When you or a loved one is concerned
about the possibility of having a dementia, getting a thorough evaluation is
the next step. Knowing and understanding what is happening will help you with interventions
So, what should you do? Here is a brief list of considerations and steps to take:
Select a physician.
- Consider the physician’s knowledge and comfort regarding working with older adults.
- Consider making an appointment with a geriatrician, a physician who is specially trained to diagnose and treat older adults. Don’t necessarily avoid other doctors, including family practitioners and internists, though; they often have the same knowledge and skills.
- Understand that additional specialists may be included in the diagnostic and treatment process. They may include neurologists, psychiatrists, psychologists, and other specialists as needed.
Schedule a doctor’s appointment, which will include several types of examinations.
- Physical exam, including
- medical history
- family medical history
- physical exam
- laboratory tests of blood and urine, particularly to rule out other possible causes of symptoms
- review of prescribed medications, patient-opted medications, and supplements
- Social and behavioral profile, particularly a log of recent changes and concerns as seen by the patient and/or others
- Neurological exam
- assessment of balance, reaction time, reflexes, coordination, muscle tone, speech, sensation, etc.
- ruling out of conditions and diseases, such tumors and strokes
- Mental status test that evaluates awareness, memory, problem solving, executive function
- Psychological evaluation, often to rule out other causes of dementia symptoms, such as depression, anxiety, other mental illness concerns/illnesses
- Brain scans (not routinely administered)
Ask the doctor questions to be sure
you understand the diagnosis.
- Diagnosis by name
- Evidence that underlies the diagnosis: What did the doctor see in exams and tests that led to the diagnosis?
- Doctor’s assessment of the current stage of the disease
- Possible interventions, including therapies and medications
- The role of the doctor going forward
Would you like help navigating the diagnosis process? Contact Dr. Cheryl Greenberg at TheAgeCoach@gmail.com to discuss your concerns and plan the next steps in getting and understanding a diagnosis.
So excited about our new course, “FULFILLING FUTURES,” at Shepherd’s Center of Greensboro!
Recently, a woman wrote to Amy Dickerson, the advice
columnist, to say that she was embarrassed to be old enough to have an
8-year-old grandchild. Ms Dickerson told the writer to embrace her life
regardless of age.
I agree. Let’s grab the rings, find the possibilities, have
Are you thinking about new adventures, roles and fun? We will explore the possibilities and make plans for a “fulfilling future” May 2 – June 6, 2019. Sign up at http://www.shepctrg.org/wp-content/uploads/2019/03/Adventures-In-Learning-Spring-Classes-2019.pdf
Look for more sessions of this workshop – or private coaching about your plans for the future – at TheAgeCoach.net or TheAgeCoach@gmail.com.
When we were children, we couldn’t wait to stay up until the
ball dropped in Times Square, the confetti was tossed, someone sang Auld Lang
Syne … or whatever meant that we didn’t have to be in bed at the usual time.
As young adults, we looked for parties and threw the
confetti ourselves. We were mature enough, we believed, to take on the world.
We wrote New Year’s resolutions that we took seriously, for a couple of days at
And then in middle age, we may have been a bit more subdued,
but noting the year and thinking about the future were still important for
So, what about older
adults? Have they seen it all? Are they “over” celebrating? Should they
have a special early afternoon party and plan to be in bed at the usual
I suggest, rather emphatically, no!
As long as older adults are physically and cognitively
healthy, celebrating and writing resolutions can still have real meaning for
them. Planning new activities, engagement with family and friends, volunteering
or working, refurnishing their houses or moving to new communities . . . new
life adventures . . . may be some of their resolutions for the new year.
As C. S. Lewis wrote
Are you an older
adult? Do you live with or care for an older adult?
I invite you to take
time to celebrate the new year and write your resolutions for 2019!
If you would like suggestions for New Year’s Eve
celebrations and making resolutions, look at New
Year’s Eve & Resolutions (Home Care Assistance) and New
Year’s Eve Party Ideas (Medicare).
The winter holidays are here! Thanksgiving with turkey and the trimmings, conversation, football on TV, and family games. Kwanza, Christmas and Chanukah are next. What warm memories of these celebrations many of us have and how much we would like to participate in all our usual traditions.
But . . .
We are caring for a loved one who has a dementia. Everyone is adjusting to new ways of living our daily lives. We don’t have energy for all our usual preparations. And some of the old traditions aren’t appropriate for a person who has a dementia.
How can we have our special holidays? Here are a few quick tips.
- Adjust your celebrations.
- Modify and simplify your traditions, keeping some of the special memories.
- Involve your loved one in holiday activities that are comfortable and safe for him or her.
- Communicate with family and friends.
- Talk about your loved one’s strengths and changes.
- Plan new traditions together.
