Alzheimer's For Dummies

by Smith, Patricia B.; Kenan, Mary M.; Kunik, Mark Edwin; Gibbons, Leeza

• ISBN13: 9780764538995
• ISBN10: 0764538993
• Edition: 1st
• Format: Paperback
• Copyright: 2003-10-31
• Publisher: For Dummies

Summary

An estimated 4 million people are living with Alzheimer's Disease (AD) in America today, with approximately 370,000 new cases diagnosed every year. AD patients live anywhere from 5 to 20 years after their diagnosis; and their inability to care for themselves grows more dramatic as the disease progresses, creating profound implications for their families and healthcare providers. Its impact on families during the caregiving years is overwhelming.If you have a family member or close friend who's suffering from Alzheimer's Disease and you're looking for current, useful information, then Alzheimer's For Dummies is for you. This reference guide also is helpful if you Need to know more about its diagnosis and treatment Want to take care of yourself while taking care of your loved one Are not the primary caregiver but want to know how to help Want to know how Alzheimer's Disease is going to affect you and your loved one Alzheimer's For Dummies takes a realistic look at Alzheimer's Disease, what it is and what it isn't. It offers pertinent, easy-to-understand advice for dealing with the myriad concerns and responsibilities that a primary caregiver must assume when managing an Alzheimer's patient. Here's a sampling of the information you'll find in this valuable guide: Maneuvering through medical, legal, and financial tangles Distinguishing AD from other brain diseases and medical conditions Handling the fears that may accompany the diagnosis Evaluating current drug therapies; watching out for scams and quack treatments Finding the best doctors; dealing with attorneys and CPAs Looking at Medicare regulations Evaluating the cost of care The current state of research, diagnosis, and treatment Television personality Leeza Gibbons, whose mother was stricken with AD, writes in the foreword of this book, "There is no upside to keeping your head in the sand. This book is a crucial step in your new fight. Arm yourself with the knowledge waiting for you in these pages. It will help you find answers and resources as you adjust to your new reality."

Author Biography

Patricia B. Smith is an award-winning medical writer. <p> Mary Mitchell Kenan, PsyD, is the Director of Education for Baylor College of Medicine&#8217;s Alzheimer&#8217;s Disease Center. <p> dwin Kunik, MD, MPH, is a geriatric psychiatrist at the Houston Veterans Affairs Medical Center (VAMC) and Baylor College of Medicine.

Table of Contents

Foreword	xix
Introduction	1	(8)
About This Book	2	(1)
Conventions Used in This Book	2	(1)
Foolish Assumptions	2	(1)
How This Book Is Organized	3	(1)
Part I: Could It Be Alzheimer's Disease?	3	(1)
Part II: Helping a Loved One Manage the Illness	3	(1)
Part III: Providing Care for the AD Patient	3	(1)
Part IV: Respite Care for the Caregiver	4	(1)
Part V: The Part of Tens	4	(1)
Icons Used in This Book	4	(1)
Where to Go from Here	5	(4)
Part I: Could It Be Alzheimer's Disease?
