After a diagnosis of Alzheimer's disease is made and a treatment plan implemented, patients should return for evaluation on a regular basis in order to allow adaptation of treatment strategies to changing needs. Patients may not be a reliable resource for history-taking, so it's wise to encourage a family member, friend or caregiver to accompany the patient.
Consider these nonmedical needs for patients with Alzheimer's:
• ongoing information and support
• a living will
• a durable power of attorney for health care
• review of finances
• planning for changing care needs over the course of the disease
• preferences for end-of-life care
There are legitimate concerns about using alternative treatments, "prevention" food and vitamins, or "memory/brain booster" supplements as an alternative or in addition to physician-prescribed therapy. Effectiveness and safety are unknown, purity is unknown, adverse reactions are not routinely monitored, and dietary supplements can have serious interactions with prescribed medications.
Risk factors identified in studies and clinical trials show that cardiovascular risk factors, such as hypertension, hypercholesterolemia and smoking, increase the risk for cognitive decline. Remaining physically active and socially and intellectually engaged can have a positive impact on cognition.
The caregiver, your partner in care
Most patients with Alzheimer's disease have a primary caregiver, often a family member, who helps to ensure appropriate care. In striving to meet the needs of the patient, the caregiver often neglects or her own needs. Many report high levels of stress; nearly 40 percent suffer from depression. Health care professionals can help by looking for signs of caregiver burnout, treating medical problems and referring them to support services, such as the Alzheimer's Association's 24/7 Helpline (800.272.3900). The Association's Caregiver Center offers guidance on how to maintain physical and mental health in the midst of caregiving, as well as advice on how to manage their loved one's daily care, enhance their daily life, and respond to negative behaviors.