A Test for Alzheimer’s

Earlier this year Ohio State University Medical Center released the Self-Administered Gerocognitive Examination (SAGE). This self administered test is meant to identify individuals with mild thinking and memory issues at an early stage. That’s really important because cognitive changes that are caught really early can be treated much earlier and generally have better treatment outcomes. This fifteen minute test can be taken at home and involves simple tasks like making change, listing items, making comparisons, and drawing geometric shapes. These activities test reasoning, problem solving skills and memory. When the Journal of Neuropsychiatry and Clinical Neurosciences released the study about the SAGE test, the demand for the test online was so huge it crashed the computer server at Ohio State University. That underscores the need for easily accessible and useful testing for cognitive issues like Alzheimer’s and other forms of dementia. Dr. Douglass Scharre, the neurologist who developed this simple test, claims it is just as accurate as other commonly used but lengthier and more complicated cognitive tests.

All this being said, you need to be aware that all the media hype surrounding this test is just that — hype. This test by itself can’t formally diagnose Alzheimer’s disease nor any other forms of dementia. At worst, you could interpret the results as a false positive and panic that you’re getting dementia. At best, it can identify some possible cognitive issues that may be developing. It could then serve as the needed push to have a frank conversation with your doctor. Taking the test can also provide a baseline for comparison with later testing. It can flag problems that can be monitored over time. Your family doctor remains the first and best source of information and evaluation of any cognitive issues that arise. How do you feel about taking a self-administered test for dementia? Share below and visit us at http://www.trilliumhomecare.com

Missing the Clues

As our parents or someone we care for age, we may start to notice some changes in their behavior. There are times when they just don’t seem like their old selves.  In the midst of conversation we sometimes have to fill in a word or name for them.  No problem…..after all, your memory fails as you get older.  Maybe we notice a stack of unopened mail or unpaid bills.  Once again, you can chalk it up to an aging memory.  And then there was the time Mom sent that telemarketer a ridiculous amount of money and got nothing for it.  In her defense, she is a very trusting person and he was a really smooth talker….how could you not help someone in need?  When you look at these incidents one at a time you can easily rationalize that they occur occasionally and at irregular intervals.  As these symptoms of dementia (we hate to admit that’s what they are) continue we will eventually have to stop ignoring them and take action.  At that point, lots of the past behaviors take on a different meaning.   Getting lost on the way to a grocery store our aging loved one has frequented for the last 20 years is not a part of getting older.  Neither is the seemingly gradual decline in personal hygiene or grooming.  We excused the extra bolts on doors and locks on garden gates we were asked to install as simple precautionary measures taken by a senior citizen living alone when in fact it may have been a sign of paranoia that often accompanies dementia.  Perhaps all those times Mom or Dad didn’t want to go to a family gathering or return a call from an old friend weren’t the result of just being tired.

The problem is that as all these events go on around us, we go on living our busy lives going to work and raising our families. These behaviors start slowly and it’s so easy to excuse them and deny that maybe something is wrong.   After all, no one wants to think their loved one has Alzheimer’s or some other form of dementia.  We want to believe it’s all just a part of getting old.  As caregivers, we have to let that mindset go.  We are doing our loved ones a disservice if we minimize their symptoms. We end up robbing them of an early diagnosis and the opportunity to actively participate in any decision making about their future lives.  In addition, an early diagnosis translates into early treatment that can slow the progression of this disease and keep your loved one at home longer.  It’s important not to miss the clues.   Visit us at http://www.trilliumhomecare.com

Am I Getting Alzheimer’s

As we get older, we may start to notice some “senior moments”.  So just which row did we park the car in while at the mall?  Who hasn’t forgotten at one time or another where they set their car keys?  Lets see….is today Wednesday or is it Thursday? Darn it….I forgot the electric bill was due yesterday!  As these moments occur, it’s natural to start wondering about Alzheimer’s and other forms of dementia.  Nowadays, there are a lot of web sites offering tests and quizzes to help us decide if we have a variety of illnesses including Alzheimer’s.  There are some that even allow us to submit a variety of symptoms and then obtain a list of possible causes or diseases.  Baby boomers are a much more computer literate group of people than their parents ever were and they increasingly turn to the internet for all kinds of information including medical advice.

