Working With Your Physician
How does your physician know if it is Alzheimer's disease?
There is no single test that can diagnose Alzheimer's disease. However, trained physicians are 80%-90% accurate. Your physician needs to do a full assessment that includes:
- An accurate medical and psychiatric history
- A neurological/physical exam
- Lab tests to rule out anemia, vitamin deficiencies, and conditions
- An evaluation of the person's ability to do common daily activities such as managing finances and medications
- A mental status exam to evaluate the person's thinking and memory
- A caregiver interview
Your physician may also request a brain scan, psychological testing, and additional lab work if he/she needs additional information.
How can you help your physician?
You can be prepared for the appointment by bringing a list of medications, a log of symptoms or behavior changes and a list of questions or concerns. It is also helpful to provide an accurate history of the person's medical conditions and any previous psychiatric treatment.
What can your physician do if the diagnosis is Alzheimer's disease?
Although there is no cure for Alzheimer's disease, there are ways to treat some of the symptoms of the disease. Your physician may suggest:
- Use of medications to treat cognitive decline and memory loss
- Referral to appropriate activities such as exercise, recreation and adult day care services
- Appropriate treatment of medical or psychological conditions that may contribute or cognitive changes to decline
What can be done for behavioral problems?
At times, a person with a dementing illness may display behavior problems such as wandering, paranoia, suspiciousness, combativeness or resistance to maintaining personal hygiene. These behavioral problems can seem overwhelming to the caregiver. The physician may suggest various strategies to assist in daily caregiving tasks, such as:
- Enrollment in the Alzheimer's Association's Safe Return Program, an identification program for memory-impaired adults
- Modifying the person's environment in order to reduce confusion caused by over-stimulation, such as reducing noise and glare from windows
- Explaining a task before you do it, such as saying, "I am going to help you put on your shirt".
- Providing a predictable routine at home with structured times for meals, bathing, exercise, and bedtime
- Providing reassurance to the confused patient without challenging their accusations or misperceptions and by reading their attention
How can the physician help you plan for the future?
The physician may suggest you start planning for health care needs now by completing an advance directive. An advance directive is a legal document that a patient signs while capable of making sound decisions. It directs how healthcare treatment will be made in the event of future incapacity. There are two parts of California Advance Healthcare Directives:
- The Durable power of Attorney for Health Care designates an individual who can make health care decisions on behalf of the impaired person if he or she is not able to give medical consent.
- The Health Care Instruction conveys a person's desires regarding end of life care and, if requested, an instruction that the person not be kept alive by artificial means. (This document is similar to a "living will," which is not legally binding).
All hospitals and health facilities should have advanced directives for patients to complete. The California Medical Association also has Advance Directive forms.
A person who may lose capacity should also consider legal and financial planning including wills, living trusts, and powers of attorney for finances. Consult an estate planning or Elder Law attorney for assistance.
How can your physician support you?
Often persons with AD and their families have questions regarding the disease, legal and financial planning, community resources (i.e. home care, adult day care, respite services) and available support. The physician may refer you to organizations such as: