WWL>Topics>>11-26 2:10pm Angela, recognizing Alzheimers

11-26 2:10pm Angela, recognizing Alzheimers

Nov 26, 2013|

How do you know if it’s simply forgetfulness or if it’s the onset of dementia or even worse--Alzheimer’s? We’ll talk to experts about the 10 warning signs for Alzheimer’s…a disease that some 5 million people are living with…and surprisingly is the 6th leading cause of death in the U.S.. (Our guests: Chet Harrell, Regional Area Director of the Alzheimer’s Association, Lisa Rabito, owner of Home Instead Senior Care and Dr. Charles Cefalu, Chief of Geriatric Medicine at LSU Health Sciences Center.

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Automatically Generated Transcript (may not be 100% accurate)

Here's the good news we're living longer. And here's the bad news the longer we -- the better chance we have of getting alzheimer's disease. One in eight people over the age of 65 hasn't. And nearly half of those over the age of 85. Have alzheimer's. What is that who gets it. And what can we do with anything and not kept. These are the questions we're asking our guest today people who are intimately involved in this disease and the people that affects. -- Harold is the state director of the Alzheimer's Association. Lisa Rubino is the owner of the local office of home instead senior care. A service that provides caregivers so clients can remain in their homes for as long as possible. And doctor Charles -- director of L issues Health Science Center. -- center of geriatric medicine he is professor and chief of geriatrics and -- issue I appreciate all of you being here. And and not just because I'm sure I'm aging but I think I've always had a fear. Of losing memory. And and now knowing people who have and seeing the effects it has on families is very devastating. So we have a lot to talk about and let's start with doctor -- About what alzheimer's is and what it's not. While alzheimer's. Column is not on a normal part of aging as we now. Alzheimer's. Clinically. Begins first with though we -- recent memory -- and has this disease progresses it then the memory loss. Becomes worse of course and it begins to affect a person's ability. To do what we call instrumental activities of daily living which is. Chores housekeeping. Arranging transportation news in the telephone. Even cooking. As the disease worsens the memory loss begins to to speed up. With the development of behaviors. Wondering. And then the ability to bathe dress in grown become impaired. Path -- physiologically. Alzheimer's disease. Has to some extent. And inherited a -- but only a small people group of people. Usually of a younger age. What we normally see with alzheimer's. In on what we call. These -- to February tangles and amyloid deposits. Where there's a lot of research going on to determine. The cause and effect you know I know what can enforce the inflammation come first to cause amyloid deposits. General from Larry tangles. And chemically there seems to be a decline in what we call. Sitio -- -- and asked him calling nasty race which promote. Prompt memory from one synapse and on -- to the other. So. It is a disease that progresses. Over time. From. Early memory loss to. Two to emote and past memory loss and then decline in function as engines at what is the difference between that and tan. Dementia. Who okay arm. Dementia if you were to take. Let's say a eight. Ground down. And then say that is a 100%. Then if you cut out fifty to 65%. Of that that's going to be alzheimer's alzheimer's is a type of dimension. Other types of dementia though. Are those related to multi -- causes which is really. That third leading cause. And second leading cause is to combine form of alzheimer's with -- and -- Malta and talk to the -- -- is typically associated with a long standing history. Among controlled hypertension diabetes. Hyper cholesterol green -- And the like. And then you have a smidgen. Other dimensions and a very very rare. Where it would be appropriate. If it doesn't fit the classic definition of alzheimer's -- vascular dementia. That they see a neurologist. Who have the proper diagnosis because there are. Very rare forms. Of dementia such as super nuclear policy. Normal pressure hide yourself from us. Metabolic dementia is. And there's even now what we called cognitive dysfunction which is related to some medications so it's very important. That before you call a person. Having dementia that you look at their medications because in the -- stages. It may be a certain medication that's inappropriate in the elderly. That's contributing a memory loss whereas when it's removed. The memory. A clear I guess what I'm saying is. Is there anything we can do to prevent alzheimer's. Not really you're shaking your head as well that the dimension then you just mentioned about. If you have high blood pressure high cholesterol diabetes those things ultimately you can control if you fight fight fight. You can't control those. If if your blood pressure and diabetes and cholesterol well control I would say you can't prevent it. What