By Kristine Dwyer, Staff Writer
Delay of Diagnosis:
Amazingly enough, there is a significant percentage
of caregivers who are told, upon bringing their
spouse or relative to the physician, that their
decline is due to “normal aging.” We now know that
dementia is not a normal part of the aging
process.It is strongly recommended that persons
experiencing any dementia-type symptoms should
undergo diagnostic testing as soon as possible. A
delay in diagnosis allows for a missed opportunity
for treating the patient and also increases the
chances for other problems and demands to multiply
for the caregiver. For example, since AD affects
memory, patients are at risk of not complying with
the treatments that are necessary for problems such
as diabetes, high blood pressure, mental health
disorders and infections. A health crisis can then
develop, compound the effects of dementia and lead
to emergency care or hospitalization.
Caregivers may initially hesitate to bring a loved
one with dementia to the physician. Researchers at
the University of Portland found that it takes an
average of 30 months from the time family members
notice the first changes and symptoms of dementia
for the person to be diagnosed with AD. Reasons
cited by caregivers were: lack of knowledge about
AD, they did not imagine that the changing behavior
was part of an illness, they were unsure what type
of doctor to see or how to describe symptoms, they
felt overwhelmed with the burden of caregiving or
they feared that the illness was truly AD. Many
caregivers have reported that prior to the
diagnosis, they were nearly overcome with anxiety as
they watched their loved one deteriorate. Once the
diagnosis was made, they felt a great sense of
relief and were finally able to name the disease and
move forward toward a plan of care.
There are several other reasons that contribute to a
delayed diagnosis of AD. Early symptoms are often
disregarded, mistakenly attributed to aging or even
misdiagnosed. Sometimes people with dementia are
unwilling to have their mental abilities evaluated,
are defensive, or in denial of the changes that are
occurring in their lives. Physicians may not feel
comfortable dealing with memory loss issues, may not
be trained to administer cognitive tests or are
reluctant to place a patient in an uncomfortable
testing situation. Patients with high intelligence
may be able to score above average on screening
tests (despite cognitive decline) and compensate for
or even mask their symptoms during the office
examination, thus leaving the physician without
sufficient evidence to provide a diagnosis. This is
the point where caregivers play an important role
and can provide the most valuable data to support
the possible diagnosis of Alzheimer’s disease.
Treatments and Medication Benefits:
Although there is no cure for AD, new and improved
treatments are on the horizon and offer hope. Most
health professionals feel that the best plan of
treatment includes a combination of medication,
changes in lifestyle and support, along with a goal
of managing symptoms that affect memory, thinking
and behavior. The regional director of the
Alzheimer’s Association of Minnesota-North Dakota
points out that there is a growing interest in the
use of non-medical interventions that may be
effective on their own or used in combination with
medications. These interventions may include memory
and communication aids, speech therapy, behavioral
therapies, memory stimulation therapy, exercise,
adequate sleep and education. The environment also
strongly influences the health and capabilities of
persons with AD; thus, it is important for
caregivers to pay attention to safety factors,
reduce stimuli and adjust the surroundings to
accommodate the disease.
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