Alzheimer’s and Dementia Is Challenging


Having a loved-one with Alzheimer’s or Dementia can be quite the challenge, whether you’re a family member or a caregiver. Progressive brain disorders such as Alzheimer’s can make it difficult to think clearly, remember things, communicate and to take care of yourself. It can also cause mood swings and change one’s personality and behavior. Luckily with the right education, resources and care, both you and your loved one can be assured that their care is in the best hands.

What is Dementia?

Dementia is considered an umbrella term for clinical presentations or symptoms like impaired thinking and memory, and is often associated with aging and cognitive decline. Alzheimer’s, amongst other diseases can cause dementia, such as Huntington’s, Parkinson’s and Creutzfeldt-Jakob disease.

These brain disorders can make it difficult to:

  • Think clearly
  • Focus
  • Concentrate
  • Remember things
  • Make decisions
  • Properly reason with, or judge
  • Regulate emotions

Alzheimer’s disease is the most commonly diagnosed cause of dementia, accounting for up 60-80% of cases of dementia. Other causes include, but are not limited to, depression, stroke, vascular diseases, chronic drug use, and infections, such as HIV. Although most causes of dementia are irreversible, as there is damage to the brain cells, sometimes there are underlying problems that can be identified and treated. Which results in the reversal of dementia, and the patient returning to their original baseline. Otherwise, symptoms can be managed under proper medical care.

Screening to determine the cause of dementia includes blood tests, mental status evaluations, and MRIs or other brain scans.

Curious to see where you or a loved one may fall on The Clinical Dementia Rating Scale?


What is Alzheimer’s Disease?

As previously mentioned, Alzheimer’s is a progressive and terminal disease and is the most common cause of dementia. Alzheimer’s is generally diagnosed in people over the age of 65. It is estimated that about 5 million Americans may have Alzheimer’s disease at this time. Although the exact cause is still unknown, it’s believed that it occurs when plaques (or proteins) and tangles (fibers) both build up in your brain and either block nerve signals or kill brain nerves. In advanced cases, the brain is shown to shrink. Although there is no cure at this time, there are ways to manage symptoms.

Some symptoms of Alzheimer’s include:

  • Difficulty remembering things (may be mild at first)
Impaired judgment
  • Personality or behavioral changes
Difficulty performing activities of daily living (ADLs)
  • Disorientation
  • Aggression
  • Apathy
Impaired speech, swallowing, or walking in the advance stages of the disease

A skilled physician should be able to accurately diagnose Alzheimer’s in 90% of cases. However 100% certainty can only be guaranteed when your brain is examined under microscope during autopsy. Your primary physician may also refer you to a neurologist, (who specializes in diseases of the brain and nervous system), a psychiatrist (who specializes in disorders that affect your mood), or a psychologist (who specializes in testing memory and other mental functions).

Ways to test if you have Alzheimer’s:

  • Thorough medical history examination by a professional
Mental status exams
  • Physical exam
  • Neurological exam
Blood tests
  • Brain imaging such as a MRI

If you, or someone you know appears to be losing mental functions that interfere with their activities of daily living, you should consult with a doctor right away. There are both medications and treatments that can assist in managing some of the symptoms, especially as an early intervention, such as in-home health care.

Curious on where you or a loved one may fall on the Global Deterioration Scale for Assessment of Primary Degenerative Dementia (GDS), also known as the Reisberg Scale? This is the most common scale used to assess Primary Degenerative Dementia. It divides the disease process into seven stages, contingent on cognitive decline.

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What is In-Home Health Care?

Home health care is short-term, skilled medical care provided by a home health agency in a person’s home. Note that not all agencies operate the same. The skilled team can be comprised of licensed healthcare professionals, such as nurses, physical therapists, occupational therapists, speech therapists, social workers and a home health aide, who can assist with activities of daily living such as supervision, housekeeping, shopping, bathing, dressing, meal preparation, eating, toileting and other tasks.

This care is provided to patients who are recovering from surgery, serious or chronic illness, or have been in an accident. Often a physician will order home health care after a patient stays in a hospital or a skilled nursing or rehabilitation facility. It’s a way to properly transition back to independently living in the home. Sometimes home health care agencies also offer in-home care that can be short or long-term non-medical care that helps with activities of daily living.

How does it help someone living with Alzheimer’s disease or other dementia?

It allows patients to stay in their own home or with family, rather than in a hospital or a care facility. It also assists caregivers, by providing extra support. Home Health Agencies will generally provide prescribed medical supplies and arrange for durable medical equipment (through the patient’s insurance company) such as wheelchairs, commodes, hospital beds, oxygen, as well as other necessities.

What can the skilled medical professionals provide?

Depending on what the physician prescribed and what the insurance approves, licensed professionals such as registered nurses (RNs), Nurses (LPNs) and Licensed Vocational Nurses (LVNs) can help with many needs. They assist with anything ranging from wound care, administering medication, injections, checking vitals, supervising your health in-between visits with your doctor. They may also help supervise physical therapy conducted by a licensed Physical Therapist (PT), occupational therapy conducted by a licensed Occupational Therapist (OT), speech therapy conducted by a licensed speech therapist (ST), and other medical needs.

Another aspect is dealt with by social workers. They locate, and make necessary referrals for community resources (i.e. housing, transportation, food delivery, caregiving, etc).

This treatment team, regardless of which disciplines it is comprised of, will work with the patient to formulate and achieve realistic health goals.

Who pays for this?

Medicare, Medicaid, the VA and many other commercial insurance companies will often approve and pay for this type of care. There are also self-pay options for both home health and private caregivers. This can cost anywhere from $20-$75 per visit, depending on the service and company you use.

How do you qualify?

Doctor must determine need for in-home health care and prescribe it
Patient must be homebound
Patient must require skilled nursing care, or physical/occupational therapies

How do you find the right In-Home Health Care Agency?

If you are in need of in-home health care post-discharge from a facility such as a hospital, nursing home or rehabilitation facility, then the case manager, discharge planner and or social worker can help connect you with the right resources. Private agencies specialize is doing this as well and have inside knowledge that will help you make the best selection for you.  Even your doctor can help you find options in your area, that are also covered by your insurance.

Keep in mind that you have the right to choose any agency you or your family likes best. Make sure that you take into consideration what kind of services you will need, and what kind of services the agency will offer. If you are also considering hiring someone privately, ensure there is a criminal background check on file, and if they have proper training and or references.

Although there is a natural challenge that comes with taking care of someone with dementia or Alzheimer’s disease, there are options available to support you at every stage. Understand that you are not alone, and with the help of in-home health care, you can feel confident in knowing you are doing the best you can to take care of your loved one.