The Alzheimer’s Diagnosis: Now What?

Learning of an Alzheimer’s diagnosis is a profound event in the lives of a person and the family. Where do you go from there? Here’s what you need to know.

By Kevin Gault

A diagnosis of Alzheimer’s disease can be devastating, not only for the person receiving the news, but also for their family. Before long, they all face a difficult, urgent question: What do we do now? The many decisions to be made can be overwhelming. It’s best to focus on becoming educated about the disease and connecting with others who have been in the same situation. Look into possible drug therapies, enlist the right specialists and make simple but beneficial lifestyle changes.

But first things first. Before you do these things, make sure the diagnosis is accurate. “People may lose their memory and other cognitive abilities for reasons other than Alzheimer’s,” says Gary Small, M.D., co-author of The Alzheimer’s Prevention Program and director of the UCLA Longevity Center. “It could be a situation that is correctable such as a thyroid disorder, an infection, a tumor in the brain or a side effect from medication.”

Gain Understanding

If the diagnosis is confirmed, the entire family should learn about Alzheimer’s to understand the issues their loved one is facing. In basic terms, Alzheimer’s occurs because of a build-up of plaque and tangled proteins inside the brain in the areas that control thinking, memory, mood and other functions. Having Alzheimer’s means these changes in the brain impair a person’s mental abilities to the point where they need help with daily living.

One way to make this situation easier is to spend time with others who have faced the same challenges. “In the early stages of the disease, this type of connection is extremely beneficial,” says Jan Dougherty, M.S., R.N., director of family and community services at Banner Alzheimer’s Institute in Phoenix, Ariz. “Becoming involved in a group and hearing other people discuss their experiences can help someone learn how to live with Alzheimer’s. Family members can join the group to learn how to care for their loved one. People who aren’t comfortable in groups should find someone they can trust who will listen and give support.”

At this early stage, the family should meet to discuss medical, legal and financial issues and learn their loved one’s preferences for care. Completing healthcare power-of-attorney forms is important. Also, a person with Alzheimer’s will need more and different care as the disease progresses—learning about options for future care and how to pay for it must be discussed.

Give Medications a Chance

Another topic to discuss is FDA-approved drug therapies that can help in the early stages of Alzheimer’s and possibly even in later stages. These medications—cholinesterase inhibitors called Aricept, Exelon and Razadyne, and another type of medication, Namenda—won’t stop the disease, but they can improve learning, memory and attention span and slow the progression of symptoms for six months to a year in some patients. There is also evidence that they may slow disease progression over the long term, if taken chronically.

Small cautions families to avoid a common mistake with these drugs: “Some patients take them and don’t experience much improvement right away, or they improve slightly and after a while they start worsening, so their family takes them off the medications. Studies show, however, that if the drugs are producing benefits and you stop these medications too soon the patient might decline more rapidly, so even if symptoms don’t improve substantially, staying on these medications can help slow symptom progression.” It is also important to realize that cholinesterase inhibitors, like most drugs, can have unwanted side effects. So it is important to keep the patient’s physician informed about any changes in well being that occur while using these drugs.

While dealing with all of these issues, it’s essential to team up with the right healthcare providers. Many primary-care physicians can competently treat people with Alzheimer’s. Ideally, a neurologist, geriatric psychiatrist or geriatric internist should also provide care. Social workers and psychologists can help family members learn new coping skills. Many university medical centers with a focus on Alzheimer’s have teams of professionals who care for families.

Lifestyle Changes Can Help

Along with specialized professional care, simple changes can be very beneficial. “It’s important that people combine proper medical management with a healthy lifestyle,” says Dr. Small. “When my patients who are in the early stages of Alzheimer’s start a regular exercise program, eat healthy foods, minimize stress and learn to stimulate their minds at the proper level, they do much better.”

Also, consider these steps:

Get help now: A serious mistake families make is not asking for help soon enough. “The independent nature of most people leads them to shoulder all of the burden of care instead of asking family and friends to help with even the smallest tasks,” says Dougherty. “No one can do it all without becoming stressed and exhausted. It really does take a community to provide care.”

Stay at home: Someone in the early stages of Alzheimer’s is coping with frightening changes in the way their mind works. Don’t make their situation worse by changing their living environment as well. “Some families make the mistake of moving their loved one to a different house to provide a change of scenery or taking them on a trip,” says Small. “We know that once dementia begins, any kind of change is difficult for a person to handle, so their symptoms might get worse if they’re faced with these types of changes.”

Get a move on: In The Alzheimer’s Prevention Program, Small details the ways that exercise can improve the symptoms of Alzheimer’s: “Most studies that show significant brain-health benefits from exercise have involved walking, but any form of cardiovascular conditioning has similar effects on increasing blood flow to the brain, which can improve mental performance. Studies show that strength training can improve cognitive function and brain health as well.”

Sharpen your memory: Research shows that practicing basic memory-improvement techniques sharpens memory and slows the mental decline associated with aging. “Using these techniques can activate and strengthen specific neural circuits in the brain’s frontal lobe, a critically important memory-processing center,” says Small. “With practice, the brain develops more efficient strategies for both learning and recall.”

Food for thought: “What we eat affects our brain function,” says Small. “Scientific evidence points to foods that promote brain health and others that are best to avoid.” Emphasize complex carbohydrates such as whole grains and avoid processed foods; eat omega-3 fats from fish at least twice a week to protect the brain and stabilize mood; fruits with a high level of antioxidants such as berries, prunes, plums, apples and apricots may help boost brain function.

Reduce stress: In addition to causing a variety of ailments from ulcers to heart disease to depression, stress can also affect brain health because it releases hormones that damage the brain’s neurons and weaken memory. Getting plenty of sleep, adding aerobic exercise to the daily routine and giving meditation or yoga a try can protect someone with Alzheimer’s from stress. Just as important, cultivating fulfilling friendships and asking friends for help when necessary can lighten the load.

Stay positive: In dealing with Alzheimer’s, keeping an optimistic attitude can lift spirits and help a family make the most of its time together. “It’s common for someone with Alzheimer’s and their family to experience depression and feelings of loss because it’s a progressive disease,” says Dougherty. “Too often they focus on what the person can’t do anymore rather than taking inventory of what they still can do! Despite the problems that Alzheimer’s causes, there is always help and hope for both patients and families.”

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