- • Overview
- • What should you do if loss of memory or confusion is evident, and dementia or Alzheimer's is suspected?
- • Alzheimer's Association can help with...
- ‣ Alzheimer's Progressive Manifestations
- ‣ If Dementia or Alzheimer's is suspected
- ‣ Home Care Option Considerations
- ‣ Placement Options Environment Factors
- ‣ Special Care Unit Components
- ‣ Alzheimer’s, Dementia & Driving
- ‣ Additional information resources
Alzheimer's a progressive, degenerative disease, a form of dementia, that attacks the brain, results in impaired memory, thinking and behavior. To date it can only be absolutely diagnosed after death, by an autopsy.
It is only one of several forms of dementia. A diagnosis of Alzheimer's disease for a living family member means a definitive diagnosis for other causes of dementia have been ruled out. Other causes may be stress, depression, nutrition deficiencies, stroke, Parkinson's disease, drug side effects, or even AIDS.
Alzheimer's care facilities specialize in care of patients with dementia. Other senior living environments (Congregate, Assisted Living, Board and Care) may be appropriate for some residents in early, or even mid, stages of the disease. But unless the community has a specialized dementia unit, transfer to another facility will be required as the disease progresses. In fact, some Alzheimer's facilities accept patients only if they are mobile, or if they do not need to be treated for other ailments not normally treated at the Assisted Living level. For an idea of what that means in your state check Assisted Living regulations for your state.
NOTE: Alzheimer's Care Facilities or Units in multi-level retirement campuses may take Assisted Living level patients, or they may be geared to late stages of Alzheimer's support and offer nursing home level of care. Costs are comparably different between the two levels, as between Assisted Living homes and Nursing Home costs. An Alzheimer's Nursing Home offers care more geared to the needs of Alzheimer's patients.
Federal regulations require any long-term care home or community to provide 30 days written notice and an appropriates discharge plan if they determine a patient is inapporpriate to remain with them. They may not just tell you verbally to relocate a loved one!
What should you do if loss of memory or confusion is evident, and dementia or Alzheimer's is suspected in you, or a family member?
Know the 10 Warning Signs of Alzheimer's Disease, as identified by the Alzheimer's Association, so you avoid jumping to conclusions, or denying that there is a possibility of Alzheimer's that should be professionally evaluated.
Difficulty performing familiar tasks
Problems with language
Time and place disorientation
Poor or decreased judgement
Problems with abstract thinking
Changes in mood or behavior
Changes in personality
Loss of initiative
Contact the local Alzheimer's Association Chapter for guidance and help with diagnosis and Alzheimer's support. Your Chapter can be found from National Alzheimer's Association on the internet or at 1.800.271.3900.
The Alzheimer's Association can help with:
How to select a physician and other professionals involved in diagnosis and treatment of Alzheimer's or other dementia.
Ideas for environmental adaptations that can assist patients to function better in non-institutional environments.
The family's need to inquire about long term care options early in the disease process.
Ideas for types of respite care options for caregivers.
Information regarding caregiver support groups in your area.
Information regarding research programs that might be available in your area.
Information regarding different types of Alzheimer's support groups.
- Ones in which patients talk openly about having the disease and take a pro-active approach, for as long as they are able.
- Those in which patients concentrate on brain stimulus and hand/eye coordination activities, and offer social interaction.
Information regarding private research groups in your area that may be working with Alzheimer's.
Progressive manifestations of the disease
Loss in short term memory.
Episodes of agitation
Disorientation and confusion
Loss of weight
Forgetfullness regarding functions of daily living
If you choose a home care option:
Can you make the environment secure and safe?
Can you hire services to come into your home to help care for the patient and provide you with respite?
- Home health aides?
Is there a senior adult day care facility available?
Are there opportunities for social interaction, mental stimulation and recreation for the Alzheimer patient?
Can the caregiver get respite care?
In considering placement options the environment should:
Be designed for dementia and Alzheimer's patients.
Encourage way finding through patterns, colors and cues.
Provide for safe wandering indoors and outdoors.
Provide furniture groupings encouraging human interaction.
Provide overall even lighting.
Include areas of privacy for residents.
Include identified and accessible safe bathrooms.
Private areas for families to interact.
Offer opportunities for nurturing and comfort.
Components of a special care unit to consider when shopping for a community:
Is the facility dedicated to dementia and Alzheimer's care?
If not, do they have a separate wing?
Do they offer specialized Alzheimer or other dementia care?
Is the facility location convenient for you, the caregiver?
Is the environment calm and pleasurable?
Is there secure outside space for use by the residents?
Is private space personalized and respected?
Does the mission statement include benefits for your family member?
What licenses does the facility have?
- State licenses?
- Medicare certification?
- Medicaid certification?
- Private accreditation?
Are other residents' functional capabilities similar to your family member's?
Is patient assessment done by an interdisciplinary staff to determine individual needs?
Will re-assessment be done at regular intervals?
Do you feel you can establish a caregiver partnership with facility staff?
Are residents' rights addressed?
Is respect shown for resident's dignity in physical psychosocial, spiritual and emotional areas?
Does medical care and supervision seem sufficient?
Are behaviors accommodated without the use of restraints?
Are fees and charges competitive with nearby comparable facilities?
Will staff honor advance directives such as Durable powers of attorney?
Are nutrition and eating needs of residents accommodated?
Is there a full daily schedule of therapeutic activities?
Are residents active and engaged in activities?
