How To Choose The Best Healthcare Team
Your primary care physician can help you assemble your healthcare team and refer you to specialists for further evaluation and treatment as needed.
There are many primary care doctors who are comfortable with treating dementia, says Graff-Radford, This is especially true if they see a lot of older patients who have been diagnosed with Alzheimers.
What Is The Clock Test For Dementia
The clock test is a non-verbal screening tool that may be used as part of the assessment for dementia, Alzheimers, and other neurological problems. The clock test screens for cognitive impairment. The individual being screened is asked to draw a clock with the hour and minute hands pointing to a specific time. Research has shown that six potential errors in the clock testthe wrong time, no hands, missing numbers, number substitutions, repetition, and refusalcould be indicative of dementia.
Are Diagnostic Tests Insured
Some insurance and managed care plans will cover the costs of a diagnostic assessment for Alzheimers disease. Check with your health plans administrator to understand the policies and procedures.
Medicare, the governments health-insurance program for people 65 and up, and Medicaid, the joint federal-state medical-assistance program for people with limited income or assets, typically reimburse doctors for a diagnostic assessment and certain medical tests needed to determine if a patient has Alzheimers disease provided your doctor accepts these plans as payment. Talk to your doctor or doctors staff about what is covered.
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How Can You Help A Loved One Who Has Dementia
There are many things you can do to help your loved one be safe at home. For example, get rid of throw rugs, and put handrails in washrooms to help prevent falls. Post reminder notes around the house. Put a list of important phone numbers by the telephone. You also can help your loved one stay active. Play cards or board games, and take walks.
Work with your loved one to make decisions about the future before dementia gets worse. Encourage your loved one to make an advance care plan that states how he or she wants to be treated when the dementia gets worse. And have your loved one name a person who will make care decisions if he or she is no longer able to make them .
Watching a loved one slip away can be sad and scary. Caring for someone with dementia can leave you feeling drained. Be sure to take care of yourself and to give yourself breaks. Ask family members to share the load, or get other help.
Your loved one will need more and more care as dementia gets worse. In time, he or she may need help to eat, get dressed, or use the washroom. You may be able to give this care at home, or you may want to think about using a nursing home. A nursing home can give this kind of care 24 hours a day. The time may come when a nursing home is the best choice.
You are not alone. Many people have loved ones with dementia. Ask your doctor about local support groups, or search the Internet for online support groups, such as the Alzheimer Society of Canada. Help is available.
Why Call The Doctor
Patients of Dementia are often confused by simple things. Consequently, theyre not very good at realizing when they might need help. So it falls on you, the caregiver, to realize when a Dementia patient might need medical assistance. This is why, in addition to properly socializing with a Dementia patient under your care, it is also important to keep an eye on their general health and wellbeing.
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What Are Memory Clinics And Centers
Memory centers are essentially a one-stop shop for everything a patient and their family may need living day to day with Alzheimers disease. These clinics offer a multidisciplinary, comprehensive approach to care.
At these clinics youll find a number of specialists, including behavioral neurologists, neuropsychologists, and geriatricians. These centers provide comprehensive diagnostic and treatment services for Alzheimers disease and other types of dementia. These centers also offer access to physical and occupational therapists and social services.
Your primary care doctor may be able to refer you to a memory clinic in your area. Many large hospitals and medical centers have memory disorder divisions.
You might also find helpful information through the Alzheimers and Related Dementias Education and Referral Center , a service of the National Institute on Aging , which funds Alzheimers Disease Research Centers at major medical institutions across the United States. The ADRCs offer help with obtaining diagnosis and opportunities to volunteer to participate in clinical trials in addition to other services. You can find a list of ADRCs on the NIA website.
Tips For Managing Dementia End
Because individuals with advanced dementia will often have difficulty communicating, it is important that caregivers keep a close eye on their loved one for signs of pain or discomfort. These signs may include moaning or yelling, restlessness or an inability to sleep, grimacing, or sweating. This may also signal that its time to call hospice or a palliative care team to help with the pain management.
If an individual with end-stage dementia is having trouble sitting up without assistance, hospice can provide a hospital bed or other equipment to lift their head.
Perhaps the hardest thing for families is when a loved one with dementia is no longer able to eat or swallow. Because an individual with dementia is unable to understand the benefits of feeding tubes or IV drips, they will often be incredibly distressed and attempt to remove them, causing added pain and risk of infection. Instead, focusing on keeping the individual comfortable. Supporting them with mouth care to prevent their mouth from becoming dry will allow them to make their final transition in peace.
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Planning For The Future
If possible, make decisions while your loved one is able to take part in the decision making. These are difficult but important conversations. Questions include:
- What kind of care does he or she need right now?
- Who will take care of him or her in the future?