can you do to prevent both -- and farm dementia and alzheimer's. Is to eat right. I would say a Mediterranean diet with a lot of -- by the way. And fruits and vegetables. To get regular physical exercise most days of the week for at least started at 45 minutes. And two remain active socially. And read. Perform on word puzzles on the light to keep your brain stimulated. So. You know. The things that can be done to prevent it so you don't just sit in front of the TV or computer screen. -- things exact talking about keep the mind. Very very sharp right reading in the -- the subject is alzheimer's and certainly if you had a family member or had a friend that's gone through which you know. How very very sad it is please feel free calls anytime to 6017. They talk about better to talk to the experts we have here. Chad Carroll who is the did I say that wrong yes check Carol. State director of the Alzheimer's Association. Lisa we're veto is the owner of the local office of home instead senior care. And we just heard from doctor Charles -- who's professor in chief of geriatrics. At the LSU Health Science Center. As as doctor -- Lou was saying. There are couple things we can do to try to prevent and that of course is what we know we should be doing on many levels which is eating correctly. And out and exercising and keeping our mind -- Just really. Focusing on things to keep the mind going. But the -- have you checked and Lisa work with people who have this disease and I would just like you to talk about things you've witnessed. And well as doctor sample -- -- -- to Cephalon mentioned. You know focus on the medical aspects of it. We would we do is we focus on the behavioral aspects you know you have the the one piece is that the physical. That -- along with that comes engaging the mind and also managing the typical behaviors and that's what we see with around client base. I'm the King Family caregivers can get variable around as you can imagine. On the date they are filled with anger with frustration with fear with anxiety they don't know how their loved one is going to wake up that morning. You know what kind of day it's going to be. So we have a couple of that. -- main areas that we focus on with our family caregivers in the first one is education. In the second when his caring for himself. The first part of education is learning how to. -- as I said -- difficult -- that's the crux of everything but let's say big an example would be somebody wakes up and that anger is there. Yes how -- two people handled it well there's it is a few things we can do with that government that we first of all. One of the things that we tell our family caregivers is never ever argue. On another thing is Q&A a one waited ten alleviate that is to redirect them. Distract them from. Another is to take the blame this is this is the end if they say. Somebody so much -- and you know somebody did not steal their -- they may have just misplaced it somewhere. Just take the plane to say you know -- I did I guarded I just wanted to see you have something in there that I needed but I put it back it's fine everything's good now so. Again arguing with them can only frustrate them more. Given simple choices is not is another -- thing for them you know -- if it's cold outside and they. They just don't wanna get -- there they just very argumentative that day -- they just you know they refuse to contrast. Don't say would you like to -- say mom until like the red by the green sweater today. Don't overwhelm them with the choices. -- again if it's something that's causing him frustration if it's an I -- him or something if -- TV and something is over stimulating them. Turn the TV off just remove the item from the environment -- -- a lot of different ways that we can manage these these. Behaviors again I think for the majority of us who have not lived with somebody with alzheimer's we think in terms of the loss of memory. And how very frustrating that must be on many levels. But the thing -- talking about or other things on. Please jump in and say yes this is part of what else congress'. Yes. -- wouldn't raise the especially in the severe stages. As Lisa says. The behavior problems become Paramount. Very Paramount. Even wandering. Which cannot be treated with medications and the use of medications to treat these behaviors can actually. Have adverse effects and are actually off label drugs. So. Reacting in a positive fashion to that patient. And as you just said would you like to Wear green and red. Rather than you know another question that would be more provocative. And also in the severe stages. What they see. They typically have a -- -- this year difficulty carrying out tasks and difficulty recognizing objects so. A very. Vivid colors come in and around. -- down can be misinterpreted as a monster and they react negative totally. And it's simply to say OK everything's okay yes you're correct that's right why don't we go sit over here. But it can be very frustrating for the caregiver. And that's why I think adult day care as a wonderful option. -- when