Archive for January, 2014


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Driving is a complex activity that requires quick thinking and reactions, as well as good perceptual abilities. For the person with Alzheimer’s disease, driving becomes a safety issue. While he or she may not recognize that changes in cognitive and sensory skills impair driving abilities, you and other family members will need to be firm, but sensitive, in your efforts to prevent the person from driving when the time comes.

How do you know when the time has come?

Signs of unsafe driving include:
• Forgetting how to locate familiar places
• Failing to observe traffic signs
• Making slow or poor decisions in traffic
• Driving at an inappropriate speed
• Becoming angry or confused while driving

Keep a written record of your observations to share with the person, family members and health care professionals.
Tips to limit driving
Once it’s clear the person with dementia can no longer drive safely, you’ll need to get him or her out from behind the wheel as soon as possible. If possible, involve the person with dementia in the decision to stop driving. Explain your concerns about his or her unsafe driving, giving specific examples, and ask the person to voluntarily stop driving. Assure the person that a ride will be available if he or she needs to go somewhere.
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Other tips to discourage driving include:

• Transition driving responsibilities to others. Tell the person you can drive, arrange for someone else to drive, or arrange a taxi service or special transportation services for older adults.

• Find ways to reduce the person’s need to drive. Have prescription medicines, groceries or meals delivered.

• Ask a respected family authority figure or your attorney to reinforce the message about not driving.

• Experiment with ways to distract the person from driving.

What if the person won’t stop?
If the person insists on driving, take these steps as a last resort:
• Control access to the car keys. Designate one person who will do all the driving and give that individual exclusive access to the car keys.

• Disable the car.

• Consider selling the car. .

• Alert the department of motor vehicles.

Want to learn more about dementia and driving? Check out the Alzheimer’s Association’s Dementia and Driving Resource Center here. Take a peek at the video below which depicts a family making decision about driving.

 

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24/7 Harry L. Nelson Helpline

The Alzheimer’s Association is available for you any time, day or night, for reliable information and support.

Our 24/7 Harry L. Nelson Helpline allows people with Alzheimer’s disease or dementia, caregivers, families and the public to:

  • Speak confidentially with our master’s-level care consultants for decision-making support, crisis assistance and education on issues families face every day.
  • Learn about the signs of Alzheimer’s and other dementia.
  • Find out about local programs and services for individuals with dementia, caregivers, family and friends.
  • Get general information about medications and other treatment options, and legal, financial, and care decisions.
  • Receive help in their preferred language through our translation service, which accommodates more than 170 languages and dialects.

To learn more about how the Alzheimer’s Association 24/7 Helpline can assist you, call us at

1-800-272-3900

Prefer to check us out online? Click here.

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Ever thought about how physicians arrive at a diagnosis of Alzheimer’s disease or other dementias?

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Finding Alzheimer’s disease (AD) is often a game of ruling out other causes — are the memory problems due to AD or is it something else? Is it caused by depression, vitamin deficiency, stress, sleep disturbances, infection, etc., etc.? Or are the memory problems in fact being caused by Alzheimer’s disease? Unfortunately there is no pass/fail test that will tell us immediately whether or not the person has a diagnosis. Because of the uncertainty with diagnosis, even experienced physicians can make mistakes and mis-diagnosis is not unheard of.

Comprehensive Diagnosis

  • Subjective complaints
  • Cognitive Testing200400104-001
  • Medical History
  • Medical Tests (i.e. blood work and brain imaging)

Rule out

  • Disturbed sleep
  • Emotional disorders
  • Metabolic disorders
  • Eye and ear impairments
  • Nutritional deficiency
  • Tumors
  • Infections
  • Alcohol, drugs, or medication interactions

It used to be that brain autopsy was the only way to receive a definitive diagnosis of Alzheimer’s disease, but with improved testing this is no longer the case. Experienced clinicians have a 95% accuracy rate in diagnosis. Furthermore, physicians can now administer tests that measure specific biomarkers in the brain that help them to determine a diagnosis.

The formation of plaques and tangles in the brain are the two hallmarks of Alzheimer’s disease (AD). Plagues are composed of a protein, beta-amyloid, that abnormally clumps together in AD. Many nerve cells, also called neurons, die as the damage of AD spreads. Dead and dying nerve cells contain tangles, which are made up of a protein called tau. The tangles destroy a vital cell transport system in the brain.

Advances in research have produced certain diagnostic tools that measure levels of tau and beta-amyloid. For instance a clinician may analyze a patient’s cerebrospinal fluid (CSF) to look for these important biomarkers. CSF is a clear fluid that bathes and cushions the brain and spinal cord. Adults have about 1 pint of CSF, which physicians can sample through a minimally invasive procedure called a lumbar puncture, or spinal tap. Research suggests that Alzheimer’s disease in its earliest stages may cause changes in CSF.

Beta-amyloid is under significant scientific scrutiny, and amyloid-plaque formations can be found in all patients with AD. Progress in Alzheimer’s disease research and imaging has made it possible to detect beta-amyloid in the human brain using radioactive tracers and positron emission tomography (PET). See the picture of a PET scan below.

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Amyloid PET Imaging

Despite these noteworthy advances, bear in mind that spinal taps and PET scans are not a definitive diagnosis! They are simply tools designed to increase the clinical certainty of the physician’s conclusion. Also note, that these tests are often expensive and not covered by most health insurances. Furthermore, amyloid imaging is usually only conducted in limited situations when the patient’s symptoms are atypical (e.g. young age of disease onset, symptoms do not satisfy criteria for AD, etc.).

Learn more about the steps involved in a diagnosis here, or call our 24/7 Harry L. Nelson Helpline to speak to a live representative.