That being said, there are a lot of reasons to catch the onset of Alzheimer’s early.  One of the most important reasons is to rule out other causes of memory loss such as a Vitamin B12 deficiency or thyroid problems.  Many of these causes are treatable if not reversible.  Knowing if you’re in the very early stages of Alzheimer’s allows you to start treatment earlier which is important because  medications for Alzheimer’s have been shown to be more effective the sooner they are begun.  An early diagnosis allows you to prepare for the inevitable effects of Alzheimer’s which is currently incurable.  You’ll have time to make medical and financial decisions and those who care about you will have time to develop a better understanding of how your behavior will change. This is an important consideration for literally millions of people.  According to the Alzheimer’s Association there are over 5 million Americans dealing with Alzheimer’s and this number is expected to balloon to over 7 million by 2025.

The thing to remember is that just because you lost something, or forgot a word or someone’s name, doesn’t mean you have or are getting Alzheimer’s.  There are age related changes to your memory that you will develop as you get older.  By all means DO NOT put your faith in any online quizzes or tests promising to give advance warning of oncoming dementia or Alzheimer’s!!!!  According to the National Core for Neuroethics at the University of British Columbia in Canada, these online tests are absolutely unreliable.  They rate “poor or very poor” for scientific validity.  If you have concerns about memory issues, go see your doctor. Trust his medical expertise to help sort symptoms out.  If he confirms your fears, you’ll get a head start on treatment.  If he tells you your suspicions are groundless, you can relax.  It’s a win-win course of action.   Have you ever taken one of those self-diagnostic tests?  Share below and visit us at http://www.trilliumhomecare.com 

 

The Silver Alert

You’d be hard pressed to find anyone these days who hasn’t heard of the “Amber Alert” which requires law enforcement to issue public bulletins to the media as soon as a child is reported missing.  If an adult is missing, the family has to wait 24 to 48 hours before they can even make a missing person’s report.  If you care for someone who has Alzheimer’s or some other type of dementia, you know the first 24 hours your loved one is missing can be the most critical.  There are almost 275,000 people in Michigan with some form of dementia and this number is expected to sky rocket as baby boomers age.  More than 60% of them will wander at some point.  This wandering will result in serious injury or death to almost half of them  within the first 24 hours they are missing.  Time is critical here and waiting 24 hours to report your loved one is missing will just stack the cards against their safe return.

 

Now there is hope.  In 2012, Governor Snyder signed the Mozelle Senior Or Vulnerable Adult Medical Alert Act into law.  It requires the police to take a report of a missing senior or disabled adult as soon as the department is notified. 

Before this law was enacted, the police were required to obtain documentation and signatures from appropriate people to verify that the missing person had dementia or was on life-sustaining medication.  This caused a delay in getting the name into the Law Enforcement Information Network system.  Now the word of the person reporting the missing senior is enough to get things rolling. The police are required to immediately forward all the information to all the law enforcement agencies that have jurisdiction in the area where the person disappeared.  This information also has to go to at least one media outlet in that same area.  With this new law  the search for a missing wanderer can begin well before that first 24 hour critical time period has passed.  For a caregiver faced with a missing wandering loved one, the odds for a safe return have just gone up.  Have you ever had to deal with a missing loved one?  Share below and visit us at http://www.trilliumhomecare.com

 

Managing the Wanderer

If you care for someone with Alzheimer’s or any other form of dementia, you have a 60% chance of having to deal with your loved one’s wandering behavior. Those are pretty high odds and especially frightening for a caregiver. Let’s face it, you can’t be with someone every minute of every day and wandering may be impossible to prevent in all cases. Take heart because there are practical steps you can take to minimize the dangers.

