Answers to Your Alzheimer's and Dementia Caregiving Questions

Peter Zander/Getty Images

A clinical diagnosis of Alzheimer's is accurate 90 percent of the time.

Below are answers from Peter V. Rabins, a member of the AARP Caregiving Advisory Panel, to some questions submitted by visitors to the Caregiving Resource Center. This page will continue to be updated with new questions and answers. Have a query or conundrum? Ask the AARP Caregiving Advisory Panel.

Q: Lately, my husband's short-term memory has gotten really bad and I'm wondering if he's developing Alzheimer's disease. Is there a test than can detect it developing?

A: A diagnosis of Alzheimer's is a clinical diagnosis, meaning a clinician — doctor, nurse practitioner, physician's assistant — needs to combine information from the examination of the patient, family history, lab results and brain scans to make a diagnosis.

At this time there is no blood test, spinal fluid test or brain scan alone that can replace the clinical diagnosis. A clinical diagnosis is accurate 90 percent of the time.

Q: My father put my mother, who has Alzheimer's, in an assisted living facility. She cannot understand why he has left her. How should we answer her questions? We've been told to never talk about her Alzheimer's but I am feeling that maybe it would be less cruel to her than letting her think her husband left her because he doesn't love her.

A: I agree with you that never talking about the diagnosis of Alzheimer's is wrong. You may find that when you explain what Alzheimer's is, even in the simplest of terms, your mother may not understand or accept it. The disease blocks the ability to recognize the problem.

I suggest you tell your mother a few times that your father didn't leave her but, because of her illness, she needed to be in a safer place than what your father could provide. Don't focus on telling her the truth or trying to make her understand if she doesn't bring it up. If she is not able to understand after a few discussions, she likely lacks the ability to appreciate her needs due to the disease.

Q: My mother, who has dementia, frequently asks for my dad and her own mother. Both have passed away. She seems to calm down when I explain the truth, but later on the same problem occurs. How should I handle this?

A: If it helps her to explain that they have passed away, but she forgets, it is OK to keep repeating when the question comes up. Typically, repetition is harder on the caregiver than it is on the person with dementia.

Keep in mind, though, that many people have acute grief — they experience the onset of the grieving process — each time the topic is brought up. If you notice that it painful for your mother each time you mention it, try changing the subject or talking about the person through memories (e.g., remember when we used to go to the beach with Grandma …). That often helps the person to continue talking about the family member that passed but with a pleasant memory so as not to cause repeated pain.

Q: My mother has dementia and gets very confused at times. Would it be a good idea to take her back to see her old house? How do we tell her it's being sold?

A: While it won't be harmful to take her back or tell her it is being sold, it is very unlikely that it will be helpful to her. She may not even remember or recognize that it is her old house.

If she asks about her old house you can share with her one or two times that it is being sold. However, if she really doesn't remember, there is no benefit to you or her to bring it up.

Q: How long does a person with severe dementia live? Are there any statistics?

A: It really depends on how the stages of dementia are defined. Each stage typically lasts three years (mild, moderate, severe).

A person with Alzheimer's dementia typically lives 10-11 years. About 20 percent live to the advanced or severe dementia stage; the majority die before this late stage.

Q: I have noticed my mom has some sort of dementia. I've attempted to get her to go to the doctor, but she is uncooperative. How do I talk her into getting diagnosed? Should I trick her into it if she refuses to go?

A: You are experiencing a common problem. It is very hard for the majority of people with Alzheimer's to recognize their problem.

If you feel that this is a serious issue (i.e., not taking medications, living alone) it is imperative that you get her to a doctor. Since she is probably not going to agree to go see the doctor to discuss memory problems, you will need to figure out another reason for the visit. Also, you may want to call ahead to the doctor's office and let them know that you are concerned about her memory issues.

If she absolutely refuses, you need to look at the risk versus the benefit. Many times memory issues develop gradually and the person is getting the help she needs. If she continues to refuse to visit a doctor, I would recommend suggesting it again every month or so. Perhaps try an approach that is linked to your concern, saying: "I am worried about you, Mom, and it would make me feel better if you went to visit the doctor so that we can rule out if anything may be wrong."

If you see a sudden change in her memory loss, it could be linked to another medical condition, and you should get her medical attention immediately.

Peter V. Rabins is a member of the AARP Caregiving Advisory Panel.

Also of Interest

• Take the Memory Quiz: Normal forgetfulness or early signs of dementia?
  
• 9 symptoms you should never ignore
  
• Get free assistance with tax-return preparation
  

See the AARP home page for deals, savings tips, trivia and more