This is the seventh in a series of articles written by Frank S. P. Yacino regarding Alzheimer’s disease. He is the husband and caregiver for his wife Barbara, who has been struggling with this disease for over fifteen years.

For us, the early stages began in 1997 when we were first made aware that Barbara had issues with her memory. She was tested by representatives of McLean Hospital from Boston when they conducted a free clinic in Worcester to anyone wishing to have their memory tested. The nurse advised us after the test that Barbara did not do very well on the test and that she should see her primary care physician for further testing. Our family recognized that Barbara was having trouble with names a year or two before this time, but she kept passing it off as “I’m getting old.” In 1997 she was only 62. It’s difficult to pin down an exact day, month, or year when this all began because Barbara was starting to have a hard time with most everything. She would forget how to do simple tasks around the house and names of the appliances in the house.  She would make name stickers and place them on the washing machine, dryer, cupboards, iron, even the closet. She was very good at covering up things and making it look like she knew what was going on. Barbara was still driving at this time, a concern we all had, and continued driving until 2004. (This subject will be taken up in a separate article.)

On June 3, 2002 we began seeing a neurologist twice a year. Barbara began taking Aricept as a medication to slow down the progress of dementia. She would be tested each time we went to the neurologist by being asked to remember certain words or phrases the doctor would give her and then ask her what those were a few minutes later. On our first visit Barbara scored a 15 out of a high of 30, which wasn’t too good. Each time we would go for her check-up that number would slowly go down and by the time we last saw the doctor on June 7, 2004 her score was 5. And that’s when we were told Barbara had Alzheimer’s. It was a serious blow to both of us, since we had not experienced this disease in our immediate families. It did occur in both my parents side of the family but not Barbara’s, to our knowledge. So by not seeing it on a daily basis or living with it we were aloof of what my cousins were going through with their parents. In December 2004 Barbara had an appointment with the neurologist but would not go because she “wasn’t making me any better.”

Up until 2005 living with Barbara was very difficult because of my not understanding what was really going on with her. (That’s when I started going to Support Meetings. That initial experience with the group was previously written about in the third article entitled “The benefits of a Support Group.) I would always try to correct her when she said something that was not correct. She would get angry at me and many times I would literally yell back at her the correct answer and ask her “why don’t you know that?” I remember many times how she would look at me and say “don’t you understand I’m losing my mind.” Honestly, I didn’t understand, but certainly do now. Deep down I can’t imagine what she really thought of me and why I showed so much anger towards her. It had to be frightening to her not knowing why the man she married and loved so much was not more understanding. In retrospect this point in time was a real low for me and I’m ashamed of the way I treated Barbara. I mull those times over in my mind daily wishing that we could go back to those days knowing what I know now.

I can very vividly remember a day we were riding in Uxbridge and she pointed to a house and said “that’s where Paul lives.” I shot back right away by saying “no it isn’t, he lives in that house” (it was two houses away). She kept insisting she was right and I wouldn’t give in to her at all. We argued about that incident all the way back to Webster. Was I right in the manner in which I dealt with this situation? Not at all, because in hindsight it would never happen today, now that I have a better understanding of what this disease is all about and the anguish she was going through.

I’m sure that any caregiver who may be reading this now has had similar experiences with your loved one and if you have, please take a moment to reflect on what you are doing and how much it is hurting your loved one to know that you don’t understand or care about their situation. My experience certainly did not show the love and compassion at those delicate moments in Barbara’s life when she really needed that love and compassion. Today it’s a different story. She gets the best of everything and my whole world revolves around her needs and her comfort. I regret all the nasty things I said and did during those tumultuous years.

During these years she also developed many idiosyncrasies, one of which was her need to have on several layers of clothing--- shirts, sweaters, or coats. It would not be out of the ordinary to see her with two jerseys and two sweaters on at the same time, or two coats. I never saw her wearing two pairs of jeans or shorts, it was only the upper half of her body she would over-cover. It was difficult to make her understand that only one layer was needed in the summer and only one overcoat in the winter. Again, this was a phase she went through and then she grew out of it once I began to dress her, as she had forgotten how to dress and what clothes to put on.

