Alzheimer’s Dementia: Symptoms and Basics.
I believe it is important to look at any illness from the point of view of a patient.
In Alzheimer’s Dementia the first thing the patient notices are his or her symptoms, like their memory is not all there, having episodes of forgetting little things, examples of this can be a patient placing the sugar bowl in the refrigerator, forgetting their son’s or daughter’s names or calling their son or daughter by a different name, forgetting the name of objects such as “give me that thing you write with” instead of calling it a “pen”.
The way it initially starts is very mild.
The patient has difficulties at times telling time and keeping schedules, as the disease advances you notice that your father, grandfather, grandma loses temper quite easily, showing poor judgment, but they are still able to function on a daily basis, so at the beginning most people tend to think “well is just old age” but this is the beginning of Alzheimer’s Dementia, reasoning is a problem, therefore, the disease falls on the caregivers, the supportive family members around the patient.
Another difficult area is planning, because even though they’re able to function on a daily basis they don’t have a sharp mind to plan ahead especially in their finances and their health. They constantly need to be reminded about their medical appointments, medications they have to take because they forget and they use poor judgment in looking for their future finances. It’s difficult for them to give up that control and It’s difficult for the caregivers to obtain the control without hurting their feelings.
ADVANCED ALZHEIMER’S DEMENTIA
In the case of advanced Alzheimer’s the diagnosis is a lot easier because it’s obvious what’s happening to the individual, to a loved one. In this case it’s important to keep everything the way it is within the household, try not to make any drastic changes in their apartment or living space. Keep pictures of your family surrounding them so that they can make eye contact and continue their social skills, this is a part that a many times also interferes with the patient with Alzheimer’s, the ability to socialize with others properly.
In advanced dementia, most times the caregiver just need to hold their hand to show love and affection, even though they’re not reaching out for you, you can reach out back to them, continue the same type of relationship that you had with that loved one since before they got ill, because even though they cannot express love in the same way as before, they are able to receive it.
Once the patient sees that they have symptoms or their loved ones see how many symptoms their relatives, parents or grandparents have, they go see a psychiatrist. At this point it’s important to understand that as a psychiatrist, the doctor must be able to rule out other illnesses that could be causing the loss of memory such as diabetes, neurological problems, a brain tumor, kidney problems, etc. All these possibilities are ruled out by doing blood work and further work up to make sure you’re not missing a different disease.
Alzheimer’s dementia is considered to be to a certain degree in our genetics and contributed also buy our environment. When I mention environment, I’m talking about, what we eat, a contributing factor is people who smoke because it affects the arteries of the brain and therefore the blood supply diminishes, lack of exercises, the age of the patient, these are contributing environmental factors in addition to the genetics, the genes that are passed on to us from one generation to another.
It’s important to keep in mind that these patients lose their social interaction so we must adapt to them and understand the illness so we’re not angry at them, because their personality is changing.
Treatment for patients with Alzheimer’s includes pharmacotherapy and behavior, counseling is a very good option, art and music therapy for moderate and advanced dementia is good.
Pharmacological therapy is essential for early moderate or advance. In moderate dementia you can still see patients that are able to function on a daily basis, they can eat they can bathe themselves, but when it comes to making decisions about their finances or “big decisions” it’s difficult for them and they usually have poor judgment as I noted before, they can become suspicious and easily angry because you point that out there deficits and they have enough understanding that they are ill but they do have a hard time admitting to it, so it creates a state of confusion.
One of the big issues in treatment is getting patients to give up driving because you’re taking away their autonomy so it’s very sensitive how the family members must approach their parents or grandparents, loved ones when they become ill with Alzheimer’s dementia
In advanced dementia, this is when the patient is unable to speak, cannot swallow, he or she has to be fed, they don’t identify family members or may identify only one
It’s a very sad depressing illness not only for the patient but for the family members as well.
Different types of dementia
Besides Alzheimer’s dementia we have vascular dementia which is poor blood supply to the brain that causes the brain to shrink and not be able to function in a cognitive way, that we can continue to take command of our lives. Understanding dementia, doesn’t matter what the causes is, is the lack of memory, difficulty for communication inability to reason and to understand the process of our thoughts.
So pretty much do understand an analogy of this, is like talking to someone who is very drunk, they can understand what you’re saying but they’re unable to reason, they make decisions that are inappropriate and they’re not in command of their cognitive function. Typical what happens with patients suffering from Alzheimer’s or any type of dementia, and the degree of the dementia, you may also use the analogy we mentioned, it depends on the amount of drinks that you take, the more you’re drunk the less cognitive function you have.
Talking about the different kinds of dementia there’s also an alcohol dementia which refers to those patients who are severely alcoholic and this alters their brain function.
There are tumors in the brain that can cause dementia, this is why it’s important that a professional makes the diagnosis and starts treatment as early as possible
Pharmacological Treatment of Dementia
There are several great medications in the market:
– Exelon Patch a medication that is a patch applied on a daily basis and its absorbed through the skin, the patches are changed every day, the medication comes 30 patches for the month and the patient or care giver changes the patch in different parts of the body in order to not develop an allergic or skin reaction.
This medication is also good for those patients who are on multiple medications as older patients are, this makes one less pill they have to take through their mouth, the importance of this is that because the patient has Alzheimer’s they need a caregiver to apply the patch on a daily basis because patients tend to forget to place the patch in a different place each day, especially those patients who have moderate to advanced dementia
– Aricept which in my opinion is a great medication, it’s a pill given 1 tablet a day, 10 milligrams daily
– Namenda is another very good medication, Namenda extended release XR 28 milligrams daily is the most common, very beneficial for all patients who have Alzheimer’s dementia weather in the early, moderate or advanced stage. Common sense of the counseling profession advance.
– Namzaric is another important medication recently in the market, it’s two medications in one which comes in 14 milligrams, in 28 milligrams / 10 milligrams / 1 tablet daily, this is one pill which includes Aricept and Namenda XR 2 in 1.
Treatment for the Caregivers
It’s important for the caregivers to also be provided with counseling because it is an absorbent amount of time and understanding that it requires for the caregivers to be able to develop patience with their loved ones.
There’s multiple associations throughout the United States, groups that can provide support for this type of patient and their families and if anyone is interested in knowing more about it you’re free to contact me and I can provide for you the different all Alzheimer’s Dementia Associations within your area.
Part of the treatment for patients with moderate to advanced dementia as I mentioned earlier, is to keep everything the same as always, they do not tolerate changes, don’t try to change their home to a better home, they’re better off were they are unless it’s absolutely necessary.
In the kitchen it’s important to label things, depending on the degree of the dementia, if its moderate or advanced, you need to actually write what is in each cabinet so when they’re looking they can read and identify, next to the phone numbers must be written, 911, doctors phones, son or daughter’s phone, they need to have everything written constantly, because they are unable to remember what is very simple to us the caregivers.
In memory, even with all these medications it is important to understand that this is not a cure is only to prevent the progression of the illness, the advance of the illness, and we must develop a way of us as caregivers adapting to the illness of the patient.
It has been a pleasure sharing a little bit of my knowledge and experience within this topic with you, please leave me your comments I would love to hear from you