What caregivers and family members need to know
Alzheimer’s disease is a brain disorder that progressively destroys memory and thinking skills, resulting in a loss of the ability to hold a conversation and respond to people and the environment. The main known risk factor is age, with the majority of people with Alzheimer’s disease being in their 60s and older.
Alzheimer’s disease, the most common cause of dementia, is the seventh leading cause of death in the United States. June is Alzheimer’s and Brain Awareness Month.
“According to the Alzheimer’s Association, one in nine people age 65 and older has Alzheimer’s disease,” says Jonathan Fialkow, MD, head of population health for Baptist Health and chief cardiology officer. at the Miami Cardiac & Vascular Institute. “The older we get, the greater our chances of developing Alzheimer’s disease, which is why we all need to be informed and aware of this life-changing disease.”
Dr. Fialkow hosted a roundtable on Facebook LIVE: Alzheimer’s: What Caregivers Need to Know. His guests: Keith Gibson, director of diversity, equity and inclusion, Alzheimer’s Association; Gillian Generoso, MD, internal medicine physician at Baptist Health Primary Care; and Khalid A. Hanafy, MD, medical director of neurocritical care and research at the Marcus Neuroscience Institute at Boca Raton Regional Hospital.
Mr Gibson gave a personal account of his experience with his brother Ronnie, who died aged 54 of vascular dementia. He explains how getting a diagnosis was a challenge after his brother suffered a massive heart attack and stroke at the same time. During his brother’s ongoing recovery, Mr. Gibson recalls the obstacles to a diagnosis of vascular dementia, a condition involving impaired thinking skills caused by reduced blood flow to various regions of the brain.
“I knew my brother had changed,” Mr. Gibson said. “There was a difference in him. And I was talking to the attending physicians and I said, “We need to do a full workup on my brother.” And they looked at me like I had… two pairs of heads on my shoulders. So it was a bit difficult for them to get referrals for the neurologist and a neuropsychologist so that we could come up with the probable diagnosis of vascular dementia. I can tell you that at first I was not the best caregiver because I thought that once I got the diagnosis I could plan his care. But that was not the case. It was a bit of a challenge. I had to make some adjustments in how I was going to approach her care.
Here are Q&A excerpts from the Facebook LIVE episode. (You can watch the full segment here).
Dr Fialkow: What is Alzheimer’s disease… and what are the most common causes of Alzheimer’s disease?
“There are issues with memory thinking and how you perform activities of daily living. However, if you forget where your keys are, that’s okay. And that’s part of what we probably all do several times a day. But if you forget your keys and they’re in the freezer, that’s a problem because it means you actually put your keys in the freezer and thought that was a normal place for them. Confusion about the day of the week or the time of day…that sort of thing is okay. And because everyone has a watch or a phone, it’s very easy to get external reinforcement about these things. But if you don’t know what month we are, what season we are, then that’s trouble. »
Dr Fialkow: As a general practitioner, do you think you will recognize the early signs of Alzheimer’s disease in patients? Or, more often, do people come and tell you I feel X, Y, and Z, and then you get Alzheimer’s?
“Most often I see family members pointing out the changes they have seen in their loved one. And one of the first things they will notice is their difficulty forming new memories, recent memories, or problems with name recall. These are patients who have known such and such their whole life — and all of a sudden — they can no longer name them. So it changes like that. And then other times there’s also a personality change, just some subtle changes in personality or mood, and also judgment. So, for example, you can leave the stove on. Changes like that. The first step towards evaluation is to see the treating physician. And then usually the office will do a cognitive test, just a little short cognitive test, and then maybe do some lab work. This is the first step.
Dr Fialkow: For a caregiver, family member, loved one of someone who has recently been diagnosed with Alzheimer’s disease, is there any specific advice you could give them, as they learn about this new reality of being involved and caring for someone with Alzheimer’s disease?
“There are two tips that I highly recommend. One is to be open to being an agent of change, to be willing to change because your loved one has changed. Second, be a good manager. And, when I say manager — manage his emotions so he can manage the care of his loved one. Also, be aware that you will become a student of disease. And it’s really up to you what kind of student you will become. You can be a good student or a bad student. The key to being a good student is that you are willing to change. You are ready to learn as much as you can because it will help equip you as a helper to be a better manager of not only caring, but also managing your emotions and also reaching out to organizations like…the Alzheimer’s disease. Association. We have a wonderful resource, which is our 1-800 number, 1-800-272-3900, which is staffed by master level clinicians 24 hours a day.”