Archive for July 2012

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Alzheimer’s and Critial End-of-Life Healthcare Decisions

Saturday, July 28th, 2012

It’s important for everyone to execute healthcare advance directives. These include a living will, which documents a person’s desires related to end-of-life medical decisions, and a durable power of attorney, in which someone is appointed to make healthcare decisions if the person is no longer able to do so, due to either a physical condition or reduced mental capacity.

It’s especially important for people with Alzheimer’s to have these documents prepared, if they don’t already have them. This should be done early in the course of the illness when the person is still mentally competent to make such decisions.

When people with Alzheimer’s have not executed advance directives and are unable to make end-of-life healthcare decisions on their own, the caregiver will need to make the decisions for them. These include several different issues over time, such as the use of CPR, antibiotics, hospitalization, a ventilator, use of a feeding tube and, ultimately, engaging hospice care services.

For detailed information about each of these issues see my Huffington Post article, “Make Alzheimer’s End-of-Life Decisions Long Before They Are Needed.”

 

 

It May Not Be Alzheimer’s Afterall

Saturday, July 21st, 2012

Alzheimer’s often progresses so slowly that the person with the symptoms and their loved ones can be in denial for months or even years. That’s unfortunate because first, if it is Alzheimer’s, treatment works best if started early. Second, a small number of people showing signs of Alzheimer’s actually have something else, and some of those can be treated or even reversed.

Conditions that can masquerade as Alzheimer’s include things such as under-active thyroid, vitamin deficiencies (especially B-12), too much calcium in the blood, syphilis that has spread to the brain, severe clinical depression, delirium, certain viral or bacterial infections, lead and mercury poisoning, schizophrenia, and a rare condition called normal pressure hydrocephalus (NPH).

So if you or a loved one is having symptoms of Alzheimer’s, be sure to consult a physician. It just may turn out to be something else that can be partially or completely reversed.

 

What If It’s Alzheimer’s? Getting a Diagnosis

Wednesday, July 18th, 2012

It takes an average of 30 months from the time family members notice the first symptoms of dementia until the person is diagnosed with it. One of the principal reasons for this is that family members hesitate to take their loved one to a doctor, fearing that the diagnosis will in fact turn out to be Alzheimer’s. And the person with symptoms usually has the same fear.

Alzheimer’s is, above all, an insidious illness. It typically begins with very mild symptoms – things we all do from time to time, such as forgetting to turn off the stove, temporarily forgetting an acquaintance’s name, or misplacing the car keys. But for the person with dementia, these events will become more frequent, and with time more serious symptoms will appear.

No one wants to have a loved one diagnosed with Alzheimer’s. There’s nothing more painful and chilling than learning your loved one has dementia, but when the person is exhibiting symptoms of the illness an evaluation has to be conducted, and the sooner the better. Treatments are typically more successful when started early. Also, early diagnosis allows the person with dementia and the family to begin planning for what the future will bring.

 

 

 

 

 

 

 

 

Alzheimer’s and Grief: Anguish Over Multiple Losses

Saturday, July 14th, 2012

Death is typically a clear starting point for grief, and it’s clear that eventually there will be more or less an end to it. But with dementia, loss comes in bits and pieces and may drag on for many years before the loved one even dies.  It is understandable why people feel overwhelmed by the prospect of so many years of grieving. There are typically four types of grief associated with loving and caring for a person with Alzheimer’s:

1.    Grief Over the Loss of the “Previous Person:” When a loved one is showing clear signs of dementia, that person begins to fade away, resulting in feelings of loss and despair.

2.    Anticipatory Grief: Anticipatory grief is that which often occurs when one is expecting a person to die. It typically has the same symptoms as grief after any other death.

3.    Grief When the Person Finally Dies: Grief when a loved one with dementia dies can be more difficult than that for other types of death. One reason is because the caregiver has usually already been grieving the loss of the person for years.

4.    Complicated Grief: Complicated grief, also referred to as unresolved grief, is that which does not lessen with time, or is so intense it significantly interferes with one’s life. Complicated grief usually requires professional help from a physician and/or psychotherapist.

