Do I tell my loved one she has Alzheimer’s disease — and how do I prepare the rest of the family for what is then in store?

February 1, 2012

- Alzheimer's Care, Blog, Elder Law Articles, Estate Planning

This is one of those topics that has been debated by experts for years. Some feel that anyone diagnosed with Alzheimer’s should be told, while others think they should be spared the knowledge. What it comes down to is this: What do you think will be best for your loved one? Some people will go into a tailspin and become severely depressed. Others might take it more in stride. Would your loved one want to know, to help her cope? Keep in mind, if you don’t speak up, someone else is liable to slip and that would be devastating. If there is a good doctor-patient relationship, it is best to let the doctor relay the information in a somewhat matter-of-fact way. A family member, however, should be with your loved one when the physician talks with her. Then, after the doctor broaches the subject, you have an opening to call other family members and let them know. A family meeting is a good idea. Having the diagnosis out in the open is usually liberating and helpful for everyone involved. At this family meeting, you can begin brainstorming about what you want to do next. Getting an Alzheimer’s patient’s financial and legal affairs is a very important step early on. One very helpful resource is this free pamphlet on estate planning “Don’t Lose Your Wallet! The Indispensable Guide to Estate Planning.” Sometimes tension arises among family members when these topics are discussed. Whatever you do, keep in mind that extra pressure is not a good thing for your loved one. You should arrange a time when you can meet without him or her present so you can talk openly with family members without upsetting him or her. If it comes to needing a mediator, then get one. This is the time to act like responsible adults and do what is right for your loved one, nothing else. Allow the individual — and yourself and family members — to grieve. Alzheimer’s can be devastating to not only the patient but also family members and other loved ones. It’s important for everyone to take care of each other and offer support. No one should be hesitant about joining a support group. It helps to be with others in a like situation. There should be one or more support groups nearby for early-stage Alzheimer’s patients. Have your loved one get involved with one of them. It’s important for Alzheimer’s patients to have a forum to express themselves to others in similar situations. (This is true for many emotional conditions and situations.) If anybody is still having a lot of difficulty coping after trying out a support group, have them consult a professional counselor. It’s vital that you support one another. Teamwork will take you farther than working alone. Let go of circumstances you can’t control. Choose your battles wisely. And, as odd as it might sound, always try to keep a good sense of humor.

Is Alzheimer’s disease hereditary? What should we be aware of?

By Anthony Ferraro on

January 31, 2012

- Alzheimer's Care, Blog, Elder Law Articles, Uncategorized

The jury is still out on this one. Scientists now tell us that if you have a blood relative who has Alzheimer’s, your chances of getting it are much greater than someone who doesn’t. This does not mean, however, that if you have more than one relative with Alzheimer’s, your family has one of the forms of the disease that apparently could be strongly inherited. A good place to look for more information on this topic is the website of the Alzheimer Society of Canada. (http://www.alzheimer.ca) There is a lot of detailed information about genetic research and Alzheimer’s here. If you have a loved one with Alzheimer’s, it’s best to deal with the situation in a constructive way. As difficult as it might be, you should not worry about something that might or might not happen, ruining your quality of life in the process. People have become debilitated by the fear of possibly inheriting Alzheimer’s. Don’t fall into this trap. Put your thoughts into a journal. Obtain professional counseling if your normal routines start to fall apart. Whatever you do, don’t try to deal with this alone. Your best support group will probably be friends and family, so keep them near. Join a formal support group (and start one if there’s not one available for you). Even if it you just wind up going for coffee with a friend or relative, that’s a start that can be built upon. You need to talk about Alzheimer’s after it has entered your life (in whatever manner it does). Talking with others in a similar situation can be especially helpful since they will understand what you are going through and vice versa. There are many beneficial resources available in the Indispensible Alzheimer’s Resource Kit including resources to assist you in journaling.

Are drug side effects or Alzheimer’s Disease itself responsible for hallucinations and delusions?