Another of her idiosyncrasies was that of taking what was not hers (bluntly---stealing). This occurred whenever we went shopping.  She would take items from the grocery store or the department store we’d go to. She’d tuck everything in her coat or shirt and I’d find it when we got home. The next day I would bring it to the store and silently replace the item where it belonged. I felt compelled to return everything in case we had been seen on the surveillance cameras. When we’d go to church she’d even take the church bulletin and hide it in her shirt or coat. I tried to explain to her when we got home that it was free to take. She never did understand that, but by this time I was aware of where her mind was and didn’t argue with her.

When she would go shopping alone she’d come home with writing pads, pens, pencils, you name it-----she was a hoarder too. Those items though she actually bought and paid for, as I would see her looking at the slips when she’d get home.

So, during the early stages, caregivers won’t really know what to expect from their loved one. Rule of thumb----expect the unexpected. Try to maintain a calm demeanor when speaking to your loved one; don’t raise your voice to him or her, be gentle, and most of all, be kind, considerate, and compassionate to them. Hopefully you will be able to learn from my mistakes, which I regret immensely, and make your loved one know how much you really care about them during this scary transition time in their life.

This is the fifth in a series of articles written by Frank S. P. Yacino regarding Alzheimer’s disease. (The Safety for the Patient article printed September 12 was mislabeled as Number 5, it should have been number 6) Mr. Yacino is the husband and caregiver for his wife Barbara who has been struggling with this disease for over fifteen years. (This information was gathered from hand-outs at one of our Support Meetings.)

It is important to keep in mind that stages are general guides, and symptoms vary greatly. Not everyone will experience the same symptoms or progress at the same rate.

These seven-stages are based on a system developed by Barry Reisberg, M.D., the clinical director of the New York University School of Medicine’s Silberstein Aging and Dementia Research Center.

Stage 1----No impairment (normal function)

The person does not experience any memory problems. An interview with a medical professional does not show any evidence of symptom of dementia.

Stage 2----Very mild cognitive decline (may be normal age-related changes or earliest signs of Alzheimer’s disease)

The person may feel as if he/she is having memory lapses by forgetting familiar words or location of everyday objects. But no symptoms of dementia can be detected during medical examination or by family, friends, or co-workers.

Stage 3----Mild cognitive decline (early-stage Alzheimer’s can be diagnosed in some, but not all, individuals with these symptoms.

Family, friends, or co-workers begin to notice difficulties. During a detailed medical interview, doctors may be able to detect problems in memory or concentration.

Common Stage 3 difficulties may include the following:

Noticeable problems coming up with the right word or name in a conversation

Trouble remembering names when introduced to new people

Having noticeably greater difficulty performing tasks in social or work settings or forgetting material that one has just read

Losing or misplacing a valuable object

Increased trouble with planning or organizing

Stage 4----Moderate cognitive decline (mild or early-stage Alzheimer’s disease)

At this point, a careful medical interview should be able to detect clear-cut problems in several areas as noted below:

Forgetfulness of recent events

Impaired ability to perform challenging mental arithmetic, i.e. counting backward from 100 by 5’s

Greater difficulty performing complex tasks, such as planning dinner for guests, paying bills, or managing finances

Forgetfulness of ones own personal history

Becoming moody or withdrawn, especially in socially or mentally challenging situations

 

Stage 5----Moderately severe cognitive decline (moderate or mid-stage Alzheimer’s disease)

Gaps in memory and thinking are noticeable, and individuals begin to need help with day-to-day activities. At this point, those with Alzheimer’s may:

Be unable to recall their home address or telephone number, or the high school or college they graduated from

Become confused about where they are or what day it is

Need help choosing proper clothing for the season or occasion

The person may still remember significant details about themselves and their family

The person may still require no assistance with eating or using the toilet

 