Chapter 1: The Facts on Alzheimer's Disease	9	(6)
Defining Alzheimer's Disease	10	(1)
Busting the Myths About AD	11	(1)
Looking at Symptoms and Causes	11	(1)
Discovering Treatment Options	12	(1)
Tackling Financial and Legal Issues	12	(1)
Making Medical Decisions and Providing Care	12	(1)
Finding Respite	13	(1)
What Should I Do Now?	13	(2)
Chapter 2: Symptoms, Causes, and Risk Factors	15	(16)
Getting an Idea of What to Look For	16	(7)
Cognitive symptoms	16	(2)
Problems with language (aphasia)	18	(1)
Non-Cognitive Symptoms	19	(1)
Social problems	20	(1)
Physical symptoms	21	(2)
Red Flag or Red Herring?	23	(1)
Looking at Some Theories on the Causes of AD	24	(4)
Aging theories	24	(1)
Genetic theories	25	(1)
Microbial theory	26	(1)
Nutritional theory	26	(1)
Cardiovascular risk	27	(1)
Head trauma theory	27	(1)
Early life education and stimulation theory	27	(1)
Immune system theory	27	(1)
Environmental triggers	28	(1)
Examining Risk Factors for Developing Alzheimer's Disease	28	(3)
Family history	28	(1)
E4 variant	29	(1)
High blood pressure and high cholesterol	30	(1)
Chapter 3: Getting a Diagnosis	31	(22)
How Doctors Diagnose Alzheimer's Disease
Finding Someone to Do an Evaluation	32	(5)
Enlisting help from your family doctor	33	(1)
Picking a specialist	34	(1)
Evaluating your choices	35	(1)
Tapping into other resources	36	(1)
Before You Seek a Diagnosis: Collecting Medical History	37	(3)
Digging through your roots	37	(2)
Keeping a journal	39	(1)
Looking for other sources of information	39	(1)
Rounding up medication records	40	(1)
Understanding AD Diagnostic Tests	40	(10)
Diagnostic screening tools	41	(3)
Competency and capacity tests	44	(3)
Neurological assessment	47	(2)
Physical and psychiatric exams	49	(1)
What to Do When the Diagnosis Is Made	50	(3)
Seeking a second opinion	50	(1)
Letting the patient know - the pros and cons	51	(1)
Sharing the news with family and friends	51	(1)
Identifying your allies	52	(1)
Chapter 4: Distinguishing Alzheimer's Disease from Other Medical Conditions	53	(16)
Making Sure that You Have a Reliable Diagnosis	53	(2)
It May Be Dementia, but Is It Alzheimer's?	55	(1)
Ruling Out the Usual (and Unusual) Suspects	56	(13)
Neurodegenerative disorders	56	(9)
Systemic conditions that mimic Alzheimer's	65	(2)
Other possible causes of dementia	67	(2)
Chapter 5: Identifying Your Fears: For the Patient and the Caregiver	69	(16)
Concerns for the Alzheimer's Patient	70	(10)
Hearing that you have Alzheimer's Disease	70	(1)
Understanding what's really bothering you	71	(5)
Fearing dependency	76	(1)
Leaving or losing your job	77	(1)
Worrying over losing your income	78	(1)
Handling your fear of loss of control	79	(1)
Coping with anger	80	(1)
Concerns for the Caregiver	80	(7)
Fearing the loss of your loved one	80	(1)
Watching memory slip away	81	(1)
Fearing that he or she will forget who you are	81	(1)
Building a new relationship	82	(1)
Worrying about finances	82	(1)
Being the primary caregiver	82	(1)
Worrying about your loved one	83	(1)
Worrying about yourself and your family	83	(2)
Part II: Helping a Loved One Manage the Illness	85	(80)
Chapter 6: Understanding the Stages of Alzheimer's Disease	87	(12)
How to Use the Classifications	88	(1)
Three Stages	88	(2)
Mild	88	(1)
Moderate	89	(1)
Severe	89	(1)
Four Stages	90	(3)
Stage 1	90	(1)
Stage 2	91	(1)
Stage 3	92	(1)
Stage 4	92	(1)
Five, Six, and Seven Stages	93	(1)
