Alzheimer’s Diagnosis: What Next?

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Being diagnosed with Alzheimer’s disease (AD) is an overwhelming experience, both for the senior and their family members. There are a number of common recommendations that doctors at Lee Physician Group Memory Care in southwest Florida make for patients who have just received a diagnosis. The overall theme is preparation. AD is a progressive neurodegenerative disorder, so planning for the future is key. Any dementia patient who is still mentally competent should focus on making medical, legal and financial preparations with their loved ones as soon as possible. Take these seven steps after the diagnosis has been made to get organized, prioritize healthy living and ensure important issues are addressed.

7 Steps to Take After an Alzheimer’s Diagnosis

  1. Begin Treatment

    The most important step after receiving this diagnosis is to begin treatment. There are medications used to treat AD that have proven effective in minimizing symptoms for a limited time (currently there is no cure). Three of these prescriptions, Aricept (donepezil), Exelon (rivastigmine) and Razadyne (galantamine), belong to a class of drugs called cholinesterase inhibitors. The fourth medication is called Namenda (memantine) and is approved for use in the moderate to severe stages of Alzheimer’s. It is important to know that these medications cannot dramatically improve a person’s memory or prevent the progression of the disease, but they can help lessen the severity of their symptoms.
  2. Make a Care Plan

    The cognitive difficulties that come with AD can cause patients to make mistakes with medications, mismanage their finances or struggle with performing activities of daily living. Dementia patients must have a comprehensive plan of care in place that will ensure they receive the assistance and supervision they need. A family caregiver could step in to lend a hand or find an elder care provider to do so.
    Be prepared to review the care plan regularly as care needs increase. Caring for a person with Alzheimer’s at home is challenging but possible. In the earlier stages, family caregivers can adopt daily routines, hire in-home care and make safety modifications that allow an elder to remain in the community. However, if a patient’s care needs surpass the abilities of their family caregiver(s), home-based care is no longer a viable option. Difficult dementia-related behaviors, such as wandering, hallucinations and agitation can make it impossible for family members to provide all the specialized care that dementia patients need. Having a long-term care plan in place will ensure you’re prepared to tackle these challenging developments, often by moving a loved one into a memory care unit or a nursing home.
  3. Evaluate Driving Skills

    Alzheimer’s disease affects a person’s memory, judgement and ability to focus—all crucial skills for operating an automobile safely. In the earlier stages of the disease, driving may still be an option, but it is wise for dementia patients to undergo regular driving evaluations to ensure they’re still safe behind the wheel. The Department of Motor Vehicles (DMV), AAA and the American Occupational Therapy Association can all offer guidance on how and where to find clinical driving assessment programs. As Alzheimer’s progresses, there will come a time when there is no doubt that a person with dementia should no longer be on the road. Caregivers should be prepared: elders typically don’t give up the car keys without a fight. Addressing this issue is very important, though, because unsafe drivers pose a serious risk to themselves and others in their communities.
  4. Get Legal and Financial Affairs in Order

    Alzheimer’s disease is a progressive disorder that eventually renders those living with it incapable of managing their own lives. Therefore, it is crucial for dementia patients to make legal preparations for who will handle medical and financial decisions on their behalf. Both a durable power of attorney (POA) for health care and a durable power of attorney for finances are critical. These legal documents appoint a trusted individual to oversee these areas of a patient’s life once they are incapacitated. An elder law attorney can draw up POA documents as well as other estate planning essentials like wills, advance directives and trusts. Making these legal preparations is an urgent matter because a dementia patient cannot do so once they are declared legally incompetent.
  5. Stay Mentally and Physically Active

    I encourage all my Alzheimer’s patients to be as mentally and physically active as possible since these factors may help slow memory loss and delay declines in their functional abilities. My patients often ask me to tell them what specific activities I recommend, but I find it is more important that they chose an activity they enjoy so they do it often.
  6. Adopt a Healthy Diet

    Diet may also play an important role in slowing down the rate of memory loss in Alzheimer’s patients. I recommend eating a diet rich in nutrients and antioxidants, such as vitamins A, C and E. These nutrients may help protect the brain from unstable molecules (free radicals) that are often associated with conditions like AD. Foods that have B complex vitamins such as folic acid also seem to protect the brain from damage. Antioxidants and folic acid are found in many fruits, vegetables and whole grains.
  7. Do Your Research

    A wise man once said that knowledge is power. This common saying applies to those with mild to moderate Alzheimer’s disease since the more you know, the more prepared you are to cope. The same applies to dementia caregivers, family members and friends. Take this opportunity to research the disease, learn what to expect and find helpful resources available near you. Being better informed will help patients and caregivers alike get the support they need throughout this difficult journey.

Next Steps After Delayed Diagnosis of Dementia

Early diagnosis is crucial for proper planning, but the truth is that many patients do not receive appropriate cognitive testing or results until their symptoms become bothersome or noticeable to others. A delayed diagnosis occurs when either a patient, caregiver or doctor does not report or recognize symptoms until the condition has significantly worsened. Research has shown that missed or delayed dementia diagnoses are quite prevalent.

Oftentimes, family members believe cognitive or behavioral changes are normal parts of aging and do not seek treatment until symptoms are more severe. Similarly, patients themselves may delay or refuse treatment due to lack of insight into the extent of their own impairment. It is important to note that next steps may look a little different for dementia patients who are already experiencing difficulty making informed decisions.

Patients and families who don’t seek diagnosis until later stages of the disease may still benefit from medications that lessen symptoms and improve a patient’s functional abilities. However, the legal aspects of a delayed dementia diagnosis are a bit more complicated. Ideally, someone with Alzheimer’s would have already drafted durable POA documents, thereby enabling their agent to assist with any other preparations that must still be made. However, if POAs are not in place and they are no longer legally competent, then it is likely too late for them to engage in legal planning. Their family will need to seek guardianship to manage their health care and finances.

For more information about this legal process, read How to Get Guardianship of a Senior.


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Sources: Medications for Memory (https://www.alz.org/alzheimers-dementia/treatments/medications-for-memory); Missed and Delayed Diagnosis of Dementia in Primary Care: Prevalence and Contributing Factors (https://dx.doi.org/10.1097%2FWAD.0b013e3181a6bebc)

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