Future Directions In Diagnosis Research
Considerable research effort is being put into the development of better tools for accurate and early diagnosis. Research continues to provide new insights that in the future may promote early detection and improved diagnosis of dementia, including:
- Better dementia assessment tests that are suitable for people from diverse educational, social, linguistic and cultural backgrounds.
- New computerised cognitive assessment tests which can improve the delivery of the test and simplify responses.
- Improved screening tools to allow dementia to be more effectively identified and diagnosed by GPs.
- The development of blood and spinal fluid tests to measure Alzheimers related protein levels and determine the risk of Alzheimers disease.
- The use of sophisticated brain imaging techniques and newly developed dyes to directly view abnormal Alzheimers protein deposits in the brain, yielding specific tests for Alzheimers disease.
How Can I Support Someone As Their Dementia Progresses
In the later-stages of dementia the person may become increasingly dependent on others for their care.
They may have severe memory loss at this stage and fail to recognise those close to them. They may lose weight , lose their ability to walk, become incontinent, and behave in unusual ways.
Not everyone will show all these signs, and some people may show them earlier on in the illness.
Alzheimers Behaviors To Track
For each of these behaviors, try to make note of the following:
- Whether theres been a decline or change compared to the way your parent used to be
- Whether this seems to be due to memory and thinking, versus physical limitations such as pain, shortness of breath or physical disabilities
- When you or another person first noticed problems, and what you observed
- What kinds of problems you see your parent having now
If you dont notice a problem in any of the following eight areas, make a note of this. That way youll know you didnt just forget to consider that behavior.
Have you noticed:
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Take The Sage Test At Home
Anyone can take the SAGE test anytime. Its free and you can get it here on the Ohio State University website.
Print the test and take it with a pen or pencil. Theres no time limit, but most people finish in about 15 minutes.
Sample questions from the test:
- How many nickels are in 60 cents?
- You are buying $13.45 of groceries. How much change would you receive back from a $20 bill?
- Write down the names of 12 different animals.
- Draw a large face of a clock and place in the numbers.Position the hands for 10 minutes after 11 oclock. On your clock, label L for the long hand and S for the short hand.
What To Expect When You See A Gp About Dementia
A GP will ask about your symptoms and other aspects of your health.
They’ll also ask if you’re finding it difficult to manage everyday activities such as:
- washing and dressing
- cooking and shopping
- paying bills
If possible, someone who knows you well should be with you at your GP appointment, so they can describe any changes or problems they’ve noticed. They could also help you remember what was said at the appointment, if this is difficult for you.
Memory problems do not necessarily mean you have dementia. These problems can have other causes, such as:
- an underactive thyroid
- side effects of some medicines
To help rule out other causes of memory problems, the GP will do a physical examination and may organise tests, such as a blood test and urine test.
You’ll also be asked to do a memory or cognitive test to check any problems with your memory or ability to think clearly.
Read more about the tests used to diagnose dementia.
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Treatment Options For Dementia
Prescription medications to specifically treat some symptoms of progressive dementias are now available. Although these drugs do not halt the disease or reverse existing brain damage, they can minimize the worsening of symptoms temporarily. This may improve an individuals quality of life, ease the burden on caregivers and delay admission to a nursing home. However, each dementia patient is different, and these drugs are not effective for everyone.
Many people with dementia, particularly those in the early stages, benefit from adhering to a clear daily routine and practicing tasks designed to improve performance in specific aspects of cognitive functioning. For example, using memory aids, such as mnemonics, computerized recall devices or note taking can help seniors maintain their day-to-day lives independently for longer.
What A Doctor May Check And Ask
Most people with suspected dementia will go to a doctors surgery to see their GP. Some doctors, however, will prefer to make a home visit to observe and assess someones behaviour in their own environment. A GP will check a persons blood pressure, temperature and pulse, listen to their heart and lungs and collect blood and urine samples for further tests to be carried out. The doctor will ask what potential signs of dementia have been noticed and when they began, how often they occur and whether they are getting worse.
The GP may ask a series of questions designed to test the persons memory and reasoning skills. The doctor is also likely to carry out a detailed review of any medication taken and ask about personal and family medical history, diet, smoking, intake of alcohol and exercise. The doctor will welcome notes perhaps kept by the patient, a partner, close family member or a care worker that outline when any symptoms or changes first happened. The GP may feel able to make a diagnosis at the conclusion of the assessment or may refer the person to a memory clinic or specialist.
