By Micha Shalev
“Are you kidding me? I have what!!” It can’t be true. It has to be a mistake. You are really angry. It’s normal to have these feelings but the important thing is to find ways to cope, and continue to have fun and laugh. What you must understand first and foremost is that you or loved one will lose short-term memory but retain some long-term memory.
There are several methods and diagnostic tools to help determine fairly accurately whether an individual with memory problems has “possible Alzheimer’s disease,” “probable Alzheimer’s disease,” or some other memory or neurological problem. “Possible Alzheimer’s disease” is defined as a dementia that could be due to another condition. “Probable Alzheimer’s disease” means there are no other causes for the symptoms that can be found. Some individuals with memory problems have a condition called amnestic mild cognitive impairment (MCI) that often precedes Alzheimer’s disease (AD). Individuals with MCI have more memory problems than normal for individuals their age, but their symptoms are not as severe as those seen in AD.
Importantly, not all individuals with MCI develop AD. At this time, a definitive diagnosis of Alzheimer’s disease can only be determined by an autopsy of the brain after death. However, at specialized centers, doctors can diagnose AD in a living person correctly up to 90 percent of the time.
A physician will diagnose Alzheimer’s in a living person by:
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- Asking questions about an individual’s overall health, past medical history, ability to perform daily activities, and changes in behavior and personality;
- Conducting memory tests, problem solving, attention, counting, language skills and other abilities related to brain functioning;
- Carrying out medical tests of blood, urine, or spinal fluid;
- Collecting information provided by family members or other caregivers about changes in a person’s day-to-day function and behavior which my help in diagnosis; and
- Performing brain scans, such as magnetic resonance imaging (MRI), positron emission tomography (PET) scan or a computed tomography (CT) scan.
A complete diagnostic workup for AD is lengthy and costly and may take as long as a year or more before a final diagnosis is made. After the diagnosis is made, the family and patient may need considerable guidance and counseling. Family members often wonder whether they should tell their loved one of the diagnosis. While it is devastating to learn that your loved one has AD, it is frequently more stressful to be aware of the signs and symptoms and yet have no answer for the problem. The family and the patient should agree before the diagnosis is made so appropriate actions are taken. Not knowing always presents the risk of the person finding out accidentally.
Open and honest communications are usually the best, but some families have their own reasons for choosing a different path. Families often look to healthcare professionals for guidance, and it is important to respect their decisions; however, physicians are advised to disclose the diagnosis to their patient.
The American Psychiatric Association recommends advising Alzheimer’s disease patients and their families of the need for financial and legal planning due to the patient’s eventual incapacity (e.g., power of attorney for medical and financial decisions, an up-to-date will, and the cost of long-term care).
Micha Shalev MHA CDP CDCM CADDCT is the owner of The Oasis at Dodge Park, Dodge Park Rest Home and The Adult Day Club at Dodge Park located at 101 and 102 Randolph Road in Worcester. He is a graduate of the National Council of Certified Dementia Practitioners program, and well-known speaker covering Alzheimer’s and dementia training topics. He can be reached at 508-853-8180 or m.shalev@dodgepark.com or view more information online at www.dodgepark.comBottom of Form