First and foremost, make sure the home environment is secure. Be certain there are secure locks on the windows and all the exterior doors. A keyed deadbolt lock that’s placed up high or down low on the door may be out of your loved one’s line of vision and less noticeable. Hanging bells on the door will alert you if someone is trying to get out. Disguising the door by painting it the same color as the wall may serve to camouflage it and deter the instinct to go through the doorway. Hanging a “STOP” sign on the door can help bring out the long ingrained response of actually stopping. If your loved one gets confused in their search for a specific room like the bathroom or bedroom, it may help to hang a picture on the door of what’s behind the door.

Try to keep any visual reminders of traveling out of sight. Don’t leave car keys, shoes, and jackets, purses, or anything that may remind your loved one of going somewhere, in plain view. Pressure sensitive alarm mats can be placed in front of doors to alert you if someone tries to leave. These are also great placed beside a bed to let you know if your loved one gets up at night. Baby monitors throughout the house can help you keep track of your loved one when you’re in a different room.

Although it does involve some expense, fencing your yard is a good idea. Make sure there are locks on the gates and any outside paths shouldn’t lead right to the gates. This may actually provide a safe place for your loved one to fulfill that need to wander. It’s also a good idea to let your neighbors know about the wandering. The extra eyes and ears will be priceless if your loved one gets out. Sewing your loved one’s name and phone number in some inconspicuous spot on their clothing will help identify them if they get lost and someone tries to guide them back. A combination of these measures will go a long way toward keeping your wanderer safe but if they do get away, call the police IMMEDIATELY. What measures have helped you keep your wandering loved one safe? Share below and visit us at http://www.trilliumhomecare.com

Stages of Alzheimer’s

Although each case of Alzheimer’s is unique, doctors and researchers have identified seven stages of the disease. Familiarity with these stages helps family members plan for the future.

Early Stage
Stage one: No impairment
Your loved one is fully functional with little sign of memory loss. At this stage a medical examiner could not diagnose Alzheimer’s.

Stage two: Very mild cognitive decline
You notice what seems to be just the normal aging process. There is some slight memory loss and confusion, especially with names and /or locations. The issues are not apparent to a medical examiner.

Stage 3: Mild cognitive decline
Your loved one begins to show signs of Alzheimer’s (see last weeks blog entry for the signs). Memory loss becomes more obvious to family members and friends. A medical examiner may be able to spot some deficiencies.

Stage 4: Moderate cognitive decline
At this stage symptoms become clear to a medical examiner. These symptoms can include forgetfulness of recent events or personal history, trouble with planning, and changes in behavior.

Mid Stage
Stage 5: Moderately severe cognitive decline
Gaps in memory become more noticeable and help with day-to-day living might be necessary, although your loved one is still able to feed him or herself and go to the bathroom on their own. Tasks like choosing what clothing would be appropriate for the weather or remembering a phone number become more difficult.

Stage 6: Severe cognitive decline
Memory continues to worsen and significant personal changes begin to occur. Your loved one’s ability to remember personal history begins to decline. Although your loved one may be able to distinguish between familiar and unfamiliar people they sometimes have problems with names of spouses or caregivers. They start to need help with simple day-to-day tasks like eating and using the restroom.

Late Stage
Stage 7: Very severe cognitive decline
In the final stage the body begins to shut down. There is a gradual loss of the ability to speak and eventually, the ability to control movement. Someone at this stage of decline needs a great deal of care.

Knowing the stages of Alzheimer’s can help you determine and prepare for what kind of care your loved one will need. If you need more resources you can visit the Alzheimer’s Association website at http://www.alz.org/apps/findus.asp, which will provide you with more information about symptoms and what kind care your loved one needs.

Caring for someone who has Alzheimer’s , at best, can be a very stressful time. If you need more information or assistance, feel free to call the Trillium office at 248-539-0714. Remember, we’re here to help.