THE
ALZHEIMER’S
ANSWERBOOK
TM
Professional Answers to More Than 250
Questions about Alzheimer’s and Dementia
hat can I do to
W
prevent Alzheimer’s?
hat is the best
W
treatment?
ow close are we to
H
finding a cure?
ow do I know what
H
level of care is right?
charles atkins, md Susan Ashley, PhD
,Contents
Acknowledgments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .vii
Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .ix
Chapter 1: What Are Alzheimer’s and Dementia? . . . . . . . . . . . .1
Chapter 2: Dementia Basics . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9
Chapter 3: Getting a Diagnosis . . . . . . . . . . . . . . . . . . . . . . . . . .21
Chapter 4: The Dementia Evaluation . . . . . . . . . . . . . . . . . . . . .35
Chapter 5: Alzheimer’s and Other Types of Dementia . . . . . . . .45
Chapter 6: Treatments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .59
Chapter 7: Taking Care of the Whole Person . . . . . . . . . . . . . . .73
Chapter 8: Medications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .89
Chapter 9: Emotional and Behavioral Changes . . . . . . . . . . . . .107
Chapter 10: Keeping Your Loved One Safe . . . . . . . . . . . . . . .131
Chapter 11: Understanding Medicare . . . . . . . . . . . . . . . . . . . .153
Chapter 12: Understanding Medicaid . . . . . . . . . . . . . . . . . . . .171
Chapter 13: Advance Directives . . . . . . . . . . . . . . . . . . . . . . . .175
Chapter 14: Other Legal and Financial Issues . . . . . . . . . . . . . .191
Chapter 15: Nursing Homes and Extended-Care Facilities . . . .205
Chapter 16: Caring for the Caregiver . . . . . . . . . . . . . . . . . . . .223
Chapter 17: If You’ve Been Diagnosed . . . . . . . . . . . . . . . . . . .243
Chapter 18: The Family . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .251
Chapter 19: Hope for the Future . . . . . . . . . . . . . . . . . . . . . . .261
Appendix A: Chapter-by-Chapter References . . . . . . . . . . . . . .273
Appendix B: Resources . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .279
Appendix C: Geriatric Questionnaire . . . . . . . . . . . . . . . . . . . .283
,Chapter 1 WHAT ARE
ALZHEIMER’S AND
DEMENTIA?
■ What is dementia?
■ How many people have dementia?
■ Is all dementia Alzheimer’s disease?
■ Is dementia the same thing as senility?
■ Isn’t dementia just a normal part of getting old?
■ Who takes care of people with Alzheimer’s and dementia?
■ Are Alzheimer’s and dementia new diseases?
■ Is there more dementia and Alzheimer’s now than there used to be?
■ Is the rate of dementia higher in the United States than in other countries?
■ What are the symptoms of dementia?
■ Is memory loss always the first sign of dementia?
, 2 The Alzheimer’s Answer Book
What is dementia?
Carl Grant was a partner in a high-powered Manhattan law firm. Two
years short of retirement, he found himself struggling with tasks that had
once seemed simple. He’d read and then have to reread briefs, at times
staring off into space and forgetting what he was doing. He became short-
tempered with his secretary, and even accused her of having lost impor-
tant documents that were later found on his desk, or misfiled in his
drawers. In meetings he grew frustrated, needing people to repeat what
they’d just said, and having trouble finding the right words.
Where he used to work late hours, he was now frightened of having to
drive home after dark, having taken the wrong exit off the highway on
multiple occasions. At home, he no longer wanted to get together with friends
for bridge. He told his wife Jeanne, “I’m too tired.” The truth was that he
couldn’t keep the cards straight and was afraid that the others would notice.
He found himself feeling depressed and thinking that something must be
physically wrong. Behind his back his partners grew concerned, and finally
confronted Carl and insisted he have a medical evaluation.
Two years later, with his wife, daughter, and son at his side, Carl
attended his retirement party, even though he had not come into the
office for the past year, after having been diagnosed with early dementia.
He smiled and shook hands, although he could not recall the names of
most of his colleagues, including his secretary who had been with him for
thirty years. He no longer drove, even though he’d often look through the
house for his keys. He now spent much of his day in front of the televi-
sion set, or else would follow his wife around the house, never letting her
out of his sight.