- Take care of yourself.
- Ask for help with holiday tasks and caring for your loved one.
- Arrange for respite time . . . quiet time, pampering, exercise . . . for you.
Holidays can still be special for you, your family and friends.
Enjoy the possible. Enjoy the moment. Enjoy new traditions.
For more about holiday celebrations, read the National Institute on Aging article, “Holiday Hints for Alzheimer’s Caregivers” at https://www.nia.nih.gov/health/holiday-hints-alzheimers-caregivers.
Celebrating in new ways:
As we approach Mother’s Day, many of us think about how different the celebration is, now, if Mom is in the middle or late stage of Alzheimer’s Disease or another dementia. We feel sadness, but we also try to honor our mothers in ways that they will understand.
Tips abound on the Internet and in publications, and the tips are wise:
- Simplify the celebrations.
- Adapt your expectations about what Mom will understand and enjoy.
- Give gifts that are meaningful today: soft items to hold, fragrant flowers, a bird feeder that Mom can watch from the living room or porch.
- Listen to Mom’s stories about the past, if she can tell them, and tell the stories to Mom if that meets her needs better.
Still, there are important statistics that suggest there is more to do.
The majority of caregivers for older adults. . . about 2 out of 3 . . . are women; about a third of the caregivers are daughters of the older adult.
As we know, caregiving is time consuming and stressful. It causes the caregiver to put aside her needs, relaxation, hobbies and interests. While the caregiver is providing love and support, she may not have time to “receive” love and support in return.
So, on Mother’s Day this year, let’s celebrate with Mom, but let’s also celebrate the caring and generous hearts of the daughters and daughters-in-law who are by Mom’s side.
- Provide respite for caregivers . . . time away from responsibilities.
- Give gifts that show appreciation and provide the pampering that relieves stress: a gift certificate for a massage, tickets to an art exhibit or popular movie, a quiet meal on the patio.
- Listen to the caregiver’s stories. She may well need to share the delights and the stresses of her caregiving days.
For ideas about celebrating Mother’s Day, read an article posted by the New York City Chapter of the Alzheimer’s Association at Honoring Mother’s Day When Mom Has Alzheimer’s.
For “2018 Alzheimer’s Facts and Figures” (and caregiving statistics), go to https://www.alz.org/facts/.
Recently, “Grandma to Be” sent a letter to advice columnist (and Wait, Wait Don’t Tell Me panelist – yeah!) Amy Dickinson.
Grandma to Be wrote with pleasure that her daughter was expecting her first child. However, she also wrote that she had an 8-year-old step grandchild. She didn’t publicly acknowledge this youngster because she didn’t want her friends to think she was old enough to have been a grandparent for almost a decade.
Dickinson answered, essentially, that life happens when it happens. Embrace the reality.
And I would go even further. Embrace new paths. Embrace change. Embrace the possibilities! New paths can be exciting and joyous.
Becoming a grandparent is one new path that we may come to as we get older. What are other paths you are considering for your life?
- A new job
- Playing with your grandchild
- Caring for an older relative
- Moving to your dream home
- Moving to a senior community
- Taking up a new sport
- Traveling across the United States
To read Grandma to Be and Amy Dickinson’s letters, go to Too Young to Be a Grandmom.
For help thinking about and planning your new paths, contact Dr. Cheryl Greenberg at TheAgeCoach@gmail.com. She will be happy to meet with you, at no cost for a sample session, to see if coaching is a good fit for you.
The legendary cellist Pablo Casals asked why he continued to practice at age 90.
“Because I think I’m making progress,” he replied.
How brilliant! How positive! How engaged in life!
The Myth of the Rocking Chair
The myth about getting older is that seniors can’t work, play or learn, at least not well. When folks believe the myth, they think they must polish up the rocking chair and isolate themselves. They feel useless to others and bored with themselves.
But that is a myth.
Pablo Casals composed his last composition in 1971, at age 94. He traveled to Israel to conduct the Jerusalem Symphony Orchestra at age 96.
Astronaut and Senator John Glenn went into space at age 77.
Everyone remembers that Grandma Moses took up painting when she was 76.
And it isn’t only famous people who have accomplished great things as seniors. In June 2014, Charlotte, N.C. resident Harriette Thompson completed her 15th marathon . . . and broke a record for women in her age group.
Teiichi Igarashi, a former lumberjack, climbed Mt. Fuji when he was 100 years old!
The Reality of New Accomplishments
There is only one secret to accomplishing great things as a senior: refusing the rocking chair and engaging in life.
What new skill would you like to develop? What new adventure is on your horizon? What passion would you like to pursue? How will you complete the sentence, “I did ____________ at age ____________?
Hear an interview with Harriette Thompson at 91 Year Old Breaks Record.