Cultural diversity is an important consideration in the assessment process. Dementia assessments need to be culturally appropriate and recognise the impact of culture on individual behaviour. An interpreter may be vital for a proper assessment.
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A Correct Diagnosis Is Important
Consulting a doctor to obtain a diagnosis is critical at an early stage.
A complete medical and psychological assessment may identify a treatable condition and ensure that it is treated correctly, or confirm the presence of dementia and then ensure assistance is provided.
Such an assessment might include the following:
Review These 10 Warning Signs Of Alzheimers
Note especially if the changes youre seeing are more sudden, which may indicate a delirium or other physical problem that may be reversed with treatment. Its critical that a physician evaluate your loved one as soon as possible in this situation.
If the symptoms have been developing more gradually over time, it is more likely that theyre related to dementia, such as Alzheimers disease.
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What Are The Signs And Symptoms Of Dementia
Signs and symptoms of dementia result when once-healthy neurons, or nerve cells, in the brain stop working, lose connections with other brain cells, and die. While everyone loses some neurons as they age, people with dementia experience far greater loss.
The symptoms of dementia can vary and may include:
- Experiencing memory loss, poor judgment, and confusion
- Difficulty speaking, understanding and expressing thoughts, or reading and writing
- Wandering and getting lost in a familiar neighborhood
- Trouble handling money responsibly and paying bills
- Repeating questions
- Not caring about other peoples feelings
- Losing balance and problems with movement
People with intellectual and developmental disabilities can also develop dementia as they age, and recognizing their symptoms can be particularly difficult. Its important to consider a persons current abilities and to monitor for changes over time that could signal dementia.
How Dementia Is Diagnosed
There is no single test for dementia, and it can be difficult to diagnose the specific type of dementia that a person has. If you want to find out if your parent has dementia or, specifically, Alzheimerâs disease, the first step is to schedule an appointment with your parentâs family care provider.
The primary care provider can do a screening that can help rule out whether your parentâs memory issues are being caused by any treatable conditions. Then, the doctor can refer your parent to a neurologist, neuropsychologist, geriatrician or geriatric psychiatrist for additional screening and tests. Snow suggests talking to the providers your parentâs doctor recommends as well as other providers in the same field to find the best fit for your parent. The Alzheimerâs Association has a guide to choosing a doctor to evaluate memory problems.
If the process is rushed and the provider misdiagnosis your parent, you might not be able to persuade your parent to be tested again. âYouâll get one shot at this,â Snow says. âDonât blow it.â
You want someone who is willing to do a thorough assessment and has experience diagnosing a variety of dementia-related diseases. A thorough exam typically will involve the following:
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Denial May Reflect That The Person Is Feeling Fearful And Needs Time To Accept What Is Happening
It is possible that they have some awareness of their cognition issues and may be feeling uneasy or anxious about this. They may also be fearful about the future.
They may feel or think that other people may feel a stigma about having a diagnosis of dementia.
Here are some ideas to consider when talking to someone about your worries.
- Broach the topic gently. It may help to remind them that memory issues dont always point towards dementia.
- Be kind and supportive during the conversation. Listen to their reasons and any fears they raise.
- Let them know that youre worried about them. Give examples of issues e.g. missing appointments, misplacing items, forgetting names.
- Break down the larger issue into smaller ones. Pick one to focus on e.g. Ive noticed youve been forgetting names of friends. Maybe the GP will be able to help.
- Keep a diary of events as proof. This will help you show someone youre worried about that you have evidence for your worries. The diary will also support you both if you see a doctor as they may want to see a record of issues.
- Turn the focus towards getting support for their friends and family e.g. If you visit the GP, we might be able to get extra help that would give me a break…
If their denial of the issue continues, this may further delay receiving an official diagnosis.
Persuade Him To Go To The Doctor
Your loved one needs an assessment by a physician. Sometimes, other reversible conditions might be causing problems with cognition, such as normal pressure hydrocephalus or vitamin B12 deficiency. Thyroid problems or medication interactions can also affect memory and judgment. An evaluation and diagnosis are important so that proper treatment can be provided.
You may find that your loved one is resisting going to the doctor. If this is the case, you can explain that it’s time for an annual check-up.
If you’re not able to get your husband to agree to go the doctor, you could talk to your physician’s office ahead of time about your concerns and ask them to call your family member to schedule a doctor’s visit. Also, in some families, there’s one person who seems to be able to be more persuasive than the others if so, don’t hesitate to ask that person for assistance so that your loved one can get the assessment and care that he needs.