it's available for the caregiver because the caregivers health. Is most important because they get depressed yes they get depressed and they need that outlet at least eight hours a day either that go to work go to shop. And it also helps you alzheimer's patient stay on the right sleep wake cycle comes with -- alzheimer's. There's a sleep wake cycle that is disrupted -- where they sleep during the day and there are up at night and that we'll grab the caregiver to put him in -- nursing -- And there are various things and certainly your company who comes in to the home and is giving relief to the caregiver. But are their daycare centers -- yes they're -- sinners there's also -- time facilities that are available on nestled into details farmers association. Is that we provide a new resource. Options that they can -- them. Com its importance in that you know depending on on they are. Mom do while on the patient's needs which will be the best option for them. Mom it's that as -- as that as both have communicated its is -- -- ten signs is actually ten signs that some of the things you should look form whenever playing let's go over diagnosis. On. I don't had to implement few that if they might have been as what was mentioned about. Just the confusion. There have been major confusion and the anger or. Our memories and -- loss of memory loss disrupts your daily life I play. And so people say well but let's talk about that because I know a lot of people I work with a lot of people -- no object couldn't remember that's different. That is different and that's a huge thing an evil even saying not to be unkind but you could not be getting alzheimer's. Because all of a sudden you can't remember it ultimately comes back to you. Where with the person just not right. Is a matter of fact. The person who complains of memory loss is more than likely not likely now -- it's probably even anxiety anxiety depression. The person who has alzheimer's is not -- volunteer that information. They're not gonna walk into the doctor's office -- gonna have to be taken in by the caregiver. And then again and deny it and as a matter of fact that then -- consent amend their depressive stages well. Which is also something that needs to be treated if it if it is suspected. -- And it's a good friend of mine told me a while ago at the difference between forgetting things -- you know how many times -- he misplaced your keys meanwhile liked. All the time. Well the difference with with just you know normal miss placing things -- is you know waited Allen keys as to oh my gosh what are these these are -- what would like you with keys. That's what advice you have for a work that's a different part of the net -- getting up and going somewhere and then forgetting which you've got to go for those types of things and getting. Lost. Getting lost but it's almost as if in our society today we are in complete overload. With all the best technology -- senator senator and so sometimes. You and we try to multitask all the time and so it's. Are we overloading our mind. And so yes I went to that room but I was really going the room to do three things that I did want -- unnoticed in -- for something else right. The tricks the -- the brain more -- right out of. At about them -- plays tremendous amount tricks on me that you absolutely. And that and that's why I mean. We always I'm a great resources to go to our web -- Debbie -- that they don't sit -- -- And on that -- the tens lines as they are it if you have any questions that she's. That you really well look for a specifically. And there's that's a great resource and then also calling. Our local office and also are 20% and help line. There's people can probably tell you on. Maybe sit on -- and you make a recommendation -- One of the things those challenges in planning -- solving problems especially if it was somebody who was a problem solver. Who was always known that and all of a sudden sees that slipping right and you think cheap that's not like him or her. We also have a -- and I think she has an interest in store Margaret. Yes I want and pat -- the -- that won't mind that if he got he had three credit card by the -- -- and charged up a whole bunch of bill. Then what is the difference between me and taking care of women in -- secondary in a minute you know when you're in the caregiver. That violent about how people go that they get biting back and you really don't know how to control all the things. You really need to get a good nurse practitioner -- help -- they get anything. But it's really a desperate situation out there and caregivers -- -- just that's you mean like Thanksgiving was spent by myself because you cannot get better. Our holidays or weekends are and I -- the -- in thirty years because you can't get better at responding. So anyway I'm excited that you're talking about that today. Well bless your heart in. If we cobol code that took the the three credit card C and you didn't know about it -- and you start getting the bills and. -- I had like two exits my business account. A piece that