Questions re: Alzheimers

This is another excerpt from THE ALZHEIMERS ACTION PLAN, a new book “… combining the insights of a world-class physician and an award-winning social worker…

GETTING OTHERS TO UNDERSTAND

Explaining Alzheimer’s to friends and family, including to those who have Alzheimer’s, is never easy and always important.

30. “How do you get your friends to understand that just because you have Alzheimer’s, you’re not deaf and dumb?”
—A sixty-year-old woman with Alzheimer’s

It might surprise people who don’t have the disease, but this is a very common and devastating problem for people with early Alzheimer’s. Friends and family make wrong assumptions about your capabilities, which makes trying to adapt to Alzheimer’s even more difficult. Here are some pointers on what to say.Your friends will probably follow your husband’s or children’s example, so start with family first. Explain very directly that:

• although you repeat yourself because you can’t remember who has heard your stories, Alzheimer’s doesn’t make you deaf or dumb (speaking loudly, for example, is completely unnecessary)
• you still enjoy going out, say, to dinner, museums, shows, or shopping, but you do better in familiar places earlier in the day or with a companion
• you would appreciate rides to places and reminders about events
• hosting or coordinating activities has become too stressful, but you would enjoy helping with them
• you hope everyone can ignore your mistakes and laugh with you at the crazy things we all do, to varying degrees, as we age

For more advice, contact the Alzheimer’s Association about joining an early-stage Alzheimer’s support group, either online or in person, where you’ll get lots of tips (and sympathy) from other members. The association also has materials illustrating how to talk to and offer dignified help to people with Alzheimer’s.

31. “How can I explain to my five-year-old why his grandmother keeps calling him by his father’s name?”
—A thirty-three-year-old daughter-in-law

Answer his questions simply and matter-of-factly. Children often surprise adults with their acceptance of differences. Read more

The Palliative Bridge

The palliative care movement is the bridge from which research, findings, information and practical applications can flow back and forth between the 2 worlds (of acute care and hospice care) we have now. Palliative care is the vehicle to blend these worlds.

Moving hospice information up to the pre-hospice world of serious illness… Read more

Midwives and Doulas…for the Dying

Have you heard of this before?

Most of us understand the midwife and doula role in the birthing process. Along with being an emotional and spiritual support for the family, the midwife is a skilled, trained practitioner who attends the birth of a baby. The doula provides emotional, spiritual comfort and logistical assistance. Read more

Alzheimer’s Action Plan…1

A representative from St. Martin’s Press contacted me about this new book, The Alzheimer’s Action Plan. I’ll be bringing excerpts of what they sent me for awhile. I thought I’d start with the following.

APPENDIX A: STAGES OF SYMPTOM PROGRESSION IN
EARLY THROUGH MODERATE ALZHEIMER’S DISEASE

By Lisa Gwyther, M.S.W, ACSW

 

This isn’t a tool that doctors use for staging patients, but it should give family members an idea of what happens to people with Alzheimer’s as the disease progresses. Doctors use other tests for determining what stage the patient is in.

FIRST STAGE (MILD OR EARLY STAGE)—LASTS TWO TO FOUR YEARS LEADING UP TO AND AFTER DIAGNOSIS

Symptoms and Examples
• Recent memory loss—repeats stories and questions.
• Confusion about places—gets lost on way to work; arrives at wrong time or place.
• Loss of spontaneity—becomes withdrawn and uninterested.
• Mood / personality changes—becomes anxious about symptoms; avoids people.
• Poor judgment—makes bad decisions.
• Takes longer with routine chores—forgets grocery list; loses things; constantly rechecks calendar or clock.
• Trouble handling money and paying bills—forgets which bills are paid.

SECOND STAGE (MODERATE OR MIDDLE STAGE)—LASTS TWO TO TEN YEARS AFTER DIAGNOSIS

Symptoms and Examples
• Increasing memory loss and confusion, shorter attention span—can’t remember visits even though the visitor just left.
• Problems recognizing close friends and / or family.
• Repetitive movements.
• Restless, especially in late afternoon and at night—may get up at night and wander.
• Perceptual-motor problems—difficulty getting into a chair, setting table for a meal.
• Difficulty organizing thoughts or thinking logically—mixes up day and night.
• Can’t find right words—makes up stories to fill in memory blanks.
• Problems with reading, writing—can’t follow written signs.
• May be suspicious, irritable, fidgety, teary, or silly—may accuse children of stealing, spouse of infidelity.
• Loss of impulse control—curses, tactless, may undress at inappropriate times or in wrong place.
• Gains and then loses weight—forgets when last meal was eaten, may gradually lose interest in food.
• May see or hear things that are not there.
• Needs full-time supervision.

THIRD STAGE (LATE OR SEVERE STAGE)—LASTS ONE TO THREE YEARS

The third stage, which we don’t discuss in this book, is when the person’s abilities deteriorate significantly and nursing-home care may be required.

From The Alzheimer’s Action Plan by P. Murali Doraiswamy, M.D., and Lisa P. Gwyther, M.S.W., with Tina Adler. Copyright (c) 2008 by the authors and reprinted by permission of St. Martin’s Press.

Look at the Hand

I was working as a case manager with a local hospice when my grandmother was diagnosed with lung cancer. She was in her late 70s, had been smoking for 60 years and had dealt with severe bouts of chronic bronchitis most of her life. The day she entered Read more