The Letter A is for Alzheimer’s

            Having just gotten my students’ grades in the mail to them in the time-honored fashion (on postcards stamped and addressed or, if they prefer privacy from their mail carrier, postcards enclosed in envelopes), I am back to share more of the letter that came after Mom’s assessment at UC Davis Neurology Center—the test that she had thought she’d aced.

Although I believe that the diagnosis of Alzheimer’s disease is accurate, problems such as syphilis or vitamin B 12 deficiency can also cause cognitive problems or make symptoms of dementia worse.  I recommend that you and Dr. Johnson discuss blood tests for RPR and vitamin B 12 levels.

Alzheimer’s disease progressively worsens, and there is presently no treatment to cure this illness.  In most cases the progression occurs over many years, but the rate of this change is quite variable from person to person and prediction of the rate of change is impossible in any given case.  However, it is important to plan that your mother will eventually need more assistance with day-to-day tasks.  This is one of the most important guiding principles underlying the management and decisions which you now face.

While Alzheimer’s disease is not curable, there are many adjustments which can be made to improve the quality of life for both you and your mother.  First and foremost is the importance of recognizing that this is an illness which affects the family, and especially the caregiver.  Therefore, it is important for you to make decisions based not only upon her welfare, but also based on your own physical and mental well-being. The ability to acknowledge your own needs, as well as those of your mother, is important in assuring that you will be able to continue to care for her in whatever way is best for both of you.

Although I do not think your mother requires continuous supervision, she may need this in the near future. 

In general, we discourage caregivers from attempting to accomplish all of the care of their own.  Some options to consider include:  1) Dividing the necessary supervision with other family members or friends.  2)  Hiring in-home help, such as a companion, homemaker or home health aide to assist with supervision and/or personal care.  3)  An adult day care program, to which your mother is taken for several hours a day.  It was our feeling that she might benefit from an adult day care program designed for people with memory loss.  The socialization, structured activity and light exercise provided by these programs often has a beneficial effect.  Although people may resist attending at first, most eventually enjoy these programs a great deal.  4)  Having your mother move to a residence where this kind of care could be provided.  Board and Care homes provide room and board, supervision, and, depending on the home, some reminders and help with dressing an bathing, medication monitoring, and activities.  The supervision and help that these homes provide varies greatly, so that each board and care facility which you may consider must be investigated carefully.

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