Stage 6----Severe cognitive decline (moderately severe or mid-stage Alzheimer’s disease)

Memories continue to worsen, personality changes may take place and individuals need extensive help with daily activities. (We must remember that it is difficult to place a person with Alzheimer’s in a specific stage as stages may overlap.) At this stage, individuals may:

Lose awareness of recent experiences as well as of their surroundings

Remember their own name but have difficulty with their personal history

Distinguish familiar and unfamiliar faces but have trouble remembering the name of their spouse or caregiver

Need help dressing properly and may, without supervision, make mistakes such as putting pajamas over daytime clothing or shoes on the wrong feet

Experience major changes in sleep patterns, such as sleeping during the day and becoming restless at night

Need help handling details of toileting, flushing the toilet, wiping, or disposing of tissue properly

Have increasingly frequent trouble controlling their bladder or bowels

Experience major personality and behavioral changes, including suspiciousness and delusions (such as believing that their caregiver is an imposter or trying to steal things from them) or compulsive, repetitive behavior like wringing or shredding paper tissues

Tend to wander or become lost

 

Stage 7----Very severe cognitive decline (severe or late-stage Alzheimer’s disease

In the final stage of this disease, individuals lose the ability to respond to their environment, to carry on a conversation, and eventually to control movement, but they may still say words or phrases

At this stage, individuals need help with much of their daily personal care, including eating or using the toilet

They may also lose the ability to smile or sit without support and pick their heads up

Reflexes become abnormal

Muscles grow rigid

Swallowing will become impaired

This is the fifth in a series of articles written by Frank S. P. Yacino regarding Alzheimer’s disease.  He is the husband and caregiver for his wife Barbara who has been struggling with this disease for over fifteen years.

Somewhere between Stages 3 and 4 safety issues of the Alzheimer’s patient will need to be considered at home. This article will address the ways in which we had to ensure the safety of my wife Barbara as she changed stages.

Barbara liked to wander and leave the house so one of the first things we did was to get alarms for the doors to the exterior of the house. The alarms were placed at the top of the door and would go off when the door was opened. The alarms were purchased at Home Depot at minimal cost and are easy to install. The alarms work well, unless you were vacuuming in the house. Unfortunately the alarm signal couldn’t be heard over the noise of the vacuum cleaner and on two separate occasions Barbara did skip out on me. When I realized she was gone I ran outside and looked both ways and saw her walking down the street. I was lucky both times that she didn’t get too far away from the house and that each time a neighbor was outside and was able to stop her until I got to where they were. There were also times the alarm would go off and Barbara would just walk right out of the house. I’d be in a different part of the house and upon hearing the alarm would run out the door and she’d be in the driveway.

Another suggestion for the doors is to purchase plastic covers that go over the door knobs that are designed not to let the knob turn unless you put pressure at certain points of the knob cover. These covers are also found at Home Depot. They are also used for children so they cannot open the door.

At this stage of the disease the patient may have no fear, and touching a hot stove or flame would be a disaster. When I began the cooking duties Barbara would always come near the stove (gas) and I’d immediately escort her away fearing she would touch the hot pot or pan I was using. During her different stages we managed to prevent any medical emergencies around the stove. Care must be used around electric stoves as well, especially the new flat-top burners. It would be nothing for a patient to walk up to the stove and put their hand down and get burned.

At night before going to bed I’d make sure the alarms were on and check the gas stove knob’s to be sure they were off and Barbara hadn’t turned them on. For a short period of time I used to take the knobs off and place them in a drawer. (At this point Barbara was still able to walk freely around the house.)

