Alzheimer's disease (AD) is a progressive, degenerative disease
that attacks the brain and results in impaired memory, thinking and behavior.
Symptoms of Alzheimer's disease can include:
A gradual memory loss
Decline in ability to perform
Disorientation to time and space
Impairment of judgment
Difficulty in learning
Loss of language and communication skills
Changes in personality including inappropriate behavior, loss of
interest, and changes in mood
Hallucinations and delusions/false beliefs
How does your physician know if it is Alzheimer's disease?
There is no single test that can diagnose Alzheimer's disease. However,
trained physicians are 80%-90% accurate. Your physician needs to do a full
assessment that includes:
An accurate medical and psychiatric history
A neurological/physical exam
Lab tests to rule out anemia, vitamin deficiencies, and conditions
An evaluation of the person's ability to do common daily activities such
as managing finances and medications
A mental status exam to evaluate the person's thinking and memory
A caregiver interview
Your physician may also request a brain scan, psychological testing, and
additional lab work if he/she needs additional information.
How can you help your physician?
You can be prepared for the appointment by bringing a list of medications, a
log of symptoms or behavior changes and a list of questions or concerns. It is
also helpful to provide an accurate history of the person's medical conditions
and any previous psychiatric treatment.
What can your physician do if the diagnosis is
Alzheimer's disease?
Although there is no cure for Alzheimer's disease, there are ways to treat
some of the symptoms of the disease. Your physician may suggest:
Use of medications to treat cognitive decline and memory loss
Referral to appropriate activities such as exercise, recreation and
adult day care services
Appropriate treatment of medical or psychological conditions that may
contribute or cognitive changes to decline
What can be done for behavioral problems?
At times, a person with a dementing illness may display behavior problems
such as wandering, paranoia, suspiciousness, combativeness or resistance to
maintaining personal hygiene. These behavioral problems can seem overwhelming to
the caregiver. The physician may suggest various strategies to assist in daily
caregiving tasks, such as:
Enrollment in the Alzheimer's Association's Safe Return Program, an
identification program for memory-impaired adults
Modifying the person's environment in order to reduce confusion caused
by over-stimulation, such as reducing noise and glare from windows
Explaining a task before you do it, such as saying, "I am going to help
you put on your shirt".
Providing a predictable routine at home with structured times for meals,
bathing, exercise, and bedtime
Providing reassurance to the confused patient without challenging their
accusations or misperceptions and by reading their attention
How can the physician help you plan for the
future?
The physician may suggest you start planning for health care needs now by
completing an advance directive. An advance directive is a legal document that a
patient signs while capable of making sound decisions. It directs how healthcare
treatment will be made in the event of future incapacity. There are two
parts of California Advance Healthcare Directives:
The Durable power of Attorney for Health Care designates an individual who
can make health care decisions on behalf of the impaired person if he or she
is not able to give medical consent.
The Health Care Instruction conveys a person's desires
regarding end of life care and, if requested, an instruction that the person
not be kept alive by artificial means. (This document is similar
to a "living will," which is not legally binding).
All hospitals and health facilities should have advanced directives for
patients to complete. The California Medical Association also has Advance
Directive forms.
A person who may lose capacity should also consider legal and financial
planning including wills, living trusts, and powers of attorney for finances.
Consult an estate planning or Elder Law attorney for assistance.
How can your physician support you?
Often persons with AD and their families have questions regarding the
disease, legal and financial planning, community resources (i.e. home care,
adult day care, respite services) and available support. The physician may refer
you to organizations such as:
If it seems that suggested strategies aren't helpful in managing the person's
behavior, the physician may want to use medications to manage symptoms of
depression, restlessness, hallucinations, hostility and agitation. Be prepared
to provide the physician with accurate information regarding the behavior
problem such as the onset of the behavior, the frequency of the behavior, the
time of day the behavior occurs, and the strategies you have tried.
Prepared by Elizabeth Heck, LCSW
Alzheimer's Association, Los Angeles Chapter
Alzheimer's Disease
Program
Mail Station 7210
Post Office Box 997413
Sacramento, CA 95899-7413
Phone (916) 552-8995
Fax (916) 552-9910
Internet: www.dhs.ca.gov/Alzheimers/