Jeanne Grant, a school teacher, made the decision five years before her
own scheduled retirement to quit her job and care for Carl at home. As
the years passed, it was as though she was watching him move back-
ward in time. She deeply mourned the loss of her husband’s quick wit,
their physical intimacy, and the travel and social plans the two of them
ALZHEIMER’S
ANSWERBOOK
TM
Professional Answers to More Than 250
Questions about Alzheimer’s and Dementia
hat can I do to
W
prevent Alzheimer’s?
hat is the best
W
treatment?
ow close are we to
H
finding a cure?
ow do I know what
H
level of care is right?
charles atkins, md Susan Ashley, PhD
,Contents
Acknowledgments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .vii
Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .ix
Chapter 1: What Are Alzheimer’s and Dementia? . . . . . . . . . . . .1
Chapter 2: Dementia Basics . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9
Chapter 3: Getting a Diagnosis . . . . . . . . . . . . . . . . . . . . . . . . . .21
Chapter 4: The Dementia Evaluation . . . . . . . . . . . . . . . . . . . . .35
Chapter 5: Alzheimer’s and Other Types of Dementia . . . . . . . .45
Chapter 6: Treatments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .59
Chapter 7: Taking Care of the Whole Person . . . . . . . . . . . . . . .73
Chapter 8: Medications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .89
Chapter 9: Emotional and Behavioral Changes . . . . . . . . . . . . .107
Chapter 10: Keeping Your Loved One Safe . . . . . . . . . . . . . . .131
Chapter 11: Understanding Medicare . . . . . . . . . . . . . . . . . . . .153
Chapter 12: Understanding Medicaid . . . . . . . . . . . . . . . . . . . .171
Chapter 13: Advance Directives . . . . . . . . . . . . . . . . . . . . . . . .175
Chapter 14: Other Legal and Financial Issues . . . . . . . . . . . . . .191
Chapter 15: Nursing Homes and Extended-Care Facilities . . . .205
Chapter 16: Caring for the Caregiver . . . . . . . . . . . . . . . . . . . .223
Chapter 17: If You’ve Been Diagnosed . . . . . . . . . . . . . . . . . . .243
Chapter 18: The Family . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .251
Chapter 19: Hope for the Future . . . . . . . . . . . . . . . . . . . . . . .261
Appendix A: Chapter-by-Chapter References . . . . . . . . . . . . . .273
Appendix B: Resources . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .279
Appendix C: Geriatric Questionnaire . . . . . . . . . . . . . . . . . . . .283
,Chapter 1 WHAT ARE
ALZHEIMER’S AND
DEMENTIA?
■ What is dementia?
■ How many people have dementia?
■ Is all dementia Alzheimer’s disease?
■ Is dementia the same thing as senility?
■ Isn’t dementia just a normal part of getting old?
■ Who takes care of people with Alzheimer’s and dementia?
■ Are Alzheimer’s and dementia new diseases?
■ Is there more dementia and Alzheimer’s now than there used to be?
■ Is the rate of dementia higher in the United States than in other countries?
■ What are the symptoms of dementia?
■ Is memory loss always the first sign of dementia?
, 2 The Alzheimer’s Answer Book
What is dementia?
Carl Grant was a partner in a high-powered Manhattan law firm. Two
years short of retirement, he found himself struggling with tasks that had
once seemed simple. He’d read and then have to reread briefs, at times
staring off into space and forgetting what he was doing. He became short-
tempered with his secretary, and even accused her of having lost impor-
tant documents that were later found on his desk, or misfiled in his
drawers. In meetings he grew frustrated, needing people to repeat what
they’d just said, and having trouble finding the right words.
Where he used to work late hours, he was now frightened of having to
drive home after dark, having taken the wrong exit off the highway on
multiple occasions. At home, he no longer wanted to get together with friends
for bridge. He told his wife Jeanne, “I’m too tired.” The truth was that he
couldn’t keep the cards straight and was afraid that the others would notice.
He found himself feeling depressed and thinking that something must be
physically wrong. Behind his back his partners grew concerned, and finally
confronted Carl and insisted he have a medical evaluation.
Two years later, with his wife, daughter, and son at his side, Carl
attended his retirement party, even though he had not come into the
office for the past year, after having been diagnosed with early dementia.
He smiled and shook hands, although he could not recall the names of
most of his colleagues, including his secretary who had been with him for
thirty years. He no longer drove, even though he’d often look through the
house for his keys. He now spent much of his day in front of the televi-
sion set, or else would follow his wife around the house, never letting her
out of his sight.
Jeanne Grant, a school teacher, made the decision five years before her
own scheduled retirement to quit her job and care for Carl at home. As
the years passed, it was as though she was watching him move back-
ward in time. She deeply mourned the loss of her husband’s quick wit,
their physical intimacy, and the travel and social plans the two of them