Barbara was still driving at this time and I would tell her not to go anywhere when I’d go off to work. (I was overseeing construction work at this time.) However, many times when I’d come home I’d put my hand on the hood of the vehicle that she used to drive and it would be warm. So finally one day when I went to work I decided to unplug the electric cord going to the overhead door button, thus when she’d push the button nothing would happen. To be doubly sure the vehicle wouldn’t leave the garage I used to put the gears to the transfer case in neutral (we had a 4-wheel SUV). If the vehicle was in neutral in the gear box no matter what position she put the shift lever into the engine would only rev up and go nowhere. It only took her one time to discover the vehicle was immobile and she didn’t try taking it any more. It wasn’t too long after that when she had to surrender her license. (That situation will be taken up in a future article.)

When Barbara was able to get up at night it was necessary for me to install a floor- mounted alarm in the hallway out of the bedroom to alert me that she was up, if I didn’t hear her get up. This type alarm may be purchased at Radio Shack.

Two other safety items that are very important for the patient upon diagnosis of this disease are the Medic Alert Medallion (1-800-363-5985) and the Safe Return Medallion (1-888-572-8566) in case the patient gets lost or is in an auto accident. Barbara has both. The medic Alert Medallion has her name, address, phone number, and disease on it. The Safe Return Medallion has her name, disease, a phone number to call, and Barbara’s I. D. number. She is registered with the Safe Return organization. If she were to get lost and then found, just by calling the number on her medallion would eventually alert the local police and ultimately our family. At the time we did this the cost for Barbara was $40, and for an additional $5 the caregiver is also allowed to obtain a medallion with the same phone number to call if the caregiver is in an accident. Barbara’s I.D. number is also on my medallion. It’s a miniscule cost to save a lot of aggravation if something were to happen to the patient, especially if the patient happened to be non-verbal at the time. It certainly is a worthwhile investment and could be a matter of life and death. Hopefully they may never be needed, but it gives everyone a sense of safety and security.

At night, or even during the day if the patient naps, there may come a time when it’s necessary to install bed-rails to prevent the patient from falling out of bed.

The safety issues I’ve described pertain to the issues that we’ve had with Barbara and may or may not be similar to every patient, as no two are exactly alike. These comments are meant to be a general guide for the caregiver’s information.

 

 

 

This is the fourth in a series of articles written by Frank S. P. Yacino regarding Alzheimer’s disease. He is the husband and caregiver for his wife Barbara who has been struggling with this disease for over fifteen years. (This information was gathered from hand-outs at one of our Support Group meetings.)

Memory loss that disrupts daily life.

One of the most common signs of Alzheimer’s is the memory loss, especially when someone forgets recently learned information. Others include forgetting important events or dates; asking for the same information over and over; or relying on memory aids such as reminder notes around the house; or relying on family members to help with things they used to handle on their own.

What’s a typical age-related change? Sometimes it’s forgetting names or appointments and remembering them later.

Challenges in planning or solving problems.

Some people may experience changes in their ability to develop and follow a plan or work with numbers. They may have trouble following a familiar recipe or keeping track of monthly bills. They may also have difficulty concentrating and taking much to long to do things than they did before.

What’s a typical age-related change? Making occasional errors balancing the check book or making change for items bought.

Difficulty completing familiar tasks at home or work.

People with Alzheimer’s may find it difficult to complete daily tasks; such as driving to a familiar location; managing a budget at home or work;  or remembering the rules of their favorite past time sport.

What’s a typical age-related change? Requiring help to use the microwave or trying to use the TV remote as a telephone.

Confusion with time or location.

People with Alzheimer’s can lose track of days, months, and years. They may not understand sometime if it’s not going to happen immediately. They may even forget where they are, what they went for, or how they got to wherever they are.

What’s a typical age-related change? When a person gets confused about the hour of the day; day of the week; or the year; but may recall it at a later time.

Trouble understanding visual images and spatial relationships.

For some people, having vision issues could be a sign of Alzheimer’s. They could have a problem reading, judging distances, and understanding color or contrast. In terms of perception, they may also go by a mirror and it appears to them that someone else is in the room with them. They may have difficulty in understanding that they are the image in the mirror.

What’s a typical age-related change? Vision changes could be caused by cataracts.

Problem with words in speaking or writing.

