In a workshop designed to help families open up and break the ice in discussing a challenging and uncomfortable topic, Chris Louie recently spoke on “Aging & Alzheimer’s”. Louie speaks on behalf of the Alzheimer’s Association Washington State Chapter in settings like local community centers.
Her conversations include: how/when to start a successful conversation with the patient, getting initial diagnosis or follow-up medical help, deciding when to approach driving concerns, and ensuring plans for finances and legal documents.
The workshop was directed to health care workers and family members. The philosophy being shared was one of inclusion. For example, Louie was adamant that family should not “gang up” on the patient by communicating with one another, as opposed to talking with the patient. “Develop a plan for using finesse,” she said, “along with journaling and logging notes that document life changes.” Talking sooner – not later was recommended. “Don’t wait for a crisis. The patients can become very sly; we have to become decoders of their conversation.” Choose a relaxed/comfortable time and setting for conversation and practice in advance. WSAA recommends, “Pair an enjoyable outing with the doctor’s visit.”
Regarding medical attention, it was noted that with Medicare there are free annual wellness visits and a brain scan is also free for those at age 71. Medical care is important because there are many treatable conditions that could cause mild cognitive impairment: tumors, supplements, urinary infections, dehydration, inactive medications, depression and disease. “You can’t battle when you don’t know what you’re battling,” Louie said while emphasizing that symptoms like urinary infections are not “felt” by older people. She said that symptoms prior to an actual Alzheimer’s diagnosis often occur ten years earlier.
Regarding use of one’s automobile during the years of Alzheimer’s, the terms “white lie” and “compassionate lying” floated around the audience when it was suggested that the family sell or keep the car out of sight of the patient. Decline in one’s eyesight, hearing, memory and other senses are normal signs of aging. Although they are not necessarily indicative of Alzheimer’s, they are still areas where care should be taken. A simple personal test for peripheral vision can predict a danger in changing highway lanes, parking, or entering a garage, for example. “Plan ahead, make a contract with the patient regarding the time to cease driving,” Louie advised while citing declamation of one’s life savings due to vehicle crashes. She shared a comical story of a male Alzheimer’s patient who purchased, one dozen at a time, side mirrors for his car. “Driving is tied to one’s independence more than everything else,” Louie said. “Be sure to log traffic accidents, scrapes on the car, mistakes while driving, being honked at.”
It was recommended that the family’s contract when determining to withdraw use of car should include: assigning designated driver duties; arranging alternate sources of transportation; assuming responsibility for taking patient to accomplish chores once a week; and arranging driving to a social activity once a week.
The Alzheimer’s and Aging Workshop had begun with statistics noting that there are 90 types of dementia and that 70% of dementias are diagnosed with Alzheimer’s. Today there are 107,000 Alzheimer’s and dementias impacting Medicare. By 2040, 700,000 will be impacting. The general public needs to begin dealing with stigma, anger and fear. It’s time to start talking the audience was told – break the ice.