Will diminished abilities and disease progression result in transfer or discharge from the facility?
Is late stage care and illness addressed maximizing functional abilities?
Are research opportunities explained?
Alzheimer’s, Dementia & Driving
Driving represents independence, competence and control. It's a means to buy necessities, be productive, stay connected to family, friends and the community and to access healthcare. Concerns about driving often surface during the early stages of dementia when individuals are still independent and able to manage daily activities.
Alzheimer's is not like other "changes" in later life that affect driving, such as eyesight problems and slow reaction times. Many older adults who don't have dementia can assess their driving changes without family intervention and do make gradual changes to the way they drive. Many are able to continue driving safely throughout their life. With dementia, an individual's capacity to assess his or her driving ability diminishes. They are especially likely to minimize the complexity of driving and overestimate their abilities. They may make excuses for their high-risk driving.
Those with Alzheimer's Disease and other dementias experience gradual and somewhat unpredictable progression in function loss. Cognitive functions critical to driving, decline; such as judgment, reaction time and problem-solving abilities. Other areas of decline are physical and sensory and they also increase driving risks.
As driving and assessment skills decline, the risk of serious loss or injury increases. Caregivers must assume the responsibility for monitoring and regulating the driving of the person with dementia. They need to realize that if there has been a diagnosis of Alzheimer's or dementia, a victim of an accident they cause will not stop their suit at the liability limit of the auto insurance. If negligence or a prior knowledge of incompetence can be found they can sue for all a person possesses. Auto insurance will indicate you did not tell them of the medical diagnosis, and you could be on your own to pay the claim.
Fortunately, in many cases, people with dementia begin limiting where and when they drive. The following signs indicate that a person with dementia is modifying his or her driving behavior:
Driving shorter distances.
Driving on familiar roads.
Avoiding difficult unprotected left-hand turns.
Avoiding driving at night, in heavy traffic, on heavily traveled roads or during bad weather.
Resolving the driving issue involves not only substituting other drivers or modes of transportation, but also addressing the reasons people want to go places. Caregivers can look for ways that others can help meet the physical needs of the person with dementia, such as:
Arrange to have prescription medicines, groceries and meals delivered, reducing the need to go shopping.
Have hairdressers make home visits.
Schedule people to visit regularly, either as volunteers or for pay.
Arrange for friends to take the person with mild dementia on errands or to social or religious events.
While caregivers consider ways to reduce the need to drive, it's also important to remember the social benefits the person with dementia derives from interacting with others. As one person reflected: "When I went to the bank or drug store, I would stop at the local bakery for some pastries. Sometimes it would take most of the morning because I could take my time and chat with different friends along the way." If caregivers consider the social needs that were met through driving, the transition to not driving will be more successful.
When possible, include the person with dementia in the planning process. People are better able to respond to appeals to safety during the early stages of Alzheimer’s Disease or other kinds of dementia.
Caregivers need to remember that family members follow long-established patterns for making decisions. It is unrealistic to think that patterns will change when handling a difficult issue like driving safety. Caregivers can work to minimize friction by listening to different opinions and appreciating what each person can contribute, even if it differs from their point of view. Disagreements in families often result when individuals do not have the same opportunities to assess driving abilities. Having factual information about driving behavior does not guarantee families will reach consensus on when to limit driving. However, frequent, open communication about specific, observed behaviors and concerns may help to lessen differences. Everyone involved in caring for the person with dementia can help by focusing on the key issues; the self-respect of the person with dementia and the safety of everyone on the road.
Information on driving and Alzheimer's was Printed with permission from The Hartford, Hartford, CT 06115. Find out more from them through our state resources.
Clinical Trials a free, easy-to-use clinical studies matching service that connects individuals with Alzheimer’s, caregivers, healthy volunteers and physicians with current studies.
Additional information resources
National Alzheimer's Association or toll free at 1.800.621.0370. They can lead you to the closest affiliated local chapter.
The Alzheimer's Research Foundation since 1988, an independent group of professionals that volunteer to help Alzheimer's patients and caregivers. Feel free to ask them about caregiver problems, alternative medications (herbals, vitamins) and offer your suggestions for others. They prefer to focus on problems and solutions for care of patients in the home.
CareScout provides ratings of Alzheimer's Communities throughout the USA. For a report fee, and registration you can check a rating for a community you are considering for a loved one.
Alzheimer's and Dementias How to care for a loved one living alone with Dementia-Alzheimer's.
BrightFocus Foundation funds research seeking cures for Alzheimers disease, age-related macular degeneration and glaucoma, and provides the public with information about risk factors, preventative lifestyles, available treatments and coping strategies.
Additional Alzheimer's Related Resources
In Lisa Genova’s extraordinary New York Times bestselling novel-Still Alice, an accomplished professor diagnosed with Alzheimer’s disease learns that her worth is comprised of more than her ability to remember. Now a major motion picture from Sony Pictures Classics starring Julianne Moore, Alec Baldwin, Kate Bosworth, and Kristen Stewart! Academy Award WinnerDVD or
Book or KindleVIDEO
- Selected Alzheimer's Related ReadingsSlow Dancing with a StrangerThrough the Seasons
The Alzheimer Conundrum
The 36-Hour Day
- ContinuedLoving and Living with Alzheimer'sDesign Innovations - Alzheimer'sHelping Caregivers CopeWhat's Happening to Grandpa?
Also check our your state resources below for caregivers, Alzheimer's or Assisted Living homes, legal and insurance help, home services and real estate sales expertise.