Those with Alzheimer’s may have trouble following or joining in a conversation and have no idea how to continue that conversation or they may end up repeating themselves several times. They may also struggle with vocabulary; have problems finding the right words, or call things by the wrong name (i.e. calling a knife a fork or spoon).

What’s a typical age-related change? Having trouble more frequently finding the right word or phrase.

Misplacing things and losing the ability to retrace their steps.

A person with Alzheimer’s disease may put things in unusual places. They may not be able to retrace their step and find what they are looking for. They may even accuse others of stealing whatever “appears” to be lost. This behavior will occur more often over time.

What’s a typical age-related change? Misplacing things more frequently, such as the car keys or their glasses, and not being able to recall where they are.

Decreased or poor judgment.

A person with Alzheimer’s could experience changes in their judgment or decision-making. As an example, they may use poor judgment when dealing with money; possibly writing double checks to pay a bill; and being the subject of scamming telemarketers. They may also pay less attention to their hygiene, bathing, or manner in which they dress.

What’s a typical age-related change?  The person will be making bad decisions more often than not.

Withdrawal from work or other social activities.

A person with Alzheimer’s may begin to exclude themselves from their hobbies, social activities, work projects, or sports. They may have trouble keeping up with their favorite sports team or remembering how to complete a hobby project. They may also avoid social activities because of the changes that are happening to them.

What’s a typical age-related change? They may be weary of work, family, and social obligations.

Changes in mood and personality.

The mood and personalities of an Alzheimer’s patient can change in a moment. It’s possible for them to become confused, suspicious, depressed, fearful, or anxious. They may be easily upset at work, home, with friends, or in places where they are out of their comfort zone.

What’s a typical age-related change? The person may have very specific ways of doing things and becomes upset when a routine is disrupted.

 

 

 

 

 

 

 

 

 

 

This is the third in a series of articles written by Frank S. P. Yacino regarding Alzheimer’s disease. He is the husband and caregiver for his wife Barbara who has been struggling with this disease for over fifteen years.

At this point in time most family members and caregivers have no idea of what Alzheimer’s is all about and the steps necessary to help the patient. A great source of information that is available in many communities is an Alzheimer’s Support Group. I can vividly remember my first encounter with the group in Webster. Our children had been trying for several years to get me to go to a meeting and I kept saying I didn’t need any help. Finally in January of 2005 I relented and went to the meeting with three of our children. As I recall there were about six people there and the facilitator. After all of the introductions were done those around the table spoke of their loved one and some of the issues they had. I discussed my wife and some of the issues at that time and the facilitator started to make some observations and suggestions on how best I should take care of my wife. Well, I wanted no part of that. I told her “no one was going to tell me how to take care of my wife, especially someone I’d just met.” My comments were a big mistake, and in hindsight I regret ever saying them, as I would learn so much in the coming months and years.

It wasn’t too long after the first meeting that the “chip” fell off my shoulder and I began the path of learning how to deal with this terrible disease of Alzheimer’s. As I look back, now over seven years ago, I have learned so much as a member of this Support Group and I now try to encourage others to attend and help them because they are not alone in this disease and there are folks out there willing to help and give of their time to help others, people who were total strangers before walking into the meeting. Our family now is the only family still attending from the group that was there in January 2005. The group has grown to over fifteen monthly participants, though sometime fewer are there because they may have decided not to attend that night or may decide not to come any more. We have two co-facilitators who have a wealth of knowledge to share with us.

It takes time for people to adjust to the disease and many are in such a state of denial that they want no part of coming monthly to discuss their loved one's condition. That’s OK, but they will soon learn that they cannot fight this battle alone and be back asking for help. Those of us there share our stories and try to help each other as the disease worsens. We are a select group as caregivers; everyone cannot do what we do on a daily basis. We all want the best care for our loved ones. No two patients will be exactly the same, but many similarities will exist among them. We are also support for each other.

