Wednesday, June 13, 2012

Information PLEASE , doctor

I am on a mission to change the way the neurologists, geriatricians and primary care doctors treat people with cognitive disorders like Alzheimer's. When doctors give the diagnosis, they offer little to no information, education or support to the family. I find this to be true of any diagnosis to do with the mind or behavior changes. Disorders of the mind make caregiving a challenge. Life is never the same again. It is a family crisis. The person with dementia is seldom able to participate in a helpful way to his care. Signs of Alzheimer's are a subtle but permanent and progressive shift in initiative, ability to structure pleasureable activities,and ability to comprehend the world around him. These difficulties lead to apathy or anger. Without someone to help make sense of what is happening to him, a person with dementia is lost. Often expressing what he is thinking or feeling becomes so difficult to impossible, he expresses his feelings in behavior. Most family caregivers try ways that are familiar like explaining why, quizzing to 'strengthen memory', and planning the future (maybe a trip going to be taken next weekend). None of these familiar ways of relating work now. In fact, these three ways of relating only add frustration for the family member with dementia. Unable to say what they are frustrated about, they DO something. Behaviors become troublesome for the family to understand and respond to. The family reacts rather than responds in a way based on an understanding of what challenges their family member is experiencing. Cconflict begins. Research and my experience with families says that education about the disorder and the person's changes in ability and behavior ease caregiving substantially and the family can give care at home up to two years longer than those without education. How do we bring this finding to the diagnosticians? Educating doctors and other health care professionals is key.

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