THE FAITHFUL CAREGIVER

Vol. 12 – May 2006

Linda Schoenmann

     As the years go by and we have more things on our mind, it’s normal to forget.  But when the forgetting is not normal, that’s a warning sign. 

     For example, it’s normal to go to Dick’s Supermarket and forget to get something you need.  It’s not normal if you go to get groceries, come

    home empty-handed, and tell your spouse that Dick’s store is no longer there.  The difference in the forgetting is pretty obvious.

     If you have a loved one with warning signs - and the chances are good that some time you will - pretending it does not exist will not make

     it go away! If you thought your loved one might have cancer or heart disease, would you ignore it and not get treatment for them?  Of

     course not!  We need to do the same for Alzheimer’s.  There are some treatable or reversible causes of memory loss so that’s another reason

     to see a doctor in case your loved one does not have Alzheimer’s.

     This disease develops for many years before it really becomes a problem in daily living.  You don’t just wake up one day with Alzheimer’s.  So

     it’s really hard to recognize.  Since a diagnosis can be very upsetting to families, and there is no cure, some people feel there is no point in

     telling the doctor.  And doctors don’t routinely screen for Alzheimer’s like they do for high blood pressure or high cholesterol. If you’re suspicious

     but you’re not sure your loved one should see a doctor, there are a few simple tests you could do at home and track the results over time to

     see if they change.

     The Clock Face Test:  Have your loved one draw a clock with the hands showing the time as 11:10.  People with memory problems have a

     hard time doing this. 

     The Mini Mental Status Exam (MMSE):  This has been the “gold standard” for cognitive testing for several years.  It’s a 30-point questionnaire

     where the patient is asked what day it is, where are we, who is the President, count back from 100 by 7s, etc.  But it is not very accurate.

     Animal Naming:  This is a new test which is pretty simple and pretty accurate.  The tester asks the patient to “Tell me the names of as many

     animals as you can think of as quickly as possible in 1 minute.”  Time for 60 seconds and record all responses.  If the patient stops before 60

     seconds, say “Any more animals?”  If the person says nothing for 15 seconds, say “A dog is an animal.  Can you tell me more?”  Count the

     total number of animals, excluding repeats and non-animals.  A normal score is around 11 or above.

     Get a doctor who is knowledgeable about this complex disease.  He’s going to be your medical partner for a long time so make sure it’s

    someone you’re comfortable with.  Be sure your family writes down specific examples and goes with your loved one to the doctor.  Your loved

    one will probably deny the problems and will appear perfectly normal to the doctor! Most doctors today are about 90% accurate in their

    diagnosis.  You will likely be given a diagnosis of “probable dementia”.  If you’re not convinced, get a second opinion.  Or go to a diagnostic

    center that specializes in cognitive testing.  There you may be able to pinpoint exactly which type of dementia your loved one has, such as

    Lewy Bodies, Pick’s, Vascular, etc. which may have different symptoms and different treatments.  We’re fortunate in Wisconsin that we have

    more diagnostic test sites than any other state!  

    We’re also fortunate to be living during this time in history.  About 90% of what we know about Alzheimer’s we learned in the last 10-15 years.

    Early treatment can help.  It is early in the disease process when most drug therapies do the most good.  Medications do not cure, are not

    effective for everyone, plus they’re expensive - but they’re cheaper than nursing homes.  Plus they can make it easier for patients and caregivers.   

    Even if the diagnosis is Alzheimer’s disease, knowing is better than not knowing.  Many people are undiagnosed and therefore not getting the help

    they need and deserve!  I remember when we got my husband Bob’s diagnosis, I felt relief.  At least I knew he wasn’t crazy, and I wasn’t crazy,

    either (although I was convinced he was doing things on purpose for just that reason!).  His primary care coordinator was a Nurse Practitioner at

   the VA Hospital, Mary Ann Reale.  She was great!  She gave Bob a prescription for Aricept.  And she gave me a prescription for a support group. 

   That was one of the best things she did for both of us!