- What can the family expect as the disease progresses?
- What kind of financial and legal planning needs to be done?
Education of the family and other caregivers is critical to successfully caring for someone who has dementia. If you are or will be a caregiver, start learning what you can expect and what you can do to manage problems as they arise. For more information, see Home Treatment.
Dementia Caregiving: Tips For When To Call The Doctor
Caring for the elderly at home can be a difficult and often challenging process. Caring for someone with Dementia is even harder. And an elderly loved one suffering from dementia can end up testing your patience and anger management. That is why its important that you be aware of when you require professional medical help, no matter what age your dementia patient is at.
NOTE: These tips are for your general guidance only. Each situation is different and you should always consult with a physician if there is any doubt.
Sometimes you might end up thinking youre alone in this momentous task. That is far from being true however. You will always be better equipped to deal with a patient of Dementia if you ask for assistance. However, when does when actually go beyond getting help from family and friends and actually call a doctor? That is what we will be talking about in this post in the hope that you might find some guidance or advice.
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Preparing For A Neurologist Appointment
- Write down all the questions you would like to ask, like the ones listed in the section below. List your most important questions first. It may be helpful to carry a small notebook or download a smartphone app that will include all your loved ones pertinent care information in one place.
- Make a list of all medications including prescription, over-the-counter and supplements your loved one takes and their dosages.
- Bring along his or her medical history and other paperwork including diagnostic test and lab results, as well as imaging scans like X-rays and MRIs.
- Bring a list of your loved ones other physicians who should have access to their neurology records.
- Ask the neurologist if there are any forms you can complete prior to your visit so you can focus, as much as possible, on keeping your loved one calm and stress-free for the appointment.
What Conditions Can Be Mistaken For Dementia
The term dementia refers to a specific group of symptoms related to a decline in mental ability. Often, people who experience subtle short-term memory changes, are easily confused, or exhibit different behaviors or personality traits are mistakenly thought to have dementia. These symptoms could be the result of a variety of other conditions or disorders, including other neurocognitive disorders such as Parkinsons disease, brain growths or tumors, mild cognitive impairment , and mood disorders, like depression.
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Can Dementia Be Inappropriately Diagnosed In A Single Visit
Sadly, yes. Although its common for doctors to never diagnose dementia at all in people who have it, I have also come across several instances of busy doctors rattling off a dementia diagnosis, without adequately documenting how they reached this conclusion.
Now, often these doctors are right. Dementia becomes common as people age, so if a family complains of memory problems and paranoia in an 89 year old, chances are quite high that the older person has dementia.
But sometimes its not. Sometimes its slowly resolving delirium along with a brain-clouding medication. Sometimes its depression.
It is a major thing to diagnose someone with dementia. So although its not possible for an average doctor to evaluate with as much detail as the memory clinic does, its important to document consideration of the five essential features as listed above.
Questions Your Doctor May Ask
- What are your symptoms?
- Do you have them all the time or do they come and go?
- What makes them better?
- Are they getting worse or staying the same?
- Have you had to stop doing things you used to do?
- Does anyone in your family have a genetic form of dementia, Huntingtons, or Parkinsons?
- What other conditions do you have?
- What medications do you take?
- Have you been under any unusual stress lately? Have you had any major life changes?
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Dementia With Lewy Bodies
Dementia with Lewy bodies looks like a combination of some features of both Alzheimers disease and Parkinsons disease. The cognitive problems begin before or shortly after the muscle symptoms. A person with Lewy body dementia has more emotional and cognitive ups and downs, more falls, more sleep problems, and more visual hallucinations than someone with Alzheimers disease.
How Does A Doctor Test For Dementia
There is no single diagnostic test for Alzheimers disease and other causes of dementia. Dementias are diagnosed by evaluating and understanding a persons memory and thinking patterns. Doctors will consider a persons memory, grasp of language, mood states, problem-solving skills, ability to maintain focus and perform complex tasks. Evaluation may include in-office cognitive screening , physical examination, and review of labs. Labwork helps to determine whether there are vitamin deficiencies or hormonal changes at play. In some cases, evaluation may require neuropsychological testing, brain imaging , and genetic testing.
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What Causes Dementia To Progress So Quickly
Dementia symptoms are typically mild at first and progress over time to moderate and then severe, over several years. The speed as which dementia progresses varies between individuals, but some factors can cause dementia to progress more quickly. These include the persons age, the type of dementia, and other long term health problems. Dementia tends to progress more slowly in people over 65 compared to younger people below 65.
How Common Is Dementia
Research shows there are more than 850,000 people in the UK who have dementia. One in 14 people over the age of 65 have dementia, and the condition affects 1 in 6 people over 80.