When a new member comes to the first meeting they are agog and have no idea of what to do. They tell the story of their loved one and are looking for immediate responses on how to stop this disease. There is no magic potion that will cure their loved one and we try to lead them on the way in the care and techniques they need to “weather the storm”.

Depending on the situation they bring up, it’s possible that someone else has experienced a similar situation. They are then given some ideas and tips on what to do.

I can remember a situation I had with my wife, who liked to chew on the tops of pencils and ball point pens. One day she chewed the eraser off a pencil as well as some of the metal that holds the eraser. The metal got stuck in her teeth and I nearly lost a finger trying to get it out. In the end, I did get it. Sometimes she would bite the ball point pen at the ink end and get ink in her mouth. As I told this story at one of our meetings, one of the participants who worked with young children, advised me of a product called “Chewy Tube” that she thought might help our situation. The material this product was made of was a hard rubber that children could bite on with no harmful affects. So I contacted the supplier in Arizona and when they arrived I put one on the pencil top she was using and it fit perfectly. I also used it on the pens. After that there were no chewed erasers or pens and it certainly helped to protect her teeth. Had I not been at this meeting I may never have known of this helpful product.

 

If anyone reading this article has a loved one with early stages of Alzheimer’s and is in need of help, I suggest that you consider attending an Alzheimer’s Support Group meeting in Webster, or if you have one in your community, and I know you’ll be welcomed with open arms by all the members. Everyone sitting in that room has already been where you are and will be willing to help you through this journey. Meetings in Webster are held on the second Monday of the month at the Chester C. Corbin Library, 2 Lake Street, from 6:15 PM to 7:45 PM in the ground floor Conference Room. Don’t be bashful; come join us, you’ll be glad you did.

This is the second in a series of articles written by Frank S. P. Yacino regarding Alzheimer’s disease. He is the husband and caregiver for his wife Barbara, who has been struggling with this disease for over fifteen years.

Prior to this diagnosis family members may have noticed the patient beginning to be forgetful and trying to cover up their forgetfulness with remarks such as “I must be getting old,” or if they were to meet someone whom they’ve known for years would just say “hi, how are you” instead of calling the person by name. Friends and family members may have noticed the patient writing down the names of household appliances as a way of remembering them or writing down names of people that they meet. These are tell-tale signs of a loved one in the early stage of dementia. A person at this stage will be prone to covering up their forgetfulness and find an excuse for doing what they did or what they said.

The above is how my wife Barbara acted in the earliest phase of her dementia. She was a pro at covering up everything that she did and said. At first we would make light of this behavior because we had not experienced this disease in our immediate family. However, after several years of this behavior, Barbara was given a test in October of 1997 by representatives of Mclean Hospital and she was found to be in the early stages of dementia. This led to many physical and psychological tests, brain therapy, and CAT-scans to confirm what the doctor had diagnosed. This went on until June of 2004.

Unknown to me and the rest of our family, Barbara was aware of this abnormality with her memory earlier than the date of her test. One of our daughters had been cleaning our attic in late May of 2012, in preparation of obtaining items for a yard sale we were going to have, and came across some hand-written notes Barbara wrote in January of 1992 where-in she wrote, and I quote, “Because I am at the age where I have a hard time remembering what has gone on from day to day I have decided to write a monthly diary of events I would like to remember. I was going to do it at the end of each month but decided it would be better to do it every half month. So here goes.” Her writings went until April 12, 1992. In 1992 Barbara was only 57 years of age. This disease has been known to afflict persons who are in their mid-forties. There is no age barrier.

Prior to finding this document I had found some calendar planning books in Barbara’s bureau drawer and in a cabinet near the couch that dated from 2002 through part of 2007 wherein Barbara wrote down some activities of the day, such as trip she made with me and other family members, whether just a ride or a shopping trip, going to church, going to the doctor, vacations, etc. These books also show how Barbara’s mind declined in her writing and spelling of words, clearly indicating her loss of memory to a point where she could not write or spell any more. Her last entry was March 28, 2007. What a difference in penmanship, spelling, and the use of words in that five plus year period. All of those writings tell a very vivid story of a woman in pain and knowing something was wrong and couldn’t figure it out.