I there's no money in the business account. Well I can't pay I can't pay bills while he was writing bills -- that into account how about how old account but I don't think I was. And there's plenty of money and that didn't account all am I going to do you start charging. Groceries on a charge card what good heavens we would've never again. All of these things get out of hand and you don't pay attention to watch you know and I did not quite so busy working I didn't pay attention. The guys that's. Particularly difficult problem that you were there. To catch it unfortunately they. But what is really tragic is the senior who is living alone. And has family eleven out of state. And someone comes to the -- And instead of writing a check 400 dollars for cleaning the owner she writes a check 4000. Or 2000. And there's people out there I don't see any -- And they get away with -- and just continues on and on until. They relative. Comes up then finds out that the her accounts this is. Is gone. It's depleted and so. Done the one that's so long it's living alone when there's no monitoring like it is really in trouble. And that could be the first sign of something going man. And -- what you're saying is. The patients. Him or herself doesn't want to admit there's an issue right so just going to the doctor generally she's gonna hide that right and and unless somebody finds out right. And also. A memo. That. In the early stages. These people may be able to function. In their house. But they cannot handle finances so finances. Telephone news housekeeping chores. Arranging transportation of the first things that go at a higher level. Before it begins to impact their basic function and finances is something that's very deadly. We hear a lot of -- studies in Florida. About seniors living there and their relatives live and up north and for instance you know I'm. The I'm asking a person that -- groceries. And so the person though that some groceries and they puts a set of groceries for himself in the trunk of the car and delivers a set in the house and the school's own on and on knowing. Until we know there in the house financial resources are depleted and I. Tea -- a million stories like that and that is the heartbreak we have a caller from Gulfport Janet. -- that news. I'm calling out with a quick question I get -- the child of an elderly. Parent and I have seen in the last month. A lot of differences in behavior and been on the computer read that characteristic of alzheimer's. And my mother is presenting lit. Pretty much all of them. And unfortunately. Trying to talk to. My dad he isn't and I -- to protect -- he doesn't want anything about it I would like to know it's getting to the point where. It. You know not only I think my dad thought of getting open in Indian he's -- and be able to cope with it. But. How elliptical lifted for our child to call the position. And just conveyed the concerns that perhaps the next time that she goes into the doctor. He may take a closer look at some of her. Skill levels embarking. On her. Yeah very very good question. But I think. I wouldn't be that concerned about the ethical issue. I would look at it from the standpoint of concern. Four year relative. -- and that year expressing to the physicians something. Then otherwise. He would not know about. And that's very important that he or she. Know that. And so I would worry about the ethical issue. Related to that you know -- your mother had any test or anything like that or. That I have my understanding is that the position mentioned that to my dad -- its game after inquired about her memory for short term memory and -- and she could take months ago. And my dad kind of pressed to not think that bill but don't we all kind of -- some of our memory as we get older. And since then I haven't heard anything where he expressed any concerns and on top of that. He is also declining. With some short term memory but not in the same way so. It's kind of like a situation where. You kind of sit back and you wonder you know when that you acting and how much do you wait in respect of you know beer. You know their individuality and there independent. Is there a an exam that could be given. That would -- show not only the mother but the father this is an issue that we need to address yes yes there is yes -- -- There's several examinations. One of pharmacy you know. Thirty point many mental status exam. Which. Take some time to administer however. Are simply throwing on the clock. With at 3 o'clock. A simple clock with the the lord's hand at twelve in the short -- at the rate is pretty sensitive and specific. For our cognitive difficulties. And you can go a step further with what we call them mini car. The mini card is a combination of the clock drawing test. And at three item Rico and the three item recall. He simply. Asked them to say ball flight -- three -- three other things. And then you carry on the conversation and after complement -- -- say below where those three things I ask you to remember. And if they have problems with one -- two down. And