mild cognitive impairment

Baby steps towards Alzheimer’s diagnosis

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Amyloid Scanning Protocols Fail to Get the Nod from CMS.

I like the above article and every single article that mentions some sort of steps moving towards diagnosis and treatment, even steps that are stunted right out of the block.

Stillness gets us no where.  Although limited, at least this article discusses some progress towards shutting down Alzheimer’s and other dementias.  During a time where very little good news is forthcoming relating to this disease, I’ll take anything – thank you very much.

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Medications: harbinger of cognitive decline?

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Why can’t I remember how to use this can opener?

English: A modern-type can opener.
(Photo credit: Wikipedia)

How in the world did I get lost driving to the supermarket – a route I drive at least once a week!

My words are getting all jumbled up and my sentences aren’t making sense.

What’s happening to me?

Are you one of the many people who started to take a medication to resolve a condition, or at least to make it better, only to end up with distressing – and life-changing – mild cognitive impairment?

How long did it take for you and your doctor to realize that this horrific change of condition was caused by a medication that was added to your health regimen?

What types of expensive, and grueling, tests did you go through prior to coming to that conclusion?  Did any of you go through neurological testing?

And how long did it take for you to feel “normal” again once you took your doctor’s advice to either go off the medication or replace it with a medication that did not cause cognitive decline?

I am personally aware of several people who experienced cognitive decline after taking the Pfizer drug, Lyrica (pregabalin).  This drug was originally intended for treatment of neuropathic pain and as an anti-seizure medication, but was approved for treatment of fibromyalgia in 2007.  Additionally, cholesterol-lowering  statin medications oftentimes cause the same cognitive outcomes.  And with the Pfizer drug Lyrica, increased depression – even suicide or newly diagnosed depression – were directly linked to this drug.

As Baby Boomers, we’re entering a phase where, depending upon what ails us, we start adding prescription medications to our health regimen in an attempt to have a high degree of health and well-being.

We need to be completely aware of how a medication may affect us, but it’s unfortunate that most of our awareness is dependent upon the Patient Information Sheet provided by the pharmaceutical companies.  These information sheets are sketchy, at best, and carry only half-truths, at worse.

Do you have similar experiences you can share?  We’d like to hear from you because awareness, and education, will help us all.

Communication Tips from Individuals with Memory Loss Alzheimers Reading Room

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Communication Tips from Individuals with Memory Loss Alzheimers Reading Room.

It’s not often that we have the privilege of hearing from someone who has dementia, providing us who don’t have dementia, with some caregiving tips.  Please take the time to listen to this person’s voice.

Adjustment disorder: a long-term care facility side-effect.

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Duct-tape Moving Van

Think of a moving/relocating experience you’ve had with all of its inherent tasks of purging of items, packing what remains, and leaving all that is familiar as you move into uncharted territory.  In your new neighborhood you’re starting all over again to find: new friends;  a new supermarket with the best deals; perhaps the best school(s) for your children; a new church; and new ties to the community.  Not exactly an enjoyable experience.  It took you some time to adjust to your new community and feel that you fit in, didn’t it?

Now imagine doing the same thing as someone who is at least 70 years old with failing health, no family nearby, and perhaps with a compromised cognition level.  Vulnerable adults move into a long-term care (LTC) housing environment because of a condition, or combination of conditions, that make living independently no longer an optionBecause of this disruptive move, another disorder – adjustment disorder – makes their move a perilous one.

A loss of context in a new environment.  In my work as an advocate for vulnerable adults, I had the privilege of hearing a wonderful speaker, George Dicks.  At the time, Mr. Dicks supervised the Geriatric Psychiatry Service clinic at Harborview Medical Center in Seattle, WA.  He was also a contracted instructor for the University of Washington, teaching courses on Gerontology, Psychiatric Consultation, and Mental Health.  He emphasized that residents living in nursing homes and assisted living facilities struggle to look for context within their new environment.  For example, context is hard to come by when your daily bath occurs at 2:00 in the afternoon instead of in the morning or evening as was the case prior to the move.  And forget about finding comfort in routine because the demands on LTC staff are such that caring for numerous residents on their shift can’t possibly assure a routine on which the residents can rely.

Just providing care doesn’t mean that a staff person is caring.  Everyone who moves into a long-term care facility will have difficulties, but those who are cognitively impaired face an especially arduous adjustment.  As I previously mentioned, staff are hard pressed to provide individual care to their residents, and oftentimes are poorly prepared to handle the disorders that walk through the door.  Just getting through their daily shift is troublesome so trying to learn the habits and routines that are so vital for quality of life of the resident with dementia is a very time-consuming task.

a hand holding unidentified white pills
(Photo credit: Wikipedia)

Quite frequently, the only contact a staff person has with a resident is when they are making demands of that resident: “time to take your medicines Mrs. Jones;” “let’s get that soiled clothing changed Mr. Smith;” “open your mouth Mrs. Clark so I can feed you.”  Providing for  basic needs is not providing care.  Why?   Because the staff are requiring something of the resident.  There is no connection.  When a staff person interacts with a resident, absent a provision of care, that’s a better definition of care.

How to lessen the effects of adjustment disorder.  Those living in a long-term care housing situation oftentimes feel as though they left all their power, and all of their basic human rights, at the door.  They are constantly surrounded with reminders of their condition – all those other residents who look as lost and helpless as they do – and it seems that the only time anyone pays attention to them is when someone is demanding something of them in the form of providing some sort of assistance with their care needs.  If every staff person spent just five minutes of non-task-oriented time with each resident during their shift, those residents just might start feeling better about themselves.

  • Walk with a resident for a few minutes by simply accompanying them in the hallway and reassuring them along the way.
  • Play music the residents like in the common areas and in their rooms – and don’t assume that you know what they like to hear.  Take the time to find out what gets their feet tapping.
  • When you walk past a resident, greet them, smile at them, just as you would if you were in a social environment instead of a clinical environment.  Again, do so even when you’re not providing a care service.  Your friendly, heart-felt greeting may just make their day.
  • Start a dialogue with residents that allows them to open up to you about who they are; what their lives were like prior to arriving at the facility.  If you need to jot down some of their stories so you’ll remember them later, do so and continue the dialogue the next time you see them.  Wouldn’t it be a pleasant surprise to a resident when you asked them, “Tell me more about your grandson Charlie.  He seems like a real character!”  Wow – you were actually listening, and it shows.  Now you’re connecting with the resident.

If you are a staff person in a long-term care facility, can you put your grandma or grandpa’s face on your patients/residents faces thereby having a greater incentive to connect with those receiving your care?  Or if that doesn’t work for you, do what you must in order to add an element of care to those you serve.  Just because you’re helping the resident perform a task, doesn’t mean that you’re providing the care that they really need.

Alzheimers Test, the Alzheimers Questionnaire Alzheimers Reading Room

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Alzheimers Test, the Alzheimers Questionnaire Alzheimers Reading Room.

No test for Alzheimer’s disease is fool proof and I would venture to say that ALL tests of this nature aren’t black & white.  There are many gray areas when attempting to discern the presence of Alzheimer’s or other dementia in its earlier stages but as is often said, knowledge is power and certainly some information and guidance is better than none.  I hope the article linked here will prove helpful to you.