The Current Thinking: Assessing Alzheimer's Stages Via Cognitive and Functional Impairment	94	(5)
Mild	95	(1)
Moderate	96	(1)
Severe	96	(1)
Profound	97	(2)
Chapter 7: Evaluating Drug Therapies	99	(12)
A Little Background on Brain Chemistry	99	(3)
Following a thread	100	(1)
Focusing on acetylcholine	100	(2)
Reviewing Current FDA Approved Drugs	102	(5)
Cognex	102	(1)
Aricept	103	(1)
Exelon	104	(1)
Reminyl	105	(2)
Considering Other Types of Drugs	107	(4)
Sleep aides	108	(1)
Sedatives	109	(1)
Anti-psychotics and antidepressants	109	(1)
Other medications	110	(1)
Chapter 8: Avoiding Snake Oil and Other Ineffective Treatments	111	(10)
Treatments and Tests That Aren't Worth Your Time of Money	112	(6)
The Zapper	112	(1)
Nutritional supplements	113	(1)
Chelation therapy	114	(2)
Self-administered tests for AD	116	(2)
Sniffing Out Scams: Five Warning Signs to Look For	118	(3)
Chapter 9: Taking Part in Clinical Trials	121	(16)
What Is a Clinical Trial?	122	(1)
Weighing the Benefits and the Risks When Participating in a Clinical Trial	123	(3)
Looking at the good	123	(1)
Facing the bad	124	(1)
Keeping a few other points in mind	125	(1)
Finding Clinical Trials	126	(1)
Enrolling in a Clinical Trial	127	(2)
Understanding exclusion and inclusion criteria	128	(1)
Understanding informed consent	128	(1)
What Happens During a Trial	129	(3)
Keeping good records	129	(1)
Bearing the cost	130	(1)
Knowing when to call the doctor	131	(1)
Potential conflicts	132	(1)
Current Alzheimer's Trials	132	(5)
Anti-inflammatory therapy	132	(1)
CATIE trial for psychiatric Alzheimer symptoms	133	(1)
COGNIShunt	133	(1)
CX516 (Ampalex)	134	(1)
Statins	134	(1)
Estrogen trials	135	(1)
Vitamin E and selenium	136	(1)
Chapter 10: Promising New Drugs and Diagnostic Tools	137	(20)
The Current State of Affairs	138	(1)
Promising (and Not-So-Promising) New Drugs	138	(4)
Memantine	138	(2)
Beta-secretase inhibitors (memapsin 2)	140	(1)
Alzhemed (anti-amyloid)	141	(1)
An Ounce of Prevention: The Hunt for an Alzheimer's Vaccine	142	(1)
Drugs and Therapies Already Approved for Other Uses	143	(7)
High-dose vitamin E	144	(1)
Estrogen	145	(1)
Erythropoietin (EPO)	145	(1)
Statins	146	(1)
Huperzine A	146	(1)
Selegiline (Eldepryl)	147	(1)
Valproate (Depakote)	147	(1)
IPA	147	(1)
Certain B vitamins	148	(1)
Non-steroidal anti-inflammatory drugs (NSAIDS)	148	(2)
Testing Positive: Looking for the Definitive Diagnosis	150	(7)
Genetic testing: Still not accurate	150	(1)
New imaging tools for diagnosis	151	(3)
Comparing imaging procedures	154	(3)
Chapter 11: Finding Alternative Therapies	157	(8)
Calming Alzheimer's Disease Patients	158	(4)
Getting help from man's best friend: Pet visitation programs	158	(2)
And a one, and a two -- music therapy	160	(2)
Having Some Fun and Easing Isolation	162	(5)
Small-group activities	162	(1)
Recreational activities	163	(2)
Part III: Providing Care for the AD Patient	165	(118)
Chapter 12: Making Medical Decisions	167	(14)
Finding the Right Healthcare Provider	168	(1)
Building a Team	169	(1)
Keeping Good Records	170	(1)
Using Alternative Therapies	171	(1)
Evaluating Clinical Trials	172	(1)
Understanding the Importance of Cholinesterase Inhibitors	173	(1)
Deciding on End-of-Life Care Options	174	(3)
Letting nature take its course	175	(1)
Palliative care	175	(1)
Aggressive care	176	(1)
Considering Brain Donation	177	(4)
Deciding whether brain donation is right for your family	177	(1)
