Jan L. Warner & Jan Collins

	JWR's Pundits World Editorial Cartoon Showcase Mallard Fillmore Michael Barone Mona Charen Linda Chavez Ann Coulter Greg Crosby Larry Elder Don Feder Suzanne Fields James Glassman Paul Greenberg Bob Greene Betsy Hart Nat Hentoff David Horowitz Marianne Jennings Michael Kelly Mort Kondracke Ch. Krauthammer Lawrence Kudlow Dr. Laura John Leo Michelle Malkin Jackie Mason Chris Matthews Michael Medved MUGGER Kathleen Parker Wes Pruden Sam Schulman Amity Shlaes Roger Simon Tony Snow Thomas Sowell Cal Thomas Jonathan S. Tobin Ben Wattenberg George Will Bruce Williams Walter Williams Mort Zuckerman Consumer Reports

Seeking help for dementia victims

http://www.NewsAndOpinion.com | Q: My 75-year-old husband has been quite forgetful of late. I didn't want to tell him because he gets so irritable, but our children have also noticed and discussed with me privately about how to handle it. He's physically healthy, we're in fairly good financial shape and purchased long-term care coverage several years ago. Is there a way to have him checked out for Alzheimer's disease without causing World War III?

A: It's important to monitor aging spouses and parents who may exhibit what appears to be unusual behavior. Unfortunately, well-meaning spouses and children often handle these situations very poorly. It's critical to learn how to deal effectively with potential problems without causing sometimes-irreversible family strife.

Basically, dementia is a succession of phases during which an individual gradually becomes more confused. Early warning signs generally include memory problems, forgetting words and personality changes. The individual may have difficulty solving problems and making decisions. Though Alzheimer's disease is the most recognizable cause, dementia can also result from alcoholism, excessive medication and such physical conditions as thyroid problems or a stroke. These diseases are progressive and degenerative brain disorders that, over time, affect the ability to perform all activities of daily life.

In some instances, depression is misdiagnosed as dementia. While there is no absolute way to diagnose Alzheimer's disease until after death through autopsy, qualified physicians have a relatively high success rate by using certain memory and blood tests. Therefore, the first step should be to secure a diagnosis from a qualified physician. This may be difficult because of the afflicted family member's denial. Relatives are often the worst people to bring up the topic. Third persons — unrelated to the family — can be the best people to get the ball rolling.

We highly recommend the use of trained, experienced geriatric care managers to make an initial determination of the potential for dementia. We believe that third persons who can gain the trust of the individual often stand a much better chance of connecting with the individual than family members who may appear to have ulterior motives. (For help in selecting someone, go to the Web site for the National Association of Professional Geriatric Care Managers, www.caremanager.org.)

Currently there is no established method for curing or preventing the onset of Alzheimer's. If diagnosed in its early stages, Aricept or Exelon, two of the most prescribed medications, may slow the symptoms. If the side effects (drowsiness, abdominal pain, insomnia) can be tolerated, individuals may be able to have a good quality of life and function appropriately for up to another year or more. Without trying this treatment, however, there is no way to predict who will benefit from it and who will not. In addition, which medication to use will vary from individual to individual (those who are helped are usually in the early stages of the disease).

Individuals with Alzheimer's disease tend to do better at home in the least-restrictive environment. So long as the family can afford it, in-home care through qualified sitters and nursing assistants will gradually have to be increased over time. More restrictive settings, like nursing homes, should be the last stop. The fact that you have purchased long-term care insurance will be a blessing.

But let's not forget the caregiver who, more often than not, wears out — and sometimes dies — before the spouse with dementia. A plan can be put in place, through the use of geriatric care managers, that will give the caregiver periods of respite to make the entire process more bearable for all concerned.

Dealing with dementia, like other illnesses that affect the elderly, requires a coordinated plan and a team approach. The family, the physician, a care manager and other professionals should understand the problems and then try to solve them shoulder to shoulder.

Find this column helpful? Why not sign-up for the daily JWR update. It's free. Just click here.

JAN L. WARNER received his A.B. and J.D. degrees from the University of South Carolina and earned a Master of Legal Letters (L.L.M.) in Taxation from the Emory University School of Law in Atlanta, Georgia. He is a frequent lecturer at legal education and public information programs throughout the United States. His articles have been published in national and state legal publications. Jan Collins began co-authoring Flying SoloŽ in 1989. She has more than 27 years of experience as a journalist, writer, and editor. To comment or ask a question, please click here.