As the caregiver for your loved one, you are often the first to hear about patients complaints about memory loss and possibly dementia.
As the caregiver, you will be the first to witness the signs that no one else would see for quite some time.
With some information, you can ID cognitive deficits along with the possible causes. You can also relay these findings to your loved ones PCP and get the correct treatment or engage the PCP for further analysis.
Cognitive impairment in older adults can have a range of causes which can include medication side effects, metabolic or endocrine derangements, delirium because of intercurrent illness, depression, dementia, and Alzheimer’s dementia is the most common.
Some main causes, like depression and med side effects can be reversed with time and treatments whil others such as Alzheimer’s disease cant be reverse no matter how much time and treatments are administers. However, symptoms can be treated for a certain period of time.
Any individuals who are developing or have dementia don’t receive a diagnosis. Most times physicians are unaware of cognitive impairment in patients. The reasoning for this is most times the patients put forth all of their energy to appear as normal as possible. This is sometimes referred to as “show-timers”.
Most families taking care of a family member with memory, cognitive or behavior complaints want a diagnosis to understand the nature of their issues and what to expect. However some families are exactly the opposite due to the fear of not only the diagnosis and the further it represents.
Medications related to Alzheimer’s related memory loss or other cognitive symptoms are very limited and non can stop or reverse the progression. However, screening and assessing the impairments and identifying its causes, especially in its early stages can offer benefits such as:
- Early treatment (if treatment is possible)
- Managing color is conditions more effectively
- Addressing potential safety issues
- Allowing patients to create of update advance directives and plan long term care
- Ensuring patients direct caregivers with meicical legal and financial concerns
- Ensuring the caregiver receives appropriate info and referrals
Physicians can do the screenings usually in 10 minutes or less to initially assess a patient for cognitive impairment.
Screenings alone are insufficient to diagnose but they are a great first step.
The AD8 along with the minicog are just a couple of the many screenings that can be implemented.
The screening I personally use is the slums test as it is the one that is used by the veterans affairs
Positive screening results tend to warrant further evaluation. A combo of cognitive testing and info from a person who has frequent contact with the patient such as a caregiver is the best way to fully assess cognitive impairment.
I have personal experience with this. I had always thought my father in law had some mental impairments with cognition. I did some basic assessments and saw some results that let us know he was not in full possession of his cognitive faculties.
I let his PCP know and through some testing and evaluation from a psychologist, t turned out he was officially diagnosed with major neurocognitive disorder. He has periods of mental state changes as I have stated in prior blog posts.
It is not easy, but being prepared for it makes things a little easier to deal with.
In later blog posts I will talk more about my experiences with major neurocognitive disorders.