Alzheimer’s and the Role of the Neurologist

Alzheimer’s and the Role of the Neurologist

If a senior loved one has been exhibiting some of the warning signs of Alzheimer’s disease or dementia, their primary care physician has likely referred them to a neurologist for more testing. For families, the diagnosis of Alzheimer’s disease is a surprisingly long process. That is because there is no conclusive test that can be performed to definitely diagnose the disease. Instead, the diagnosis requires other illnesses and diseases that can mimic Alzheimer’s disease be ruled out. Those diseases can include a thyroid disorder, severe vitamin B12 deficiency, some medications, hydrocephalus, tumors, alcoholism and more.

How can you help your aging loved one prepare for their first visit with a neurologist?

Here are few suggestions:

  • Review with your loved one how active of a role they want you to play in the appointment. Do they want you to go in the examination room with them or wait in the lobby?
  • Be sure you are clear on any pre-appointment protocols before the appointment. The neurologist might want to do bloodwork that requires your family member to fast ahead of time or they might want you to send copies of any testing already done to them a week before the appointment.
  • Keep a symptom journal that is thorough but concise. You want to be able to quickly and clearly share concerns during your time with the neurologist.
  • Make sure you have a list of medications they are taking including dosage amounts with you at the appointment.

What can you expect at the first neurologist visit?

The neurologist will likely follow a fairly standard protocol to determine if your senior loved one might have Alzheimer’s disease. That usually includes:

  • A physical exam
  • A neurological exam (reflexes, walking, muscle strength, coordination and balance)
  • A mental status test

They will also likely order bloodwork to rule out a vitamin deficiency or thyroid disorder and some type of brain imaging. That could be a CT scan, an MRI or a PET scan.

The bottom line is to be prepared for all of this to take some time. No news isn’t necessarily bad news when you are waiting for the final word on an Alzheimer’s diagnosis.

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Caregiver Questions Regarding Medicare Open Enrollment

Caregiver Questions Regarding Medicare Open Enrollment

Dear Donna:

I am the caregiver for my 71 year old mother who has Alzheimer’s disease. In the past she has been able to handle Medicare open enrollment on her own. This year, for the first time, I will be responsible for this task. I’m not yet eligible for Medicare myself so this is all new to me. Can you help me figure out where and how to get started? I know this is important and I don’t want to make a mistake.

Karen in Holland, Michigan

Dear Karen:

Thank you for this great question! The open enrollment period for Medicare runs from October 15th through December 7th every year. It is the time when Medicare recipients can make changes to their current plan. Because we do receive this question from the adult children of our residents quite often, we have put together this list to help you make the most of open enrollment.


  1. Review your mother’s Annual Notice of Change (ANOC) even if you are happy with her current coverage. Double check to be sure the benefits of her plan will be the same in 2014 and that her current health care partners will still be a part of the plan.
  2. Should you decide you want to investigate different options for her, the Medicare Plan Finder tool will allow you to search for plans in her area by zip code.
  3. If your mother is participating in a Medicare Advantage plan, the Medicare Advantage Disenrollment Period (MADP) is from January 1st through February 14th each year. If you are unhappy with her plan, you can dis-enroll then.
  4. Drug coverage is always an area where adult children have many questions. To learn more about this part of her Medicare benefit, you can visit the Medicare website drug coverage resources.
  5. Finally, Medicare developed a brochure Have You Done Your Yearly Medicare Review that you can download for free to help you conduct this annual audit of her Medicare coverage.

I hope this helps you get started! If you have specific questions about her Medicare coverage, you can call Medicare directly at 1-800-MEDICARE for help. I always recommend that caregivers take notes when they call Medicare including the date, time and name of the person they spoke with for advice.


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Winter Safety for Older Adults in Michigan

Winter Safety for Older Adults in Michigan

Like it or not, old man winter is making his way to Michigan. For older adults in colder climates like ours, winter creates additional risk factors. The aging experts from the Heritage Senior Communities offer these 3 winter safety reminders for seniors in Michigan:

Home Heating Sources

Rarely does a winter pass in Michigan that we don’t we hear about a family who loses their home or even their lives because of problems stemming from a heating source. Older adults that live on a fixed income may try to cut expenses and that makes them even more vulnerable.

  • Be sure your aging loved one has their furnace inspected each year in the early fall.
  • You also want to be certain their smoke detector is working and has good batteries.
  • A carbon monoxide detector is a must in all homes.
  • Space heaters can be a hazard. While they are great for warming up drafty rooms, fire safety experts say nothing should be placed within three feet of a space heater. Also make sure the heater has an automatic off in case it tips over.