the clock drawing testers abnormal they are definitely the method and you can do that test and two minutes so it's called the many cock. Test which combines the clock telling test and the three item recall if that's abnormal then they need a formal evaluation. And then with -- with with your situation with your father I would it's just that. Just explaining to them that having an early diagnoses. And getting it kindness. We'll open up a lot of information and resources and and and maybe even recommendations. By the doctor are on on the -- and handle those very good point. In this initiating -- and any man she needs to -- I really appreciate you calling in Japan it. Thank you very much appreciate the advice and information. Well as. And -- my generation and her generation she's probably younger we are taking care of her parents. And need to be alert to all kinds of things and I'm glad to know something that simple you can make it -- game let's Mecca clock. Deceive and it's about now everybody is listening to them to do that three -- thing you know that -- -- by the time everybody has dinner there and do the three words but. These are important things right. Absolutely. Not it's just we were talking earlier and again. Certainly somebody's living alone but even if they're not living alone leaving mr. Obama leaving a candle burning thing should not even thinking about. That could be devastating. Sure. You know there's one other thing I'd want to mention to that caller to and that is. Before I would ever consider anybody demand that. I haven't alzheimer's I wanna look at their drug blessed. Especially for its early. Because there's a group of peers called. A group of drugs called de -- list of inappropriate drugs in the elderly and it's published by the American geriatrics society. And I also want concern. And evaluate them put depression because depression can be the great masquerade there. Dementia and so. Simple depression can cause cognitive dysfunction and if it is traded and this is in the early stages of cognitive dysfunction and you notice I didn't say dementia because that -- -- personality. Than treating the depression may resolve. The memory problems. However depression. Is back and say one other thing may also. Be the precursor to the development dimension as well. That is very very. Very interesting and very important about the drugs my my mother who died a year and a half ago one Christmas a few christmases ago we went out and she was on 26 different drugs. And thank -- I'm married to a physician we sat down. And that -- sent there for three hours and block it out we call that doctor and suburban to be here 48 hours. When can we meet with the got down to six. For 26 to six if it happens like that -- -- and you just have to be still on top of that all the time it's very very frightening the caller marry you had a question. Yes. My question is. Wouldn't put the genetic relationship with this and that -- -- -- this is because the 1996. I lost my mother to alzheimer's than in 1997. I -- my diet alzheimer's. Can't -- -- now is that my mother's father has that quality you're crippling panic. And there have -- that hail that fell on -- generations. With all content -- -- both. Put generations on one side but it's on both sides of my dream like. Doctor Cephalon. Well. You have to look at the -- factors. Normal wind as Angela said his age. I don't know the ages of your grandparents died at age 8080 Fabrice a 50% chance even if there's no genetic component to it. To answer your question. -- -- -- at about seventy years so much bad shot started showing him about the same. OK so that's probably not. It may be it's hard to say but there is a genetic predisposition. On the April before. And other chains. Which is a principal. -- it carries alzheimer's disease. Of course you know on biopsies. Aren't blood test. A person can get alzheimer's and have the eight -- I'm sorry the apo. On the other hand a person can get alzheimer's and not have the capability forward. -- and so -- com. I would say. The biggest group of people with genetic risk are going to be. Families. In much smaller group of people say maybe one to 35%. Of the population. I'm gonna have that genetic risk. Where they're going to pass -- on for mourns him into another. But again -- April before genius the wind. And there's several other genes as well but there's no guarantee. Just because you have that change -- gonna get alzheimer's. And you can have it and not get it too soon. We're gonna have to wrap this up as much as I've thoroughly enjoyed everything we've been saying but the final thought is. Christmas is coming up kids are gonna be around pay attention paid attention and -- -- to look at your parents' finances in and you know just kind of getting insulin when they are non aspects of their lives and the Alzheimer's Association is a great resource. Absolutely -- -- it -- Oregon arm if you blunt if miss on the way. Our dollar are on Tony for -- and help line at 1802723900. I think each and every one of you for being with us today.