The diagnosis is Alzheimer’s disease – So now what?

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shalev_hsBy Micha Shalev MHA CDP CDCM

Are you kidding me, I have what?! It can’t be true. It has to be a mistake.

When you or your loved one first receives a diagnosis of Alzheimer’s disease (AD), it can feel like the world is slipping away from you. It can be hard to move at all, much less stay positive and start making the future plans that will make the later stages of the disease easier both for you and those around you. You may also feel really very “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.”

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 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.

It’s important to know that 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 can diagnose Alzheimer’s in a living person by:

  • Asking questions about the individual’s overall health, past medical history, ability to perform daily activities, and changes in behavior and personality
  • Conducting memory tests such as problem solving, attention, counting, language skills and other abilities related to brain functioning
  • Carrying out medical tests on blood, urine, or spinal fluid
  • Collecting information provided by family members or other caregivers about changes in a person’s day-today function and behavior which may help in the diagnosis
  • 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 communication is 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 (APA) 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).

In the long run, however, most people find that the best thing to do with an Alzheimer’s diagnosis is to stay as proactive as possible, and to try to keep a sense of humor, especially when they’re having a bad day. Most patients will have good days and bad days. If you’re having a bad day, just hold on, because a good day will come along soon.

Micha Shalev MHA CDP CDCM CADDCT is the owner of Dodge Park Rest Home and The Adult Day Club at Dodge Park, 101 Randolph Road, Worcester, as well as the new state of the art Oasis at Dodge Park. He is a graduate of the National Council of Certified Dementia Practitioners program, and well-known speaker covering Alzheimer’s and Dementia training topics. The programs at Dodge Park Rest Home specialize in providing care for individuals with dementia and Alzheimer’s disease. The facility holds a FREE monthly support group meeting on the second Tuesday of each month for spouses and children of individuals with dementia and/or Alzheimer’s disease.

Shalev can be reached at 508-853-8180 or by e-mail at [email protected]. For more information, visit www.dodgepark.com. Archives of articles from previous issues can be read at www.fiftyplusadvocate.com.