Geriatric Care Management Blog

Oct 23

Written by:
10/23/2011 8:51 AM 

Alzheimer’s Disease is the most common form of dementia, affecting about 5.3 Americans, and it is expected to grow to 15 million Americans with this disease by the middle of this century.  Almost everyone has heard about the condition, and we even see advertisements on television for medicines that may be able to slow the progression of the disease.  What we probably do not hear a lot about is that Alzheimer’s commonly is accompanied by other neurological problems that caregivers and Alzheimer’s patients’ providers should be looking for.



While challenging to diagnose in patients with Alzheimer’s or other dementias, depression reportedly affects as many as 20 to 32% of dementia patients.  It is particularly common with those who manifest vascular dementia.  It is hard for providers to diagnose, because the confusion or lack of focus common to depression also are frequently the hallmark of dementia as well.  As a caregiver, be alert to insomnia or hypersomnia as well as agitation or suicidality in patients who have been diagnosed already with Alzheimer’s Disease. In addition to medications that may be effective in treating the depression, therapists encourage caregivers to encourage focus on positive aspects of life, happy memories and noteworthy accomplishments of the individual.



About one in five patients with dementia may also show signs of anxiety, especially in the early stages of the dementia.  It is less common in Alzheimer’s, however.  Because anxiety will be particularly sensitive to situational stressors, it will be important for caregivers to report the anxiety that may manifest itself as irritability, restlessness, tiredness or difficulty sleeping through the night to the provider. 



Memory lapses can fuel some delusions among Alzheimer’s patients and result in outright hallucinations in as many as 15% to 20% of patients with dementia.  The incidence of these psychoses will increase as the dementia progresses, and agitation that typically is characterized as “angry outbursts” or blatant aggression has been documented in 27% of patients some form of dementia.  These episodes are more pronounced when an Alzheimer’s patient is challenged by a new situation or an unfamiliar environment.  As common are cases of outbursts or failure to cooperate in bathing, dressing or other activities of daily living where assistance may be required. 



So, as if caregiving is not complicated already, the individual who is responsible for a partner or an older adult with Alzheimer’s or other dementia needs to remember that they are not just treating the memory loss.  There are other psychological dynamics that will challenge a caregiver, and it will be important to treat all identifiable conditions in order for the treatment of any one to have a chance at being effective.  So, take notes on behaviors that may seem out of character beyond the short term memory issues so that a medical professional will be able to diagnose any of these other co-morbidities that may be accompanying the dementia.  With everyone on the caregiver team collaborating, the elder or other person with special needs will be assured better care.



Charlotte Bishop is a Geriatric Care Manager and founder of Creative Case Management, certified professionals who are geriatric advocates, resources, counselors and friends to older adults and their families throughout metropolitan Chicago.  Please email your questions to Charlotte Bishop.

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