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Category Archives: caregiving

Guidelines For The Diagnosis And Treatment Of Dementia

People with mild to moderate dementia (and Alzheimer’s) are usually cared for by the family personal care physician and the patient’s family. The personal care physician is often very busy and is not a specialist in the area. The family is often ill equipped to take on this task due to lack of formal training, education, and experience. Family caregivers and the primary caregiver usually take a learn as you go approach. A team of physicians, teachers, and researchers have created a set of guidelines for personal care physicians on how to manage dementia once a diagnosis is made. This article should be read by physicians but I found it very helpful as a caregiver. From the caregiver perspective it will help you understand the services you need and help you interact with your family physician to assure that appropriate actions are being taken and treatments rendered.

Guidelines for the diagnosis and treatment of dementia (PDF)

Canadian Medical Association Journal Press Release

People with mild to moderate dementia are cared for largely by family physicians as well as the patient’s own family, and management of care can be complex and challenging. A team of clinicians, teachers and researchers from the University of Calgary, Dalhousie University, McGill University, Sunnybrook Health Sciences and the University of Toronto, University of Ottawa, University of Western Ontario, Universite de Montreal, University of Saskatchewan and affiliated institutions have created comprehensive guidelines for family physicians on how to manage dementia once a diagnosis has been made. This approach focuses on supporting both the patient and the primary caregiver.

From Diagnosis and treatment of dementia: Approach
to management of mild to moderate dementia

Recommended actions to assist patients with a mild to moderate
dementia and their families after a diagnosis has been made

• Inform the patient and his or her family (if present and appropriate) of the
diagnosis (this would include general counselling and responding to specific
questions)

• Identify the presence of a family caregiver, what support this person can
offer, his or her status (i.e., evidence of strain) and his or her needs (this
would include trying to deal with any identified needs) — ongoing activity

• Decide on the need for referrals for further diagnostic and management
assistance (e.g., referral to genetic clinic for suspected familial cases) —
ongoing activity

• Assess for safety risks (e.g., driving, financial management, medication
management, home safety risks that could arise from cooking or smoking,
potentially dangerous behaviours such as wandering) — ongoing activity

• Determine presence of any advance planning documents (e.g., will, enduring
power of attorney, personal directive). If there are no such documents, advise
that they be drafted. Note that this may include assessing the patientís capacity
to either draft these documents or whether they should be put into effect.

• Assess the patient’s decision-making capacity — ongoing activity

• Refer the patient and family to the local office of the Alzheimer Society of
Canada (www.alzheimer.ca/english/offices/intro.htm [English] or
http://www.alzheimer.ca/french/offices/intro.htm [français])

• Provide information and advice about nonpharmacologic and pharmacologic
treatment options and availability of research studies*

• Develop and implement a treatment plan with defined goals; continually
update plan

• Monitor response to any initiated therapy

• Monitor and manage functional problems (e.g., urinary incontinence) as they
arise

• Assess and manage behavioural and psychological symptoms of dementia as
they arise

• Monitor nutritional status and intervene as needed

• Deal with medical conditions and provide ongoing medical care

• Mobilize community-based and facility-based resources as needed (this
includes being knowledgeable about supportive housing and long-term care
options and the appropriate timing, and process, for facility placement)

David B. Hogan MD, Peter Bailey MD, Sandra Black MD, Anne Carswell MSc PhD, Howard Chertkow MD,Barry Clarke MD, Carole Cohen BA MD, John D. Fisk PhD, Dorothy Forbes RN PhD,Malcolm Man-Son-Hing MSc MD, Krista Lanctôt PhD, Debra Morgan RN PhD, Lilian Thorpe MD PhD

Contact: Dr. Hogan, University of Calgary, 403-220-4578, dhogan@ucalgary.ca

Original content the Alzheimer’s Reading Room.

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The 36-Hour Day

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This best-selling book is the “bible” for families caring for people with Alzheimer disease. The book is ranked the number one best seller in three categories on Amazon: Alzheimer’s disease, Caregiving, and Eldercare. It carries a five star review from customers.


The 36-Hour Day: A Family Guide to Caring for People with Alzheimer Disease and Memory Loss in Later Life

In addition to the practical and compassionate guidance that have made The 36-Hour Day invaluable to caregivers, the fourth edition includes new information on medical research and the delivery of care.