There are also visiting physicians in some communities who will perform house calls to evaluate and treat their patients.
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Dementia Care Tips From Experienced Caregivers
Caring for someone with dementia isnt intuitive and doesnt come naturally. Theres a lot to learn, but you dont have to figure everything out the hard way.
In a helpful article at Verywell, social worker Esther Heerema shares 12 dementia care tips that caregivers have learned and wished theyd known sooner.
This advice isnt meant to add pressure or expectations to your already tough job. Theyre tips from caregivers who have been there and done that that can lighten your load, reduce stress, and help you cope with the challenges.
Here, we share highlights from Esthers article along with some of our own insights.
1. Its not worth it to argue with someone who has dementiaAlzheimers and dementia causes your older adults brain to malfunction. When they say things that dont make sense or are clearly untrue, they believe what theyre saying because its what their brain is telling them.
Its frustrating to hear things that arent true and instinctive to try to correct or remind. But that will only lead to both of you arguing or getting upset. And you simply cant win an argument with someone who can no longer use reason or logic consistently.
2. Ignoring symptoms wont make them go awayWhen you notice your older adult struggling with memory, thinking, or judgement, its scary to think that they might have dementia. Because it can be so hard to accept, many people hope that the symptoms will go away on their own or that theyre mistaken.
Dealing With A Parent Who Denies Dementia Symptoms
Is Dad or Mom having difficulty remembering appointments or names? Or getting lost coming home from the grocery store? You may notice it is becoming more difficult to have a conversation as your parent becomes confused and cant find the words to finish a sentence.
The signs of dementia are obvious to you, but when you mention the possibility to your parent, they deny the dementia symptoms and refuse to get help. What can you do?
Its important to understand the two main reasons why a parent would deny dementia symptoms:
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If You Are Diagnosed With Dementia
Obtaining an early and accurate diagnosis can improve the quality of life for people with dementia.
Talk to your doctor about treatment and ongoing assessment.
Support and information is available through the National Dementia Helpline on 1800 100 500.
Thanks to Associate Professor David Ames for reviewing this material.
How To Convince Someone With Dementia They Need Help
Many people say that one of the biggest worries about growing older is the fear of losing their memory.
And yet for many people when this does start to happen they have no awareness of it. Its their family and friends who notice it most and inevitably have to pick up the pieces.
Trying to get someone with early dementia to recognise they need help is not easy, and the subject demands far more attention than in a single article like this. However, weve outlined a real case study here , and weve pulled together some tips and advice from the family concerned.
You may find this advice helpful if youre in a similar situation with a relative or friend with dementia
However, she was forgetting conversations, her house was deteriorating, she was losing touch with the realities of day-to-day life, she would open her post but not deal with it, junk mail was accumulating in every available space in the house, and bills and important items of mail were getting lost in all the piles of paper.
Not only was this a fire hazard, especially in the kitchen, but it soon became clear from the final demands lying around under all the paper that Alice was not paying her bills. Having her phone cut off and receiving a demand from the power company to enter her property were the final straw.
Here are some of the familys ideas about getting a relative with dementia to recognise their need for help:
If a Power of Attorney is already in place
Please share your thoughts and comments.
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Who Else May A Person With Dementia See
A person with suspected dementia may come into contact with a range of health and social care professionals. Consultants usually operate within specialist teams, including nurses, psychologists, occupational therapists and social workers. Nurses who work with people with dementia, and those caring for them, include: community mental health nurses , who work in the community, providing treatment, care and support for people with mental health problems and dementia district or community nurses, who provide care and advice for people living at home and practice nurses, who work with doctors in GP practices.
Clinical psychologists, who often work with consultants in memory clinics, assess memory and learning abilities. Occupational therapists can advise people on ways of maintaining their independence including carrying out adaptations and using special equipment. Social workers may be involved in assessing someones need for care services and home care workers may be brought in to help with personal and other care. Physiotherapists may be asked to advise on exercise for people, particularly in the early stages of dementia. Dieticians may be asked to provide guidance on nutrition, poor appetite, weight loss or weight gain.
Who Is This Dementia Quiz For
Below is a list of 10 questions designed for people who are concerned about memory loss. The questions relate to life experiences common among people who have been diagnosed with dementia, a neurocognitive disorder, and are based on criteria in the DSM-5 .
Please read each question carefully, and indicate how often you have experienced the same or similar challenges in the past few months.
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