Understanding the donation procedure	178	(1)
Finding research facilities that accept donated brains	179	(2)
Chapter 13: Understanding Legal Issues for Alzheimer's Patients	181	(22)
Getting Started	182	(1)
Evaluating Your Legal Options	183	(1)
Durable Power of Attorney	184	(7)
How many agents are needed?	185	(1)
Should power of attorney be given to my lawyer?	186	(1)
Choosing the correct type of power of attorney	187	(1)
What kind of "powers" does power of attorney bestow?	188	(1)
Can someone use power of attorney to steal assets?	188	(1)
Changing your mind	189	(1)
How much does it cost?	190	(1)
Guardianships or Conservatorships	191	(4)
What does a guardian do?	191	(1)
How are guardianships awarded?	192	(1)
Why choose a guardianship?	193	(2)
Living Trusts	195	(2)
The advantages of a living trust	196	(1)
Transferring property into a living trust	196	(1)
Exploring Miller trusts	196	(1)
Making Choices for Medical Care	197	(2)
Advance directives and living wills	197	(1)
Healthcare proxies	198	(1)
Drawing Up a Will	199	(4)
Understanding the benefits of a will	199	(1)
Deciding if you need an attorney to make a will	200	(1)
Dying without a will	201	(1)
Making a will for an incompetent person	201	(2)
Chapter 14: Working through Financial Issues for Alzheimer's Patients	203	(24)
Reviewing Financial Needs and Resources	204	(3)
Comparing resources to needs	204	(1)
Projecting future costs	205	(1)
Managing paperwork	206	(1)
Reviewing your own financial needs and resources	207	(1)
Taking Over the Financial Reins	207	(2)
Understanding Changes in Tax Status	209	(1)
Deciding Whether You Need a Financial Advisor	210	(4)
Types of financial advisors	211	(2)
Cost issues	213	(1)
Quitting Work	214	(3)
Properly timing the departure	214	(2)
Sharing the diagnosis	216	(1)
Evaluating Insurance Coverage	217	(6)
Medicare	217	(4)
Medicaid	221	(1)
Medigap	221	(1)
Private insurance	222	(1)
Long-term care insurance	223	(1)
Help for veterans	223	(1)
Running Out of Resources: What Next?	223	(4)
Using permanent assets	224	(1)
Getting help from other family members	225	(1)
Getting help from your community	225	(2)
Chapter 15: Evaluating Care Options	227	(24)
Identifying Your Options	228	(3)
Respite Care Options	231	(11)
Caring for your loved one at home	231	(2)
Paid in-home care	233	(6)
Adult daycare	239	(3)
Making the Transition to Residential Care	242	(2)
Residential Care Options	244	(7)
Assisted living centers	245	(1)
Licensed residential care homes	246	(1)
Dedicated Alzheimer Care Centers	247	(1)
Nursing homes	248	(3)
Chapter 16: Caring for the Alzheimer's Patient	251	(32)
Making a Care Plan	252	(1)
Defining Practice Parameters and Standards of Care	253	(3)
Standards of Care	254	(1)
Practice Parameters	255	(1)
Putting Practice Parameters and Standards of Care to use	255	(1)
Standards of Care and Practice Parameters for AD Patients	256	(1)
Caring for AD Patients	257	(16)
Driving Miss AD Patient	258	(1)
Managing personal hygiene	259	(7)
Dealing with incontinence	266	(2)
Preventing bedsores	268	(2)
Nutritional challenges	270	(3)
Planning Activities and Exercise	273	(3)
Entertaining activities	273	(1)
Safe exercise options	274	(2)
Preparing for Bed	276	(1)
Making the House Safer	277	(3)
Patient proofing your home	277	(2)
Getting clutter out of the way	279	(1)
Considering remodeling	280	(1)
Dealing with the Patient's Emotions	280	(5)