As you can see, Barbara wrote from January 1992 through April 12, 1992 and then we have no writings until I found the daily calendar planning books starting in 2002. There’s a ten-year gap unaccounted for, unless we find other documents in the future.

What was I doing throughout this period of time? Four words can describe my demeanor;

I was in denial, plain and simple. Not ever having dealt with this disease I had no clue what we were in for. This was the most difficult time in our lives. Barbara would say things and then repeat them over and over again--------literally driving me up a wall. She was very forgetful and I would get agitated at her.  Now that I know it was the disease doing this to her I regret all the arguments and my walking away from her just not to hear her constant repetition of words. In retrospect, at a time when she really needed me to help her, I was walking away. Today I say of myself how cruel, and wish I could go back and help her. So if other caregivers are reading this now and experiencing what I have described with their loved ones, my most important suggestion would be to have patience with your loved one regardless of how many times they may repeat something to you, because someday that “wire” in their brain to talk will be gone and you’ll long to hear that voice once again. I know I do.

This is the first in a series of articles written by Frank S. P. Yacino regarding Alzheimer’s disease. He is the husband and caregiver for his wife Barbara, who has been struggling with this disease for over fifteen years.

Alzheimer’s disease--these are dreaded words when heard from the doctor to a patient who is experiencing memory loss. This disease falls under the general term of “dementia”. Today there are more than 5.3 million Americans who have heard that term used as their diagnosed reason for their forgetfulness. It’s on the same level as a patient hearing that they have cancer, be it pancreatic, liver, lung, brain, thyroid, prostate, bone, stomach, and the list goes on. However, there is more hope in being cured with some of these cancers than there is with Alzheimer’s. We all know there are many other diseases that we humans encounter over our lifetime. Today it seems that the more we talk with other people the more we learn that someone we know is a victim of Alzheimer’s.

This disease destroys brain cells, causing problems with memory, thinking, and behavior severe enough to affect work, hobbies, and social life. It gets worse over time and can cause death. It is the sixth-leading cause of death in America according to the Alzheimer’s Association.

The root cause of this disease is not really known, though there is speculation it has to do with plaques which are deposits of a protein called beta-amyloids which build-up in the brain. There is no known cure for this disease and the confirmation that the patient had this disease is usually confirmed after an autopsy of the brain has been done upon the patient’s death.

The diagnosis of Alzheimer’s can be very devastating to the patient’s family. The first reaction by all will be denial, unless they have seen it in other family members or friends. The thought is this really isn’t happening to us; he or she will get better. This type of “head-set” will doom the family, since once diagnosed the patient will tend to slowly decline little by little each day.

So what is a family to do when this happens? There are several things that can be done concurrently. The first, and most important, is to get all the immediate family members together and discuss the situation, so that everyone is in agreement with regard to the manner of how the care for the patient will be done. Two important non-family members that will be key advisors and can provide quality advice are the tax preparer and an Elder Law Attorney. They can steer the family in the right direction as it pertains to the finances and legal aspects of the patient. Thought should be given whether or not the intention of the family is to keep the patient at home, or if the need arises, placement into a long-term care facility.

The decision to keep the patient home will require considerable outside help. Family members alone cannot provide the needed care twenty-four/seven. There are programs and agencies that can provide some respite care for the primary caregiver. Anyone who thinks they can do this alone is sadly mistaken and in major denial of the entire situation.

Long-term care will not be required upon the first diagnosis of Alzheimer’s/dementia. Although no two patients progress in this disease in the same way, and at the same rate of progression, some may live longer than others before long-term care is required. This disease may last several years or a decade or more.

During the progression of this disease the patient may become combative, argumentative, and aggressive or they may become passive and docile.

In subsequent articles we will get into more details of what has been written here, and we will try to guide the caregiver with as much information as possible in the care of their loved one.