By Anthony Ferraro on

January 23, 2012

- Alzheimer's Care, Blog

Both can cause hallucinations or delusions. It’s worth keeping in mind that hallucinations and delusions are not the same thing. First, delusions are beliefs that do not agree with existing facts and persistently remain, despite all evidence against them. Hallucinations can involve any sense but are usually associated with seeing or hearing. They cannot be confirmed by anyone other than the person experiencing them. If you think medication might be causing either of these in your loved one, consult the individual’s doctor. You also can do some research yourself by speaking with the pharmacist or by clicking into the medication’s own website. (Just type in the name of the medication in whatever search engine you use, and you should get the information you need.) Even then, if you believe a medication is the reason for hallucinations or delusions, check with the prescribing doctor before cutting off its use. Why? Many medications should not be stopped abruptly and need to be tapered off. Another cause of delusions and hallucinations can be dementia. Alzheimer’s disease, for example, affects each person in a different way. Some people have delusions. Some experience hallucinations. Some have both, some neither. A general rule of thumb is if the hallucinations don’t frighten or upset someone (they’re “friendly” hallucinations), the people around the sufferer need to just “go with the flow.” Validation is important when hallucinations appear to enter the picture. If a loved one says he or she hears or sees someone who isn’t really there, you can ask, “Are they nice?” or “What’s your friends’ names?” The situation gets more difficult, of course, if hallucinations are not friendly. The sufferer might think someone is out to kill him or her, violate his or her loving space or do some other type of harm. Validation helps in this situation, too, but getting it is trickier than with “friendly” hallucinations. This is where “therapeutic fibs” might come in handy. You won’t be telling the entire truth but it will be in your loved one’s best interests. If your loved one feels threatened, you can sympathize and say that you, too, were worried so you called 911 and authorities took the offender away. This might or might not put the person’s mind at ease; and even if it does, it might not last long. Unfriendly hallucinations can start up again and you will have to respond again. If such a routine persists, you should consult a doctor. For more information about Alzheimer’s and how it might affect a loved one, check out the free, Indispensable Alzheimer’s Resource Kit from The Law Offices of Anthony B. Ferraro, LLC.

Should I move my mother who has early-stage Alzheimer’s across the country to be nearer to me? What’s the best environment for her?

By Anthony Ferraro on

January 19, 2012

- Alzheimer's Care, Blog

Discuss this situation with her directly if she is still lucid and can be meaningfully involved in reaching a decision. If possible, have a face-to-face talk with her. If this means traveling to her home, use the opportunity to assess her living conditions and suitability to live alone. Determine if you are comfortable with her solo routine, and if in-home care would be a suitable accommodation. This could set the stage for your hiring a geriatric care manager to look after her when you leave. If this is something you don’t want to do or isn’t feasible, then you can explore care facilities in her area. Discuss the situation with a social service agency near where your mother lives to find suitable resources. You can still hire a geriatric care manager to make regular visits and report regularly to you if she does move to a facility. The manager would be your liaison and be an advocate for your mother to ensure she gets proper care. THEN if you are still not comfortable, discuss her moving closer to you. There are numerous considerations for this, such as will she live with you or in a facility near you? If she were to live with you, would she need additional supervision (while you were at work or otherwise away)? In-home care is an option, and adult daycare may be another. You’ll want to get a hold of a social service agency in your area to obtain a list of nearby resources. With adult daycare, your mother could get supervision and also meals, socialization and activities. Some might also offer nursing services. These centers typically have transportation services of some sort so you should inquire about them, if you do not otherwise have a way to drop her off or pick her up each day. By talking with your mother, you will be able to form ideas about what environment would be best for her. Carefully consider the options — and be sure to bounce ideas off a trusted friend. Then make a decision and proceed with optimism. Alzheimer’s affects people all around Chicago and its suburbs. The Law Offices of Anthony B. Ferraro can help you plan what’s right for you and your loved ones. See our free, “The Indispensable Alzheimer’s Resource Kit,” for many more tips and advice.

My wife has Alzheimer’s. Can she be affected by “Sundowning?”

