What should you do if
loss of memory or confusion is evident, and dementia or Alzheimer's
is suspected in you, or a family member?
Know the 10 Warning
Signs of Alzheimer's Disease, as identified by the Alzheimer's Association,
so you avoid jumping to conclusions, or denying that there is a possibility
of Alzheimer's that should be professionally evaluated.
- Memory loss
- Difficulty performing familiar
tasks
- Problems with language
- Time and place disorientation
- Poor or decreased judgement
- Problems with abstract thinking
- Misplacing things
- Changes in mood or behavior
- Changes in personality
- Loss of initiative
Contact the local Alzheimer's
Association Chapter for guidance and help with diagnosis and Alzheimer's
support. Your Chapter can be found from National Alzheimer's Association on the internet
or at 1.800.271.3900.
The Alzheimer's Association
can help with:
- How to select a physician and
other professionals involved in diagnosis and treatment of Alzheimer's
or other dementia.
- Ideas for environmental adaptations
that can assist patients to function better in non-institutional
environments.
- The family's need to inquire about
long term care options early in the disease process.
- Ideas for types of respite care
options for caregivers.
- Information regarding caregiver
support groups in your area.
- Information regarding research
programs that might be available in your area.
- Information regarding different
types of Alzheimer's support groups.
- Ones in which patients talk
openly about having the disease and take a pro-active approach,
for as long as they are able.
- Those in which patients concentrate
on brain stimulus and hand/eye coordination activities, and
offer social interaction.
- Information regarding private
research groups in your area that may be working with Alzheimer's.
Progressive manifestations
of the disease
- Loss in short term memory.
- Wandering
- Episodes of agitation
- Depression
- Disorientation and confusion
- Incontinence
- Loss of weight
- Sleeplessness
- Forgetfullness regarding functions
of daily living
If you choose a home
care option:
- Can you make the environment secure
and safe?
- Can you hire services to come
into your home to help care for the patient and provide you with
respite?
- Nurses?
- Home health aides?
- Homemakers?
- Companions?
- Is there a senior adult day care
facility available?
- Are there opportunities for social
interaction, mental stimulation and recreation for the Alzheimer
patient?
- Can the caregiver get respite
care?
In considering placement
options the environment should:
- Be designed for dementia and Alzheimer's
patients.
- Encourage way finding through
patterns, colors and cues.
- Provide for safe wandering indoors
and outdoors.
- Provide furniture groupings encouraging
human interaction.
- Provide overall even lighting.
- Include areas of privacy for residents.
- Include identified and accessible
safe bathrooms.
- Private areas for families to
interact.
- Offer opportunities for nurturing
and comfort.
Components of a special
care unit to consider when shopping for a community:
- Is the facility dedicated to dementia
and Alzheimer's care?
- If not, do they have a separate
wing?
- Do they offer specialized Alzheimer
or other dementia care?
- Is the facility location convenient
for you, the caregiver?
- Is the environment calm and pleasurable?
- Is there secure outside space
for use by the residents?
- Is private space personalized
and respected?
- Does the mission statement include
benefits for your family member?
- What licenses does the facility
have?
- State licenses?
- Medicare certification?
- Medicaid certification?
- Private accreditation?
- Are other residents' functional
capabilities similar to your family member's?
- Is patient assessment done by
an interdisciplinary staff to determine individual needs?
- Will re-assessment be done at
regular intervals?
- Do you feel you can establish
a caregiver partnership with facility staff?
- Are residents' rights addressed?
- Is respect shown for resident's
dignity in physical psychosocial, spiritual and emotional areas?
- Does medical care and supervision
seem sufficient?
- Are behaviors accommodated without
the use of restraints?
- Are fees and charges competitive
with nearby comparable facilities?
- Will staff honor advance directives
such as Durable powers of attorney?
- Are nutrition and eating needs
of residents accommodated?
- Is there a full daily schedule
of therapeutic activities?
- Are residents active and engaged
in activities?
- Will diminished abilities and
disease progression result in transfer or discharge from the facility?
- Is late stage care and illness
addressed maximizing functional abilities?
- Are research opportunities explained?
Alzheimer’s, Dementia
& Driving
Driving represents independence,
competence and control. It's a means to buy necessities, be productive,
stay connected to family, friends and the community and to access
healthcare. Concerns about driving often surface during the early
stages of dementia when individuals are still independent and able
to manage daily activities.
