by Shelley | Mar 22, 2021 | Alzheimer's and Dementia
When you notice changes in an aging parent’s memory, you might worry it is Alzheimer’s. For many people, it’s the only symptom they are familiar with. Others, such as a change in disposition or problems managing finances, can be red flags, too. But each of these can also be warning signs of a reversible medical condition, such as a vitamin B12 deficiency or an undetected infection.
While there is currently no cure for Alzheimer’s, early interventions may help slow progression of the disease. That’s why it’s important for a senior to see their physician when changes first begin to appear.
How Physicians Diagnose Alzheimer’s
People are often surprised to learn there is no single test that can diagnose Alzheimer’s disease. Instead, it is a process of identifying common symptoms of the disease and eliminating other potential causes.
If a physician suspects Alzheimer’s disease, they will usually complete the following tests to arrive at a diagnosis:
- Family and personal medical history: Your parent’s doctor will likely ask you to share the changes that concern you, so create a list before the first appointment. The doctor will also ask questions about the senior’s medical history and personal lifestyle factors. Diet, exercise, alcohol consumption, and smoking will likely be discussed.
- Physical examination: The physician will assess the senior’s mental and physical wellness. This usually includes checking blood pressure, heart rate, temperature, pulse, and reflexes. The doctor will assess cognitive abilities by asking the senior a series of questions or presenting them with problems to solve. They are designed to evaluate memory, judgment, attention span, reasoning, and language skills.
- Brain imaging: Brain scans are usually conducted. They help detect if the brain is shrinking, while also looking for other potential causes of the changes you’ve noticed in your parent. An aneurysm, tumor, nerve injury, or stroke can all be detected through brain imaging. These conditions can also cause symptoms that look like Alzheimer’s.
- Blood tests: To rule out other conditions that mimic Alzheimer’s, bloodwork will be performed. It can detect a thyroid problem, a urinary tract or other infection, or vitamin B12 deficiency.
- Depression evaluation: Depression is another illness that causes symptoms similar to Alzheimer’s. So much so, it is often referred to as pseudodementia. The physician will usually conduct a depression screening or refer the patient to a mental health expert for an assessment.
- Spinal tap: A process that has been used with success in European countries is collecting cerebrospinal fluid (CSF) to identify biomarkers. It’s done through a spinal tap. In 2018, the Food and Drug Administration approved it for use in this country.
Based on the results of these tests, the primary care doctor will determine if the symptoms are likely Alzheimer’s or another form of dementia. If so, they may refer the patient to a neurologist for further follow-up. The tests might also identify a different medical condition that will require appropriate follow-up.
Leaders in Memory Care Services
At Heritage Senior Communities, we understand how difficult it can be to meet the needs of a loved one with memory impairments at home. Whether it’s Alzheimer’s disease or a different type of dementia, safety and quality of life are issues families worry about.
That’s why many of our assisted living centers have a dedicated unit focused on memory care called The Terrace. We invite you to call The Terrace program nearest you with questions about memory care or to schedule an in-person or virtual tour.
by Shelley | Mar 15, 2021 | Healthy Aging
After a long, cold winter, many people find themselves suffering from a vitamin D deficiency. We may see a significant increase in vitamin D deficiency this spring due to the months of quarantining at home because of COVID-19. That’s because a lack of exposure to sunlight translates to less vitamin D production.
There are other medical conditions that can cause low vitamin D, such as obesity, Crohn’s disease, cystic fibrosis, and celiac disease. These health issues make it more difficult for the body to process and absorb vitamins and minerals.
Knowing how much vitamin D you need in a day and how to work it into your daily diet is an important part of successful aging.
Vitamin D and Healthy Aging
Getting the right amount of vitamin D is important for everything from quality sleep to cancer prevention. Here are a few problems that can occur when the body is deficient in this essential vitamin:
- Cancer: Vitamin D deficiency is linked to higher rates of some forms of cancer, such as prostate, thyroid, lung, and breast.
- Dementia: There is evidence that seems to indicate low vitamin D may put people at increased risk for cognitive decline and dementia.