By Anthony Ferraro on

January 17, 2012

- Alzheimer's Care, Blog

“Sundowning” is the name of condition that results in a person becoming increasingly confused or agitated as the day wears on. While the actual cause of it is unknown, its occurrence can be somewhat predictable once a pattern begins. Fatigue, low lighting and increased shadows — the basis for the sundowning label — are factors known to bring on the condition. As they become more prominent during the day, an individual with Alzheimer’s tends to become more confused. Certain steps can be taken to make things easier on individuals with Alzheimer’s and their caregivers. For example, urging your loved one to nap after lunch, or at least have some “quiet time” during his or her daily schedule is a good idea. Relaxation can help a person “recharge” to deal with the rest of the day with less confusion or agitation. Create a good setting to promote relaxation by considering all five senses:

put on relaxing music,
get your loved one to a comfortable chair or bed,
burn incense or a fragrant candle,
dim the lights,
turn on something that can create “white noise,” such as a bubbling water or a fan.

You can also gently massage her hands and arms with pleasant lotion. Always soothingly inform your loved one of the changes you are introducing, especially if you’re going to turn the lights off altogether or otherwise drastically change the atmosphere. This relaxation period is an excellent time for an outside volunteer (a neighbor, friend, church volunteer or other family member) to get involved your loved one’s care. It’s also a good way to get you, or whoever the regular caregiver is, a break from regular duties. Since shadows and darkness are what tends to make “sundowners” confused, make sure there is plenty of lighting after the relaxation period, and throughout the rest of the day. Placing nightlights throughout the living quarters is a good way to keep lighting up. To avert problems with sundowners who are in non-typical settings, such as a hospital room, be sure to keep familiar things on hand. These could include pillows, stuffed animals, a special radio or quilt and so on. As a person’s typical sundowning time period begins, try to keep him or her very busy. If they feel they are involved in something worthwhile, it could be enough of a distraction to lean toward neutralizing the agitated, confused behavior. More information on this topic, and others about living with Alzheimer’s disease, can be found in our free Alzheimer’s Resource Guide. Whether you’re in Illinois or beyond, Alzheimer’s disease is a difficult challenge with which to deal. Don’t try to do it without help.

Can a person lose speech with early-stage Alzheimer’s Disease?

By Anthony Ferraro on

January 16, 2012

- Alzheimer's Care, Blog

Because Alzheimer’s affects individuals in different ways, at different rates, with different symptoms and at different times, it is impossible to say that no one with early-stage Alzheimer’s will ever lose the ability to talk. But it is not likely. If loss of speech happens at all, it is typically occurs in mid- to late-stage Alzheimer’s. The brain deteriorates and systematically starts to shut down certain body functions, one of them being speech. At first, a person might struggle with words, and then phrases or concepts. Eventually, entire sentences could be lost. There is also the possibility that someone will talk gibberish: He or she could be talking in full sentences but the words make no sense. Complications of neurological diseases such as Alzheimer’s could include mini-strokes, which could lead to the loss of speech. These mini-strokes, also known as TIAs (for transient ischemic attacks), are not uncommon in people with dementia. Sometimes, strokes come first and a person develops dementia secondarily. Severe strokes can result in the loss of speech. In these cases, time spent with a speech therapist can result in regained speaking abilities. It’s important to consult a doctor if speech is lost soon after a patient’s dementia/Alzheimer’s diagnosis. And, as always with such professionals, if you’re not satisfied with what you hear or how you’re treated, keep looking until you are. Consulting a specialist such as a neurologist is very important, too. Mini-strokes often may be too small to detect with an MRI, experts remind. Doctors who are experienced will be able to determine diagnoses through observation and interviews with family members. Although it is not common to lose speech with early-stage Alzheimer’s, you should always consult your physician whenever a medical condition like this is in question. Remember: Alzheimer’s treats people uniquely. While some characteristics — such as memory loss and insecurity — may be common, some symptoms may never appear in certain individuals. There are, for better or worse, few definites with Alzheimer’s. For more information about Alzheimer’s and how it might affect a loved one, check out the free, Indispensable Alzheimer’s Resource Kit from The Law Offices of Anthony B. Ferraro, LLC.