Alzheimer's is not like
other "changes" in later life that affect driving, such as eyesight
problems and slow reaction times. Many older adults who don't have
dementia can assess their driving changes without family intervention
and do make gradual changes to the way they drive. Many are able to
continue driving safely throughout their life. With dementia, an individual's
capacity to assess his or her driving ability diminishes. They are
especially likely to minimize the complexity of driving and overestimate
their abilities. They may make excuses for their high-risk driving.
Those with Alzheimer's
Disease and other dementias experience gradual and somewhat unpredictable
progression in function loss. Cognitive functions critical to driving,
decline; such as judgment, reaction time and problem-solving abilities.
Other areas of decline are physical and sensory and they also increase
driving risks.
As driving and assessment
skills decline, the risk of serious loss or injury increases. Caregivers
must assume the responsibility for monitoring and regulating the driving
of the person with dementia. They need to realize that if there has
been a diagnosis of Alzheimer's or dementia, a victim of an accident
they cause will not stop their suit at the liability limit of the
auto insurance. If negligence or a prior knowledge of incompetence
can be found they can sue for all a person possesses. Auto insurance
will indicate you did not tell them of the medical diagnosis, and
you could be on your own to pay the claim.
Fortunately, in many
cases, people with dementia begin limiting where and when they drive.
The following signs indicate that a person with dementia is modifying
his or her driving behavior:
- Driving shorter distances.
- Driving on familiar roads.
- Avoiding difficult unprotected
left-hand turns.
- Avoiding driving at night, in
heavy traffic, on heavily traveled roads or during bad weather.
Resolving the driving
issue involves not only substituting other drivers or modes of transportation,
but also addressing the reasons people want to go places. Caregivers
can look for ways that others can help meet the physical needs of
the person with dementia, such as:
- Arrange to have prescription medicines,
groceries and meals delivered, reducing the need to go shopping.
- Have hairdressers make home visits.
- Schedule people to visit regularly,
either as volunteers or for pay.
- Arrange for friends to take the
person with mild dementia on errands or to social or religious
events.
While caregivers consider
ways to reduce the need to drive, it's also important to remember
the social benefits the person with dementia derives from interacting
with others. As one person reflected: "When I went to the bank or
drug store, I would stop at the local bakery for some pastries. Sometimes
it would take most of the morning because I could take my time and
chat with different friends along the way." If caregivers consider
the social needs that were met through driving, the transition to
not driving will be more successful.
When possible, include
the person with dementia in the planning process. People are better
able to respond to appeals to safety during the early stages of Alzheimer’s
Disease or other kinds of dementia.
Caregivers need to remember
that family members follow long-established patterns for making decisions.
It is unrealistic to think that patterns will change when handling
a difficult issue like driving safety. Caregivers can work to minimize
friction by listening to different opinions and appreciating what
each person can contribute, even if it differs from their point of
view. Disagreements in families often result when individuals do not
have the same opportunities to assess driving abilities. Having factual
information about driving behavior does not guarantee families will
reach consensus on when to limit driving. However, frequent, open
communication about specific, observed behaviors and concerns may
help to lessen differences. Everyone involved in caring for the person
with dementia can help by focusing on the key issues; the self-respect
of the person with dementia and the safety of everyone on the road.
Information on driving
and Alzheimer's was Printed with permission from The Hartford, Hartford,
CT 06115. Find out more from them through our state
resources.
Alzheimer's
Clinical Trials a free, easy-to-use clinical studies matching service that connects individuals with Alzheimer’s, caregivers, healthy volunteers and physicians with current studies.
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Additional information
resources
The Alzheimer's Research Foundation since 1988, an independent
group of professionals that volunteer to help Alzheimer's patients
and caregivers. Feel free to ask them about caregiver problems,
alternative medications (herbals, vitamins) and offer your suggestions
for others. They prefer to focus on problems and solutions for care
of patients in the home.
CareScout
provides ratings of Alzheimer's Communities throughout the USA.
For a report fee, and registration you can check a rating for
a community you are considering for a loved one.
BrightFocus Foundation funds research seeking cures
for Alzheimer’s disease, age-related macular degeneration
and glaucoma, and provides the public with information about risk factors, preventative lifestyles, available
treatments and coping strategies.
