How do you know for sure? The only way an absolute diagnosis can be made is through an autopsy where plaque, tangles, and abnormal proteins appear on the brain. Well, you're not about to get your dad tested this way! So how do doctors know?
Diagnosing Alzheimer's is really a process of elimination. The first step is for your dad's primary physician to rule out any reversible signs of dementia, such as a drug reaction that causes him to be confused. If that's not the case, he should be seen by a geriatrician or a neurologist (a doctor who specializes in the nervous system). A full workup takes two to three hours. The physician should listen to you and other family members describe changes in your dad's behavior.
The evaluation will include a Mini-Mental Status Exam which is a short test to determine your dad's ability to handle simple tasks, work with numbers, communicate, recall new and recent information, and process abstract thought. As a result, Dad will probably be asked to name the current President, count backwards, draw a familiar object, and complete a task with simple instructions. The evaluation can include a neurological exam; blood and urine tests to determine if he has a condition that can cause confusion such as a thyroid abnormality or vitamin B-12 deficiency; and various scans such as a CAT and MRI of the brain to identify damage from a stroke, seizure, or blood clot. The scan may also pick up the accumulation of spinal fluid. A spinal tap may be ordered if an infection or disease of the nervous system is suspected. And finally, a psychiatric consult is advised to identify possible causes of Dad's symptoms that might not be related to dementia such as depression.
Since there is no definite, proof-positive test to determine Alzheimer's, as can be done with cancer or diabetes, doctors rely on a battery of tests to rule everything else out. In 5 to 10 percent of the cases, the symptoms that appear to be dementia are caused by a condition that can be reversed. This might be a good point to use to convince Dad he should be evaluated. He may be trying to hide his symptoms for fear of Alzheimer's and refuse to see a doctor. Letting your dad know that there are a number of reasons that could account for what he is experiencing might alleviate his fears and encourage him to find out what's really wrong. Either way it turns out, he and you will be better for knowing the truth.
Regretfully, there is no cure for dementia and Alzheimer's disease. If this is the diagnosis, you'll need to work closely with your parent's physician to monitor the effects of any medications your parent is taking. Drugs can help treat some of the symptoms and promising new drugs are being introduced every year. Gingko and vitamin E also have been reported to slow the progression of the disease for some people.
Be aware that psychotropic (mind-altering) drugs are very powerful. Figuring out the right dosage may take time and these drugs should never be mixed with alcohol. However, most of the care for someone with Alzheimer's is not medical. It involves a lot of love, support, and creative strategies to make life familiar and safe for your parent.
The Three Stages of Alzheimer's Disease
There are three basic stages that most people with Alzheimer's experience:
- During Stage I Dad has trouble remembering anything recent. He has a hard time concentrating, his speech may be slightly impaired, he has trouble thinking of the right word, he doesn't care about his personal grooming, abstract thinking is out of reach for him, and he easily gets upset, anxious, or angry. Other days he may be depressed.
- In Stage II Dad's behavior becomes much more extreme. His short-term memory is nearly gone, his coordination is poor, and he needs help getting dressed, eating, or bathing. Making decisions—even choosing what to wear—seem overwhelming. He becomes easily agitated and begins wandering or pacing back and forth. It's harder to understand him, as his speech and language skills deteriorate. You may hear the same story repeatedly, or he may repeat the same action almost incessantly. He can become outraged for no reason. His sleep cycles are disturbed and nighttime wandering is common.
- In Stage III Dad is in the final stages of the disease. Even his long-term memory has faded away, and he needs total care. What becomes most difficult for families is the paranoia Dad may experience, believing those around him are out to hurt him. His joints become rigid and his range of motion limited; eventually he becomes bedridden, unable to speak or feed himself. His immune system becomes dangerously weakened, leaving him vulnerable to pneumonia and other infections.
Not everyone experiences each of these behaviors, but it's important for you to know what to expect. Your dad doesn't love you any less if he forgets your name, can't recall his marriage, or lashes out at you. Most of the care for someone with Alzheimer's is not medical. It takes a lot of love and support. Join a support group to learn how to cope and make life better for your dad.
More on: Aging Parents
Excerpted from The Complete Idiot's Guide to Caring for Aging Parents Â© 2001 by Linda Colvin Rhodes, Ed.D. All rights reserved including the right of reproduction in whole or in part in any form. Used by arrangement with Alpha Books, a member of Penguin Group (USA) Inc.
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