Alzheimer's Diagnosis Points to the Best Treatment

When an older person seems to be forgetting things frequently, how can a concerned spouse, child, relative or friend determine whether it's just mild forgetfulness or the onset of Alzheimer's disease or some other dementia?

In the experience of Lynne Gallagher of the Family Service Association of Toronto, one of the first signs is the senior making the same phone call over and over again, often to an adult child. At workshops for caregivers, Gallagher often hears versions of this exchange:

"What time are you picking me up?"

"At 2 p.m., Mother."

Ten minutes later: "Hello dear, what time are you picking me up?"

"Mom, what's the matter? I just told you. Two p.m."

"Oh, 2 p.m. Okay, dear."

Twenty minutes later: "What time?"

To the person on the receiving end of the phone call, the senior can come across as annoying or attention seeking. For people close to the senior, denial is a common reaction. Or spouses and children can be "terribly protective," says Gallagher, program co-ordinator for caregivers education services, at Toronto's Family Service Association. Family members might adopt ruses to disguise the loved one's loss of memory.

Another symptom of Alzheimer's disease, the best known and most serious of the dementias, is personality change.

"For families, it's a real struggle if a mother who was always sweet now wants control over everything and gets angry if she can't get it," Gallagher says.

At her workshops, she asks caregivers to document and track such changes. "I ask them, 'What were they like two or three years ago? And is this a change in behaviour?'"

If a senior is experiencing difficulty in learning, thinking or remembering or is showing changes in personality, it's essential to arrange for a medical evaluation.

A number of other reasons might be responsible for memory loss, including the effects of anesthesia, drug interactions or injury. It's important to identify the reason, and whether it's treatable or even reversible. An evaluation should also pinpoint the needs and resources of the affected person and the caregivers.

Gallagher recommends The 36-hour Day, a book by Nancy Mace and Peter Rabins published by Johns Hopkins University Press. It's a family guide to caring for persons with Alzheimer's, related illnesses and memory loss in later life.

Gallagher also points to these quick facts about Alzheimer's:

  • The loss of short-term memory is one of the first indicators, although long-term memory might persist for some time
  • Alzheimer's affects men and women equally and does not depend on personality or any social factors
  • With Alzheimer's, memory loss is permanent. The course might be slow or rapid, but progressive memory loss that is never restored is a major sign.

New medications can prolong the early to mid stages, but a downward slide is inevitable. If Alzheimer's is confirmed, one of the first tasks of the caregiver is to persuade the person to give up responsibilities now beyond him or her, such as driving a car.

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