Managing mood swings	281	(1)
Depression and Alzheimer's Disease	281	(2)
Part IV: Respite Care for the Caregiver	283	(50)
Chapter 17: Coping While Caregiving	285	(12)
Caregiving Is Hard Work	286	(1)
Caring for an AD Patient Affects You Emotionally	287	(5)
Dealing with negative emotions	287	(3)
Accepting altered relationships	290	(1)
Finding serenity	291	(1)
Caregiving and Your Physical Health	292	(2)
Taking care of yourself first	293	(1)
Fighting fatigue and illness	294	(1)
Using Humor to Cope	294	(1)
Knowing When to Ask for Help	295	(2)
Making a volunteer list	295	(1)
Getting help for abusive tendencies	296	(1)
Chapter 18: Finding Support	297	(8)
Finding Out What's Available	298	(4)
Formal support - enlisting the experts	298	(3)
Informal support - getting by with a little help from your friends	301	(1)
Looking into Support Groups	302	(2)
Finding a Counselor	304	(1)
Chapter 19: Taking Care of the Caregiver	305	(10)
Giving Yourself a Break	306	(2)
Turning off the guilt	306	(1)
Scheduling personal time	307	(1)
Being Good to Yourself	308	(3)
Treating yourself to a little pampering	308	(2)
Pampering yourself macho style!	310	(1)
Avoiding Isolation	311	(4)
Understanding why you really do need people	312	(2)
Keeping good friends around	314	(1)
Chapter 20: Handling Work and Family as Caregiver	315	(10)
Understanding the Importance of Routines	316	(1)
Juggling a Job and Caregiving Responsibilities	316	(5)
FMLA to the rescue	317	(1)
Throwing a rope: How employers help working caregivers	317	(2)
Grabbing the rope: Taking advantage of employee benefits for caregivers	319	(1)
Making a contingency plan	320	(1)
Balancing Family and Caregiving	321	(3)
Smoothing things over with the kids	321	(1)
Making a schedule	322	(1)
Being creative	322	(1)
Communicating	323	(1)
Making Time for Your Family	324	(1)
Chapter 21: Helping When You're Not the Primary Caregiver	325	(8)
Understanding How Family Dynamics Affect Caregiving Decisions	326	(3)
Staying in the loop	328	(1)
Getting together	328	(1)
Learning How to Help	329	(3)
Helping the primary caregiver	330	(1)
Offering financial assistance	331	(1)
Dealing with Out-of-Towner's Guilt	332	(1)
Part V: The Part of Tens	333	(12)
Chapter 22: Ten Tips for the Alzheimer's Caregiver	335	(4)
Good: Ask for Help	335	(1)
Bad: "I'd Rather Do It Myself"	336	(1)
Good: Modesty Garments	336	(1)
Bad: Birthday Suit	336	(1)
Good: Ask for Volunteer Assistance	337	(1)
Bad: "I Don't Need Help from Anyone"	337	(1)
Good: Cook Once, Eat Twice	337	(1)
Bad: Fast Food Bingo	337	(1)
Good: Remember to Laugh Daily	338	(1)
Bad: Wallow in Your Misery	338	(1)
Chapter 23: More Than Ten Internet Resources for Alzheimer's Caregivers	339	(6)
ADEAR (Alzheimer's Disease Education and Referral)	340	(1)
Administration on Aging	340	(1)
Alzheimer's Disease information	340	(1)
Eldercare Locator	341	(1)
Caregivers Guide	341	(1)
State Agencies on Aging	341	(1)
National Family Caregiver Support Program	341	(1)
AgeNet Eldercare Network	341	(1)
Alzheimer's Association	341	(1)
Alzheimer's Caregiver Support Online	342	(1)
The Alzheimer's Foundation of America	342	(1)
benefitscheckup.org	342	(1)
Caregiver.com	342	(1)
CareSsentials	343	(1)
Family Caregiver Alliance	343	(1)
The Leeza Gibbons Memory Foundation	343	(1)
Long-Distance Caregiving	343	(1)
National Family Caregivers Association	344	(1)
Needymeds.com	344	(1)
Medlineplus.gov	344	(1)
Index	345