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Alzheimer's Care: How Do You Know When It's Time?
Assessing the needs of a loved one in any stage of Alzheimer's can be incredibly difficult and painful. Many family caregivers liken it to being a first-time parent who senses something amiss with a newborn, but lacks the experience to know exactly when to seek medical intervention. And when symptoms are sporadic, as in the case of neurological disease, medical decisions may present an even greater challenge. These sporadic symptoms, say experts, can leave family members affected by Alzheimer's feeling confused and exhausted.
When the Time Comes
"It is time to consider getting help to care for a person with Alzheimer's when there are changes in mood, behavior, appearance, functioning, or health status that are unmanageable without help and that place the person or others at risk, because these changes can result in many serious events," says Claudia Fine, LCSW, MPH, CMC, executive vice president and chief professional officer for SeniorBridge, a complex care management program in New York City.
One reason for delaying care is the desire to avoid disrupting the lifestyle of a person with Alzheimer's. But, says Fine, this theory can backfire. "A senior who needs Alzheimer's Care
but doesn't have it may experience significant weight loss because he can no longer shop or cook," she says, adding that the person might not be able to manage medications, pay bills, or keep appointments. "And, there can be life-threatening risks related to driving with cognitive and sensory impairments, or taking too little or too much medication, or forgetting to turn off a stove."
When Gary Baker's mother went from early- to late-stage Alzheimer's almost overnight after suffering a hip fracture, his family quickly realized they needed help caring for her. "My dad had been taking care of my mom at home, but we quickly needed to incorporate about 50 hours of home help, including the nanny who helped with my children for many years, another aide, daily nurse visits, and family members," says Baker.
Expense is another factor in determining when and what level of Alzheimer's Care
is needed. "We've found Home Care
that comes close to being 24/7 isn't just more comfortable for my mother, it's less expensive than a nursing home would be," says Baker.
Degrees of Care
Fine says it is very important to select the right level of care for the situation, while anticipating the progression of the disease "A person with early dementia who recognizes his or her deficits might be able to remain in their home and community with family support, care management, and Home Care
," she says. "But if the individual is resistant to accepting support, the situation might unfortunately have to worsen before a significant change can be made."
Keeping in mind that Alzheimer's patients require the same kind of care as any patient with a progressive, deteriorating illness, and they also need help with all activities of daily living, intervention should match the level of need and be introduced gradually. "This is often easier to accomplish in a home setting," Fine says.
Baker knows that someday, his mother might no longer be able to remain at home. "But, while she can walk and talk and somewhat respond to basic directions necessary to care for her, we'll stick with home care to help her maintain as much of her old life as we can," he says.
"Although she may not know she's lived in this apartment for more than 30 years," he says, "when she holds our hands and looks us in the eyes, she knows she's with someone who loves and cares about her."
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