This edition includes:

new information on diagnostic evaluation-resources for families and adult children who care for people with dementia-updated legal and financial information-the latest information on nursing homes and other communal living arrangements-new information on research, medications, and the biological causes and effects of dementia.


Tami Greene said…

This book has been the single most helpful tool my family has been given to help us help my mother as she progresses with Alzheimer’s Disease. While other books have touched on many of the topics in this book, no where else have we found as much practical information on how to avoid confrontations with her; ways to improve her daily living; ideas to keep her involved with us and to provide meaning to her life; questions to ask her doctors; types of resources that are available (depending on your area); what to expect as the disease progresses; and how to help each other as we take on the many different roles needed to provide care for her.

I highly recommend this book to others; in fact, I have purchased multiple copies to share with family members and donate to my local library – that’s how helpful and important this book is!

Arthur Jones said…

This is a excellent book and reference for those learning to deal with Alzheimer. Plenty of resources and ideas of what to look for when caring for someone with this disease. You can get a good idea of what to expect and how to help those suffering with this devastating disease. Easy to understand and read. Can’t recommend this book enough.

Amazon.com Widgets

 

The New Old Age Blog

I recently ran across this New York Times blog–The New Old Age.

The blog is dedicated to Baby Boomers and issues they will be facing. You should consider adding this blog to your reader.

I will also be adding it to my Blog Roll (Weblogs) for your convenience. I included the link and the description in the clip below.

About The New Old Age

Thanks to the marvels of medical science, our parents are living longer than ever before. Adults over age 80 are the fastest growing segment of the population, and most will spend years dependent on others for the most basic needs. That burden falls to their baby boomer children, 77 million strong, who are flummoxed by the technicalities of eldercare, turned upside down by the changed architecture of their families, struggling to balance work and caregiving, and depleting their own retirement savings in the process.

Jane Gross on eldercare

In The New Old Age, Jane Gross explores this unprecedented intergenerational challenge and shares the stories of readers, the advice of professionals, and the wisdom gleaned from her own experience caring for her mother in her waning years. You can reach Ms. Gross at newoldage@nytimes.com.

blog it
 

Alzheimer Disease Behavioral Symptoms Protocols

I found this very informative and valuable handout for caregivers on the Indiana University Center for Aging Research website. The opening webpage is titled Alzheimer Disease Behavioral Symptoms Protocols. On the right hand side of the page you will see a link entitled View Behavioral Symptoms Protocols and this will take you to the handout. If you prefer you can get to the PDF by clicking on this link, Behavioral Symptoms Protocols.

Please pass this information and link on to others. Please consider subscribing to our email or list or added our RSS feed to your reader.

 

Alzheimer’s Caregivers

I recently received my copy of Alzheimer’s Caregivers . This free handbook and tip sheet is well worth obtaining. You can get up to three free copies so its also easy to share. Get your free copy.

If you obtain the handbook, please let me know your reaction. Feel free to email this post to your friends and relatives.


The 36-Hour Day: A Family Guide to Caring for People with Alzheimer Disease and Memory Loss in Later Life

 

Alzheimer’s Caregivers

I recently received my copy of Alzheimer’s Caregivers . This free handbook and tip sheet is well worth obtaining. You can get up to three free copies so its also easy to share. Get your free copy.

If you obtain the handbook, please let me know your reaction. Feel free to email this post to your friends and relatives.


The 36-Hour Day: A Family Guide to Caring for People with Alzheimer Disease and Memory Loss in Later Life

 

Health Implications of Family Caregiving

Follow the link for additional information. Sponsored by the National Institute for Health this looks like it could be very informative and of great value to caregivers. This is only a short list of the topics being covered.

clipped from videocast.nih.gov

View event:

You will be able to view the event at http://videocast.nih.gov when the event is live.

Air date:

Wednesday, June 25, 2008, 1:00:00 PM

Caring for a loved one?

Overview of the issue of health and caregivers

Male caregiver’s experience

Powerful Tools for Caregivers

Veterans Affairs efforts to support family caregivers

Sponsors: Centers for Medicare & Medicaid Services and the Department of Health and Human Services New Freedom Initiative Subcommittee on Caregiving

 
 
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