The number of people with dementia is increasing because people are living longer. It is estimated that by 2025, the number of people with dementia in the UK will be more than 1 million.
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Learn About Neurology Specialists
Though many primary care physicians are able to make an initial diagnosis of dementia and provide basic care for memory-impairing diseases, working with a specialist in brain disorders and taking advantage of the physicians more extensive experience is a necessity for more thorough treatment. According to Dr. Piero G. Antuono, Silverado Brookfield Medical Director, those seeking the most thorough treatment and care of dementia are best served by consulting doctors with formal training and experience in geriatrics, neurology or psychiatry.
When To Visit A Neurologist For Dementia
Caring for an older adult who has Alzheimers disease or another form of dementia requires a team approach that includes physicians, social workers, care coordinators and other specialists. It takes a dedicated care team to ensure the health and longevity of affected seniors and to help relieve stress for caregivers.If your senior loved one has recently been diagnosed, the first step is to decide on a course of treatment. While there is no cure for Alzheimers or dementia, there are steps you can take that may help to delay the progression of your family members disease. During this time, you will likely work with a variety of medical professionals to coordinate your loved ones care. It is important to understand the role and function of each of these specialists.
Begin by developing a strong relationship with your seniors primary care physician. They will act as the care teams quarterback, ultimately responsible for managing medications and therapies, monitoring for any conflicting treatments or side effects, and helping to assemble other specialists.Another key member of your loved ones dementia care team will be the neurologist. These specialists are trained in diagnosing, treating and managing disorders of the brain, nervous system and spinal cord. Many neurologists also have specialized training in one area of neurology such as stroke, epilepsy or dementia.
When to See a Neurologist
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Can Dementia Suddenly Get Worse
The progression of dementia depends on the underlying disease. Some diseases have a rapid progression. Others progress more slowly. Any sudden change with either slow or rapid progression should be evaluated for another cause. In most cases, changes with dementia may seem like they came out of the blue when they actually may have been slowly developing in the background. The best way to prepare for changes and manage expectations is through information. Your doctor and medical team will be a valuable resource. There are a variety of educational resources that are also available through the Alzheimer’s Association.
What Are The Symptoms
Usually the first symptom is memory loss. Often the person who has a memory problem doesn’t notice it, but family and friends do. As dementia gets worse:
- You may have more trouble doing things that take planning, like making a list and going shopping.
- You may have trouble using or understanding words.
- You may get lost in places you know well.
Over time, people with dementia may begin to act very differently. They may become scared and strike out at others, or they may become clingy and childlike. They may stop brushing their teeth or bathing.
Later, they cannot take care of themselves. They may not know where they are. They may not know their loved ones when they see them.
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Neurologist Or Memory Disorder Specialist
A neurologist is a specialist who is trained in nervous system disorders, especially issues with the brain, spinal cord, and peripheral nerves.2
As with most branches of medicine, neurologists can focus on different aspects of these disorders, or choose to concentrate their care on one disorder. This is something to consider when looking for a neurologist: ask them if they specialize in dementia or the care of Alzheimers patients.
In addition to a medical degree, neurologists complete an internship and then a residency in neurology that is at least three years long. If they decide to pursue further specialization like training in sleep medicine or want to focus on one disorder, they might have additional training after their residency.3
You might also see doctors labeled as memory disorder specialists. These can be neurologists, psychiatrists, psychologists, or geriatricians who specialize in diagnosing and treating dementia or other memory disorders.
Talking With The Doctor
Keep in mind that in order for physicians to speak with you about their patient, they will typically require either verbal permission from the patient to do so or a copy of the medical power of attorney for healthcare decisions.
Additionally, make sure that you have provided the physician with a copy of the living will if one exists so that the treatment decisions reflect your loved one’s choices that they’ve previously made regarding their care.
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Key Features Of Dementia
A person having dementia means that all five of the following statements are true:
- A person is having difficulty with one or more types of mental function. Although its common for memory to be affected, other parts of thinking function can be impaired. The 2013 DSM-5 manual lists these six types of cognitive function to consider: learning and memory, language, executive function, complex attention, perceptual-motor function, social cognition.
- The difficulties are a decline from the persons prior level of ability. These cant be lifelong problems with reading or math or even social graces. These problems should represent a change, compared to the persons usual abilities as an adult.
- The problems are bad enough to impair daily life function. Its not enough for a person to have an abnormal result on an office-based cognitive test. The problems also have to be substantial enough to affect how the person manages usual life, such as work and family responsibilities.
- The problems are not due to a reversible condition, such as delirium, or another reversible illness. Common conditions that can cause or worsen dementia-like symptoms include hypothyroidism, depression, and medication side-effects.
- The problems arent better accounted for by another mental disorder, such as depression or schizophrenia.