Come Back Early Today Is a Finalist in Still Another Competition

Wednesday, July 11th, 2012

I just found out that Come Back Early Today has been named a finalist in the Readers Favorite Awards. Final winners will be announced at the beginning of September. This makes a total of five “finalist” and “honorable mentions” for the book.

It was a finalist for the Santa Fe Writers Project Literary Awards and the Eric Hoffer First Horizon Awards (for new authors). Then two stories from the book were given honorable mention in the 2012 Writers-Editors Network International Competition. The first story was “The Little Yellow One,” about me giving Ed the little chick and so many other stuffed animals. The second story was “Please Wear a Tux,” about the violinist I had come play a special concert in his room at the nursing home.

Cross your fingers. I have a good feeling that I may just win the Readers Favorites Award in the memoir category!

 

 

I’m Planning a New Book

Sunday, July 8th, 2012

I think I have accidentally written a second book. I realized a few months ago that I’ve published over 50 articles online at the Huffington Post, The Alzheimer’s Reading Room and other sites, and that I could put them all together to come up with some sort of caregiver manual.

I have found a marvelous editor – Marjorie Rentz, MSW, who is with the Greater Cincinnati Chapter of the Alzheimer’s Association. Marjorie was my on-line caregiving coach when Ed had Alzheimer’s and we’ve stayed in touch. With her background in social work and all of her experience with Alzheimer’s disease, I couldn’t have found a better editor for my new book.

We’re just in the early stages of work. It’s going to be awhile before it’s out, but when we get closer to publication I’ll have a place on this website where you can pre-order copies.

Breaking the News When It’s Alzheimer’s

Thursday, July 5th, 2012

Why Informing Others Is Important: When a person is diagnosed with Alzheimer’s it may be difficult to decide whether to make the diagnosis public, but there are many advantages to doing so. One is that it will help others be more understanding and compassionate with the diagnosed person. Perhaps one of the most important reasons to go public is that it enables the patient and the caregiver to receive understanding and emotional support.

Who Should Make the Decision: When people with Alzheimer’s are still able to participate in the discussion, it should ultimately be their call. If they can no longer make such decisions then it’s up to the spouse, children or other close relative to decide what to do.

Whom to Inform: At a minimum, immediate family members, including teens and younger children, should be told about the diagnosis. It’s also helpful to let close friends know what’s going on. In addition, you may want to let neighbors and more casual acquaintances know about the diagnosis.

How to Let People Know:  There are several ways to communicate to others that you or a loved one has been diagnosed with Alzheimer’s. First you need to decide who will announce the news – the patient, a family member, or close friend. Respect the patient’s desires in this matter if possible. The announcement may be made at a family meeting or you may want to inform people individually by phone or in person. Sometimes sending out a letter can be helpful because it gives people time to digest the news before talking with you about it. This avoids putting them on the spot.

If You Decide to Keep It Confidential: You have the right, of course, to keep the diagnosis confidential, but realize this can sometimes lead to stress for everyone involved. It prevents both the patient and the caregiver from getting much-needed support from friends and family members.

Conclusion: Informing people that you or a loved one has been diagnosed with Alzheimer’s can be painful and exceedingly difficult, but in most cases it’s the best course of action.

A Valuable Resource: The Website of Bill Hammond, Elder Law Attorney

Sunday, July 1st, 2012

Bill Hammond is the founder of the Kansas Elder & Disability Law Firm in Overland Park, Kansas. His website, www.kcelderlaw.com, has a wealth of valuable resources for Alzheimer’s caregivers.

  • A free guide, “How to Deal With Alzheimer’s at Any Stage Even if You Are Low on Funds or Don’t Know Where to Begin”
  • Another lengthy and very detailed free publication, “The Alzheimer’s Legal Survival Action Guide”
  • Videos on various Alzheimer’s legal issues
  • A blog on relevant legal issues

When you sign up to get the free guides you’ll have to give your email address and Bill will send you valuable frequent emails about legal issues. (You can opt out at any time.)

These items are packed with excellent information, but before taking any actual legal action consult a local attorney because laws vary from state to state.