аЯрЁБс>ўџ 9;ўџџџ8џџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџьЅС% №Пbbjbj%ч%ч !4GGFџџџџџџlРРРРРРРд|||8Д Рlдzz88888888езззззз$є ЖћР88888ћтРР88.ттт84Р8Р8ет8етN т0Ž!hРРЉ8, ^3!@ХдЈ|lv‰Љ,><z™ЪтЪЉтддРРРРйAlzheimer's Disease Treatment: Working with Your Physician Los Angeles Alzheimer's Association Adapted by the UCLA Division of Geriatrics What is Alzheimer's Disease? Alzheimer's disease (AD) is a progressive, degenerative disease that attacks the brain and results in impaired memory, thinking and behavior. Symptoms of Alzheimer's disease can include: Gradual memory loss Decline in ability to perform routine tasks Disorientation to time and space Impairment of judgement Difficulty in learning Loss of language and communication skills Changes in personality, including inappropriate behavior, loss of interest, and changes in mood Hallucinations and delusions/false beliefs How does your physician know if it is Alzheimer's Disease? There is no single test that can diagnose Alzheimer's disease. However, trained physicians are 80%-90% accurate. Your physician needs to do a full assessment that includes: An accurate medical and psychological history A neurological exam Lab tests to rule out anemia, vitamin deficiencies, or other conditions An evaluation of the person's ability to do common daily activities, such as managing finances and medications A mental status exam to evaluate the person's thinking and memory A caregiver interview How can you help your physician? You can be prepared for the appointment by bringing a list of the medications you take, a log of symptoms or behavior changes you have noticed, and a list of questions or concerns. It is also helpful to provide an accurate history of the person's medical condition and any previous psychiatric treatment. What can your physician do if the diagnosis is Alzheimer's disease? Although there is no cure for Alzheimer's disease, there are many ways to treat some of the symptoms of the disease. Your physician may suggest: Use of medications that may delay (or in some cases improve) cognitive decline and memory loss Referral to appropriate activities, such as exercise, recreation, and adult day care services Appropriate treatment of medical or psychological conditions that may contribute to cognitive changes or decline Referral for counseling to help family members and caregivers understand how to best help an affected individual and create a safe environment. What can be done for behavioral problems? At times, a person with dementia may display behavior problems such as wandering, paranoia, suspiciousness, combativeness or resistance to maintaining personal hygiene. These behavioral problems can seem overwhelming to the caregiver. The physician may suggest various strategies to assist in daily caregiving tasks, such as: Enrollment in Alzheimer's Association's Safe Return Program, an identification program for memory impaired adults Modifying the person's environment in order to reduce confusion caused by over-stimulation, such as reducing noise and glare from windows. Explaining a task before you do it, such as saying, "I am going to help you put on your shirt." Providing a predictable routine at home with structured times for meals, bathing, exercise, and bedtime. Providing reassurance to the confused patient without challenging their accusations or misperceptions and by redirecting their attention. If suggested strategies are not helpful in managing the person's behavior, the physician may want to use medications to manage depression, restlessness, hallucinations, hostility and agitation. To guide treatment, the caregiver should provide the physician with accurate information regarding the behavior problem, such as the onset of the behavior, the frequency of the behavior, the time of day the behavior occurs, and the strategies tried. How can the physician help you plan for the future? For an individual who is still able to make decisions for him/herself, your physician may suggest planning for health care needs by completing an advance directive. This is a legal document that a patient signs while capable of making sound decisions to direct how treatment decisions should be made in the future when the patient may not be able to decide. The advance directive can specify who should make decisions and what sort of decisions should be made. 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