- Heart disease: The risk for cardiac diseases also goes up when your vitamin D is low. This is especially important because heart disease is the leading cause of death in this country.
- Multiple sclerosis (MS): Studies show maintaining adequate levels of vitamin D may help prevent or treat MS, a disease that attacks the protective sheath that covers nerve fibers. It results in communication problems between the brain and the body that can be disabling.
- Osteoporosis: Studies suggest maintaining proper levels of vitamin D and calcium can slow bone mineral loss, which helps prevent osteoporosis and bone fractures.
One challenge with preventing a vitamin D deficiency is that the symptoms can be easily overlooked. Here are a few signs to watch for in yourself or a senior loved one.
Recognizing a Vitamin D Deficiency
Recognizing a vitamin D deficiency is difficult because the symptoms are so vague. They are often mistaken as a normal sign of aging or a side effect of medication. Vitamin D deficiency symptoms can include:
- Fatigue or weakness
- Muscle or joint pain
- Aching bones
Your primary care physician can order a simple 25-hydroxy vitamin D blood test to make a clear diagnosis. If you are deficient, treatment will depend on the severity. Your physician may order a prescription dose of vitamin D to take once a week for a few months or an over-the-counter supplement.
Daily Recommended Dose of Vitamin D
Experts disagree on how much vitamin D we need, sometimes by fairly significant numbers. Many factors can impact how much vitamin D you need each day, such as age, weight, and chronic health conditions.
Experts from Harvard Medical School say if you’re taking a vitamin D supplement, 600 to 800 IU per day is likely adequate. People with a medical condition that impacts how vitamin D or calcium is absorbed, such as Crohn’s disease, may need more. If you are under a physician’s care, the maximum upper limit of vitamin D is 4,000 IU a day.
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by Shelley | Mar 8, 2021 | Caregiving, Dear Donna
Dear Donna:
My 84-year-old father is starting to develop a few health issues. Nothing serious, but concerning enough that we’ve been spending more time at the doctor. While his physician is cordial, he always seems hurried. My dad doesn’t talk about his medical problems very easily, so it sometimes takes a few minutes for him to open up.
I suspect my dad’s physician is a better fit for younger adults than for seniors. How can I tell if it’s time to make a change? If it is, what steps can I take to find a physician who is comfortable working with seniors?
Any suggestions are appreciated!
Sincerely,
Lisa
Is It Time for a New Physician for a Senior Loved One?
Dear Lisa:
What a great observation! It’s one we often hear from adult children. Not every primary care physician is comfortable caring for older patients, just as some aren’t at ease with younger children. Here’s some insight you might find helpful in making this decision.
First, mutual respect is essential in your father’s relationship with his primary care physician. While they are busy professionals, your father needs to feel like his doctor is listening to him. On the other hand, it sounds like your dad has been this doctor’s patient for a while. There is value in working with someone who knows his medical history.
Is there anything you can do to help your dad better communicate with his doctor? Do you make a list of concerns and review them ahead of time? Before you give up and find a new doctor, it’s worth trying to prepare more before appointments.
There are other issues to consider, too. Can you get an appointment easily? Is his doctor able to quickly make a diagnosis? Is the location of the office convenient? Is the physician part of a reputable provider network?
If you take an objective look at the situation and decide it is in your dad’s best interest to find a new physician, here are a few tips to keep in mind.
Tips for Finding a New Physician
- Insurance: Research which physicians accept your father’s health insurance. While you might think all physicians accept Medicare, a growing number of doctors are declining to work with Medicare and Medicaid due to perceived low reimbursement rates.
- Referrals: Ask friends, family, and colleagues you trust for referrals. It’s a good way to gain insight on what it’s like to be a patient of any physician you are considering.
- Location: While a good doctor is worth driving farther for, a great distance can be tough if your dad needs to visit often.
- Reviews: While reviews for physicians are tough to come by, a few sites are worth investigating. Healthgrades and Vitals are two. Medicare’s Physician Compare tool is another.
- Appointment: Finally, schedule a new patient appointment with the doctor. These appointments are usually longer and will give you a good idea whether the doctor will be a good fit for your father.
