Are You a Likely Candidate for Alzheimer’s?

I recently had the opportunity to participate in a radio series focusing on Alzheimer’s caregivers. My mom and I were interviewed by Sean Corcoran of WCAI radio, the NPR station on Cape Cod. The series was divided into five parts which were played on five different days. Sean did an outstanding job of illustrating many different family situations with a family member who has the disease. He has won many awards for his work and I am sure this series will be another award winner.

Here is a link to the series: www.wgbh.org/wcai/alz2.cfm

The research has shown that there are no specific strategies anyone can take to avoid the disease. No amount of crossword puzzles, brain teasers or mental exercises can protect your brain from Alzheimer’s. But according to Lisa Genova, author of “Still Alice” the most incredible book I’ve ever read about an Alzheimer’s patient, early detection is valuable.

Lisa states that “Awareness leading to earlier diagnosis is important. Although the current drugs available for treating Alzheimer’s do not change the ultimate course of the disease, they can stave off its progression for a significant amount of time, allowing the person with Alzheimer’s to live on sort of a plateau, to enjoy the capabilities they still have for a longer time”

Research has also shown that 50% of the children of Alzheimer’s patients will get the disease themselves. I am a child of an Alzheimer’s patient. Should I be tested to determine if I am likely to get the disease? Recent advances in testing can indicate if you have a very high likelihood of getting the disease but can’t tell you for sure if you will. So does it make sense to have the tests done or just let life take it’s course?

At this point I have decided not to be tested but to live my life to the fullest and be conscious of the occurrence of symptoms. I checked with the Alzheimer’s Association at their website http://www.alz.org/alzheimers_disease_10_signs_of_alzheimers.asp and learned that there are ten indicators to be conscious of . If you have any of these ( or if a loved one does) check with your doctor:

Memory loss that disrupts daily life.
Challenges in planning or solving problems
Difficulty completing familiar tasks at home, work or at leisure
Confusion with time or place
Trouble understanding visual images and spatial relationships
New problems with words in speaking or writing
Misplacing things and losing the ability to retrace your steps
Decreased or poor judgement
Withdrawal from work or social activities
Changes in mood or personality

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Do Not Resuscitate?

Many of us mistakenly believe that if we have gone to the trouble of having our parents complete a living will and have had an attorney prepare an advance directive identifying a health care proxy for them we have covered all the bases. But this is not the case!

Advance Directives and living wills are not accepted by Emergency Medical Services (EMS) as legally valid forms. If a patient has a living will that states that they do not wish to be resuscitated but does not have an appropriately filled out state sponsored form that is co-signed by a physician, the Emergency Medical Technician (EMT) will attempt resuscitation. This is a little known fact to many patients and primary care physicians that can cause patients to be resuscitated even if their family has given instructions not to do so. Although this law is currently being evaluated for a constitutional challenge it is still in place.

A do not resuscitate document is a binding legal document that states resuscitation should not be attempted if a person suffers cardiac or respiratory arrest. A DNR does not affect any treatment other than that which would require intubation or CPR. Patients who are DNR can continue to get chemotherapy, antibiotics, dialysis, or any other appropriate treatment.

The DNR documentation is especially complicated since each state has its own specific approved form. The DNR form for residents of the State of Arizona is required to be printed on orange paper or it is not valid.  The Massachusetts form can be obtained from the Department of Emergency Services and can be downloaded from the site: www.mass.gov/Eeohhs2/docs/dph/emergency_services/comfort_care_bracelet.pdf  It provides for a bracelet to be applied to the patient’s wrist.

It is imperative that you contact your state health and human services department to determine what form is approved in your state. The form must be signed by the health care proxy ( sometimes called the health care agent) or a durable power of attorney and cosigned by a physician. It is recommended that the original DNR form be kept in safe place, and that copies be kept in places that will be readily available to EMS personnel

Holiday Elder Blues Depression or Dementia?

The holiday season is quickly coming upon us. If you are a caregiver for an elderly loved one, you may notice a change in your loved one’s mood as the holidays approach. Perhaps you are one of many, who visit elderly parents and family during the holidays who live a distance away. When you visit you may notice that loved ones are not as physically active, or they show symptoms of fatigue or sadness and have no interest in the holiday or in their surroundings.

How do you know if it is depression or dementia?
Depression and dementia share similar symptoms. A recent article on Helpguide.org gives some specific differences:

In depression there is a rapid mental decline, but memory of time, date and awareness of the environment remains. Motor skills are slow, but normal in depression. Concern with concentrating and worry about impaired memory may occur.

On the other hand, dementia symptoms reveal a slow mental decline with confusion and loss of recognizing familiar locations. Writing, speaking and motor skills are impaired and memory loss is not acknowledged as a being problem by the person suffering dementia.

Whether it is depression or dementia, prompt treatment is recommended. A physical exam will help determine if there is a medical cause for depression. A geriatric medical practitioner is skilled in diagnosing depression and illnesses in the elderly. If you are a care taker of an elderly person it may be beneficial for you to seek out a geriatric health care specialist. For more information on senior health services go to http://www.longtermcarelink.net/about_senior_health_services.htm

Treating depression in older people.
Once the cause of depression is identified, a treatment program can be implemented. Treatment may be as simple as relieving loneliness through visitations, outings and involvement in family activities. In more severe cases antidepressant drugs have been known to improve the quality of life in depressed elderly people. Cognitive therapy sessions with a counselor may also be effective.

As a care giver or family member of a depressed older person, make it your responsibility to get involved. The elder person generally denies any problems or may fear being mentally ill. You can make the difference in and remove the Holiday Blues from seniors suffering from depression.

The Geriatric Mental Health Foundation offers a “Depression Tool Kit.” To read more about the tool kit and depression in the elderly go to http://www.gmhfonline.org/gmhf/consumer/depression_toolkit.html

To find a Senior Health Care Services in your area on the National Care Planning Council website go to http://www.longtermcarelink.net/a7seniorshealthservices.htm

The National Care Planning Council supports the work of geriatric practitioners and their services to the growing senior population. If you are a geriatric practitioner and would like to list your services with the NCPC please call 800-989-8137.