Alzheimer’s: The Elephant in the Room and the Crystal Ball
Last week I met with a man who has been experiencing symptoms of memory loss for almost four years. I also met with his wife and daughter. They came to the Alzheimer’s Care Resource Center because “Ed’s” conditon appears to be getting worse.
We talked about dementia and about some of the challenges they were facing individually and as a family. Ed expressed his concern about his memory loss and his desire not be a burden. His wife cried and expressed her inability to cope with the changes in her life and her fear about the future. Their daughter cried because she’s afraid her mom is going to end up in the hospital and doesn’t understand why her dad’s memory is getting worse.
After some gentle probing I learned that Ed hasn’t seen a neurologist, and that they haven’t tried to determine the cause of Ed’s memory issues. And the more we spoke, the more it became apparent that we had a big elephant in the room – Alzheimer’s disease. Two of the most dreaded and frightening words to someone whose memory is fading and to the people they love.
Just thinking that you or someone you care about might have Alzheimer’s is scary. And saying the words out loud and speaking about it was something this family was clearly not comfortable doing. So we talked about the elephant in the room, and about memory loss and dementia. We talked about how they are coping right now and how many of their fears, thoughts, and decisions have been largely based on the unknown.
I shared with them that this is pretty common and that theoretically, they’ve been looking into a crystal ball and searching for answers with no real understanding of exactly what they might be dealing with.
We talked about the pros and cons of learning the real reason behind Ed’s memory loss and each of them shared how that knowledge might be useful to them individually and as a family.
And at the end of our time together, everyone said the words “Alzheimer’s disease” out loud. Although we hope that Ed’s memory loss stems from something else, this lovely family is moving forward with the understanding that sometimes knowledge is power, and elephants and crystal balls serve no real purpose – except when visiting the circus.
10 Warning Sign of Alzheimer’s Disease
As we get older our memory changes. But changes in memory that affect and disrupt our daily life are not typically part of the normal aging process.
When loss of memory begins to interfere with ones ability to get through the day, it may be a symptom of dementia. The most common form of dementia is Alzheimer’s disease, which is a fatal disorder that results in the loss of brain cells and brain function.
The following list, originally published by the Alzheimer’s Association, provides 10 warning signs of Alzheimer’s disease.
- Memory changes that disrupt daily life
- Challenges in planning or solving problems
- Difficulty completing familiar tasks
- 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 steps
- Decreased poor judgment
- Withdrawal from work or social activities
- Changes in mood and personality
National Memory Screening Day – Free Memory Screenings
Tuesday November 18th is National Memory Screening Day. If you are concerned about your memory, contact the Alzheimer’s Care Resource Center to schedule a free, confidential screening. Screenings can be done in their office or in your own home.
You can reach the Alzheimer’s Care Resource Center at 561-588-4545 or visit their website at www.alzheimerscareresourcecenter.org
How to Find Out If Your Loved One Has Alzheimer’s Disease
When caregivers call us to inquire about our programs and services, we spend some time talking about the patient’s diagnosis. So often we speak with caregivers who “think” their loved one has Alzheimer’s disease but can’t tell us how the diagnosis was made. It’s important to find out if your loved one has a probable Alzheimer’s diagnosis or if his or her symptoms stem from another type of dementia or neurocognitive disorder.
The first step in finding out if your loved one has Alzheimer’s disease is to be aware of the symptoms and to follow-up with your loved ones physician. This initial visit should be with the physician that your loved one is most comfortable with. It may or not be with a neurologist. There is no single doctor that specializes in diagnosing or treating memory disorders and many people feel more comfortable with the family doctor that they have seen for many years.
That being said, it’s important that should the family doctor recommend diagnostic procedures or refer you to a neurologist, that your loved one will be willing to go. We have found that most family physicians or primary care physicians (PCP) will refer the patient to a specialist. This could be a neurologist who specializes in diseases that affect the brain; a psychiatrist who specializes in disorders that affect mood and the way in which the mind works; or a psychologist who has special training in memory and other mental functions.
