October 4, 2022 by John Fernandez
Alzheimer’s: What Caregivers, Family Members Need to Know
Alzheimer’s disease is a brain disorder that progressively destroys memory and thinking skills, leading to loss of the ability to carry on a conversation and respond to people and the environment. The primary known risk factor is increasing age, with the majority of people with Alzheimer’s being in their sixties and older.
Alzheimer’s, the most common cause of dementia, is ranked as the seventh leading cause of death in the U.S. June is Alzheimer’s and Brain Awareness Month.
“According to the Alzheimer’s Association, one in nine people, age 65 and older, have Alzheimer’s disease,” explains Jonathan Fialkow, M.D., chief population health officer for Baptist Health and chief of cardiology at Miami Cardiac & Vascular Institute. “The older we get, the higher our chances are to develop Alzheimer’s disease, which is why we all should be informed and aware of this life-altering disease.”
Dr. Fialkow hosted a Facebook LIVE panel discussion: Alzheimer’s: What Caregivers Need to Know. His guests: Keith Gibson, director of Diversity, Equity and Inclusion, Alzheimer’s Association; Gillian Generoso, M.D., internal medicine physician with Baptist Health Primary Care; and Khalid A. Hanafy, M.D., medical director of neurocritical care and research at Marcus Neuroscience Institute at Boca Raton Regional Hospital.
Mr. Gibson provided a personal testimony of his experience with his brother Ronnie, who died at the age of 54 from vascular dementia. He explains how getting a diagnosis was a challenge after his brother suffered a massive heart attack and a stroke at the same time. During his brother’s ongoing recovery, Mr. Gibson recalls the obstacles toward a diagnosis of vascular dementia, a condition involving a decline in thinking skills caused by reduced blood flow to various regions of the brain.
“I knew that my brother had changed,” Mr. Gibson said. “There was a difference in him. And I was talking to the attending physicians and said: ‘We need to have a complete workup regarding my brother.’ And they looked at me like I … had two sets of heads on my shoulders. So, it was a bit of a challenge for them to get referrals for the neurologist and to a neuropsychologist so that we could get to the probable diagnosis of vascular dementia. I can tell you that early on, I was not the best caregiver because I thought that once I got the diagnosis, then I could plan out his care. But that was not the case. It was a bit of a challenge. I had to do some adjustment in terms of how I was going to approach his care.”
Here are question-and-answer excerpts from the Facebook LIVE episode. (You can watch the full segment here).
Dr. Fialkow: What is Alzheimer’s … and what are the more common understood causes of Alzheimer’s?
“There are issues with memory thinking and how well you carry out activities of daily living. That being, if you forget where your keys are, that’s okay. And that’s part of what we probably all do many times per day. But if you forget your keys and they’re in the freezer, then that’s a problem because that means you actually placed your keys in the freezer and thought that was a normal place for them to be. Confusion about the day of the week or time of the day … these kinds of things are okay. And because everyone has a watch or phone, it’s very easy to get external re-enforcement about those things. But if you don’t know what month it is, what season it is, then these are problems”
Dr. Fialkow: As a primary care doctor, do you find that you will recognize early Alzheimer’s signs in patients? Or, more commonly, do people come to you saying I’m feeling X, Y, and Z, and then you pick up Alzheimer’s?
“Most typically, I see family members pointing out changes that they’ve seen in their loved one. And one of the first things that they’ll notice is their difficulty in forming new memories, recent memories, or problems with name recall. These are patients who have known so-and-so all their lives — and all of a sudden — they can’t name them. So, it’s changes like that. And then other times, there’s also a change in personality, just some subtle changes in personality or mood, and also judgment. So, for example, you may be leaving the stove on. Changes like that. The first step towards evaluation is to see the primary care doctor. And then typically, the office will do a cognitive test, just a short little cognitive test, and then maybe do some work-up with labs. That’s the initial step.”
Dr. Fialkow: For a caregiver, a family member, a loved one of someone who’s recently been diagnosed with Alzheimer’s, is there any particular advice you’d give the, as they’re learning this new reality of being involved with and giving care for someone who has Alzheimer’s?
“There are two pieces of advice that I would highly recommend. One is being open to being a change agent, being willing to change because your loved one has changed. Secondly, be a good manager. And, when I say manager — managing one’s emotion so that they can manage their loved one’s care. Also, be conscious of the fact that you will become a student of the disease. And it’s really up to you what type of student that you’ll become. You can be a good student, or you can be a bad student. The key to being a good student is that you’re willing to change. You’re willing to learn as much as you possibly can because this is going to help equip you as a caregiver to be a better manager, not just of care, but to also manage your emotions and also reach out to organizations like … the Alzheimer’s Association. We have a wonderful resource, which is our 1-800 number, 1-800-272-3900, which is staffed by master-level clinicians 24 hours a day.”