Auto Safety

Winter can be tough on our vehicles. If the older adult in your life is still driving, remind them to schedule a winter tune-up. Specifically ask them to check tires and tire pressure, window wipers, and the battery. Don’t forget anti-freeze and wiper fluid.

Fall Prevention

Icy walkways and porches create fall risks for seniors in the winter. If a landscape service to clear sidewalks is out of the budget, there are a few ways to help keep seniors safe:

  • Non-skid shoes and boots are a must. You can even add non-skids pads to your loved one’s everyday shoes and boots.
  • If your older loved one still shovels their own walkways, consider investing in a shovel on a wheel. Sounds strange but it not only helps to maintain balance while shoveling, it can also prevent back strain.
  • Call your local agency on aging. Many have budget-friendly programs to help seniors with snow removal.

 Are you a Michigan caregiver for a senior loved one who lives alone?

What is your biggest worry for them in the winter months?

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Respite Care in Michigan

Respite Care in Michigan

Dear Donna:

I am the primary caregiver for my 88-year old mother who lives in Saline, Michigan. I stop at her house every day either on my way to work or on the way home from work. When I had my annual physical last week, my physician told me she thinks care-giving is taking its toll on my health. My cholesterol is up, as is my blood pressure. She strongly encouraged me to find a respite program for my mother for a few weeks so that I can get some rest. Can you please explain to me what respite is?

Diane in Southeast Michigan

Dear Diane:

Many caregivers find themselves in your position. Juggling the care of an aging loved one with work and your own family can lead to increased health risks. In fact, the Center for Disease Control (CDC) estimates that at least half of all caregivers experience a decline in their own health. Respite is one way to get help.

In plain terms, respite is designed to give caregivers a break from their duties and allow them time to rest and renew. How respite works is that your mother would temporarily “move in” to a senior living community for a week or two. Any amount of time up to 30 days. She will have the full benefit of nutritious meals, life enrichment activities and outings, and all of the services every other resident enjoys. Some families even use respite on a regular basis.

Most health professionals, like your physician, stress how important it is for caregivers to take a break before they are exhausted. Because caregivers are often reluctant to admit that they do need help, researchers at California State University San Bernardino created a quick caregiver burden quiz . It only takes a few minutes to complete and it will assess the risk a caregiver is at for burnout or a serious medical condition.

Are you a family caregiver in Michigan?

Each of the Heritage Senior Communities across the state of Michigan offers respite.

Call the community nearest you for more information.

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When the Sun Goes Down: How to Manage One of the Most Challenging Behaviors Caused by Alzheimer’s Disease

When the Sun Goes Down: How to Manage One of the Most Challenging Behaviors Caused by Alzheimer’s Disease

If you are a Michigan caregiver helping to provide for a loved one living with Alzheimer’s disease, you may be witnessing this behavior and not know what it is. As the sun begins to set, restlessness, agitation and anxiety in a loved one peak. Just as a caregiver’s energy level is at its lowest, your loved one’s pacing and wandering begin. Sundowners Syndrome, also referred to as sundowning, is one of the most challenging behaviors for caregivers to manage. Estimates from The Alzheimer’s Association are that about 20 – 25% of those living with Alzheimer’s disease will experience sundowning.

How can families keep a loved one with sundowning safe?

One of the difficulties in managing this behavior is that the cause remains elusive. Alzheimer’s experts believe it is somehow tied to a disruption in sleep patterns. But there are some tactics that are commonly believed to help minimize the symptoms:

  • Plan your activity for each day in advance. Try to concentrate appointments and other activities that might be over-stimulating for early in the day.
  • Keep afternoons more low key including the noise level from the television or radio. Also consider limiting caffeine and sugar intake in the afternoon.
  • Consider taking a peaceful stroll around the neighborhood each day well before the sun begins to set. It will be good for you and for your loved one!
  • Some experts believe sundowning may be the result of unexpressed needs such as hunger, thirst or the need to use the restroom. So be sure your loved one has enough to eat and drink throughout the day and that you show them to the rest room at least every few hours.
  • This behavior often creates frustration for weary caregivers. But it is important not to lose your temper. Speak in a low voice and try to remain calm to avoid making the situation worse.
  • Pull the curtains and blinds well in advance of it becoming dark outside. Turn on all of the lights. This may help prevent your loved one from experiencing the anxiety that seems to be linked to dusky skies.
  • Consider the use of respite services a few times a month so you aren’t too tired to cope.

If you’d like to learn more about strategies for coping with Sundowners Syndrome, you can visit The Alzheimer’s Association Sleep Issues and Sundowning.

Is your loved one experiencing sundowning?

Have you found any approach that helps make it easier for them?

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