Because there is no single test that can definitively show that someone has Alzheimer’s disease, a full medical workup is performed to evaluate the persons overall health and to rule out other causes of memory loss and cognitive decline.
What Types of Dementia are Diagnosed Most Frequently?
Dementia is defined as a progressive state of mental deterioration characterized by memory problems or confusion. There are multiple causes of dementia, all leading to the destruction of brain cells. What are the Different Types of Dementia?
Dementia is defined as a progressive state of mental deterioration characterized by memory problems or confusion. There are multiple causes of dementia, all leading to the destruction of brain cells.
Here are some of the types of dementia we see diagnosed most frequently:
- Alzheimer’s Disease – The most common type of dementia, Alzheimer’s accounts for 60-80% of cases. Symptoms include difficulty remembering names or recent events, impaired judgement and disorientation, and confusion.
- Vascular Dementia – When the brain is subject to decreased blood flow, the cells are impaired. This is often a result of strokes that block crucial arteries.
- Dementia with Lewy Bodies – Lewy bodies (alphasynuclein deposits) form inside nerve cells in the brain, leading to hallucinations, tremors, and alertness issues.
- Normal Pressure Hydrocephalus – A buildup of fluid in the brain causes difficulty walking, memory loss, and incontinence. This form of dementia can be corrected by draining the excess fluid.
- Mild Cognitive Impairment - A form of dementia that is not severe enough to interfere with daily life. Some may recover and revert to normal cognitive functioning.
- Frontotemporal Dementia – Pick’s disease, for example, causes damage to brain cells in the front and side regions of the brain. This causes changes in personality and difficulty with language.
- Parkinson’s Disease – Often, Parkinson’s damage leads to dementia in later stages.
- Creutzfeldt-Jakob Disease – A rapidly fatal disorder, Variant Creutzfeldt-Jakob disease is a result of eating meat tainted with Mad Cow Disease. When the prion protein in the brain misfolds, coordination and memory are impaired.
I am often asked what some of the main characteristics are of someone who might need to be evaluated due to symptoms of Alzheimer’s disease. Here are some of the characteristics that might be worth a check-up:
- Memory problems, inability to remember names, people, or events in recent history
- Combativeness in conversations
- Loss of coordination, especially eye-had coordination; slowing reflexes; bumps and falls
- Confusion over days and time
- Unwarranted fears and suspicions
- Overreactions, emotional outbursts, uncharacteristic profanity, and loss of “filters”
- Hoarding, stealing, and possessiveness
- Urinary incontinence
- Unusual moodiness, boredom, or inability to follow a story
- Loss of appetite
Scientists also believe that one of the first areas of the brain affected by Alzheimer’s disease is the sense of smell. If your loved one has difficulty recognizing the aromas from roses, peppermint, leather, pineapple, natural gas, smoke or lemons, it may indicate a disruption in the brain’s hippocampus, the area where such memories are stored.
Some of the most helpful tips that I can pass long to anyone caring for someone with a cognitive impairment include:
- Don’t argue, but change the subject
- Don’t try to shame or lecture your loved one into doing what is best for them; distract and divert their attention
- Avoid using the word “remember”. Instead reminisce with your loved one, remind and reassure
- Physical touch is important
- Monitor medication
- Get rid of clutterl
- Simplify as much as possible
- Take care of yourself
There is a wide range in the estimated number of people with Alzheimer’s disease – between 2 million and 5 million people. That’s becausee scientists are discovering that some of the symptoms of the disease may occur earlier than previously thought.
In other words, the exact point at which Alzheimer’s may be said to be present in the body is becoming more and more difficult to determine.
Definitions of mild Alzheimer’s vary, and different doctors may use different criteria. Furthermore, diagnosis of Alzheimer’s disease is generally obtained by excluding all other conditions that might be causing signs and symptoms.
As a result of all these reasons, it often becomes a challenge to determine precisely who has Alzheimer’s and who doesn’t. Many scientists and professionals worldwide are working to come up with improved criteria for diagnosis.
You can learn more about Alzheimer’s disease here.