I hope these tips are helpful to you and your father, Lisa! I’m sure this won’t be an easy decision to make.
Kind regards,
Donna
Heritage Senior Communities
A fourth generation, family-owned company, Heritage Senior Communities has locations throughout Michigan and one in Indiana. With options for care that include independent living, assisted living, memory care, and respite, you’ll likely find a good solution for a senior loved one.
by Shelley | Mar 1, 2021 | Dear Donna
Dear Donna:
My 85-year-old dad is very independent. While I understand his age shouldn’t be the sole criteria in determining his health and well-being, one area I am concerned about is driving.
How can I tell if my dad is a safe driver? Are there steps I can take to make him less likely to experience an accident? I want to support his desire for independence as long as possible, but I also want to keep him safe.
Do you have any advice?
Thank you in advance,
Vickie
Tips to Evaluate Older Driver Safety
Hi, Vickie:
You are correct in not relying on your father’s age to determine whether or not he is a safe driver. While age can play a role, it’s not the only factor to consider. Other signals can indicate it’s time for your dad to stop driving, and adaptive aids address some common senior issues.
- Be the passenger.
An easy and non-confrontational way to evaluate your father’s driving is to ride along as the passenger. Look for warning signs that can indicate a problem, including:
- Bumping into curbs while parking or turning
- Pausing too long at stop signs and red lights
- Inability to maintain their lane
- Repeated and unnecessary braking
- Tailgating cars in front of them
- Driving too fast or too slowly
- Evaluate the driver’s comfort level.
When an older driver thinks they have no other option than to keep driving, they might become afraid behind the wheel. Skittishness can affect their driving. A few things to look for are:
- Anger: Road rage can happen to older drivers too. It might be their way of coping with their anxiety and stress about driving.
- Anxiety: Does your dad seems nervous when he’s driving? Nerves can impact safety.
- Confusion: Adult children may panic and assume a parent is developing dementia if they seem confused while driving. While it may be an early sign of Alzheimer’s or another type of dementia, it could also be fear.
If your father exhibits any of these signs, it’s probably time to sit down and talk with him to determine how he feels about driving.
- Consider medical conditions.
Some medical conditions and medications can impact a senior’s ability to drive safely. If your dad takes any prescription or over-the-counter medicine, check the labels to see if there are any cautions about driving. If he takes more than a few types of medicine, call the pharmacist to see if there may be any potential interactions or adverse reactions.
Health issues most closely linked to driving safety among seniors include:
- Alzheimer’s disease: In the earliest stages of Alzheimer’s, the senior’s physician might say they are still safe to drive. As the disease advances, however, it’s common for adults with Alzheimer’s to get lost traveling to and from once-familiar places. Judgment may also be impaired, putting good driving decision-making abilities at risk.
- Decreased flexibility: One common age-related change is a loss of flexibility. People with arthritis are at especially high risk. This makes it more difficult to turn your head to look over your shoulder or slide in and out of the car.
- Slower reflexes: This also occurs with aging. For drivers, being slow to react can be especially problematic. It can result in the senior taking too long to respond to road hazards and having an accident.
- Vision loss: While some vision changes can be treated or corrected with glasses, others can’t. Glaucoma and age-related macular degeneration make it difficult to spot road signs, traffic signals, and pedestrians.
Fortunately, there are a few tools that can make driving a little easier for seniors. Here are some driving aids you might consider for your father:
- Swivel seat: These devices make it easier to slide behind the wheel of a car. They usually cost less than $30 and can be purchased at auto parts stores and online retailers.
- Seat belt pull: The process of dragging the seat belt across the body and locking it is easier with a seat belt pull. This handle-like device gives an older driver up to 6 more inches of reach.
- Mirror adapters: A mirror adapter allows senior drivers to better view their surroundings. They are available for both the rearview and side mirrors.
- Pedal extender: While it’s an issue seniors joke about, research shows older adults often lose several inches in height as they age. A pedal extender is inexpensive and might help. They allow seniors to reach the car pedals without sitting too close to the steering wheel.
I hope this information is helpful, Vickie! Good luck talking with your father about driving.
Kind regards,
Donna
