A Doctor’s Guide to Dealing with Alzheimer’s Disease

Lesage_Suzanne_0648Alzheimer’s is a confounding disease, even for doctors. Salida (Colorado) neurologist Dr. Suzanne Lesage ought to know. Through her role with the Heart of the Rockies Regional Medical Center, she sees new patients who may be concerned about memory loss. Dr. Lesage also counsels others living with the diagnosis on how to best cope with a disease for which there is currently only treatment of symptoms but no cure.

In a recent informational session conducted for 50-plus community members by the Alzheimer’s Association of Colorado, Dr. Lesage joined fellow neurologist Dr. Yvonne Rollins and Ann Carter, regional director of the Southern Colorado Region of the Alzheimer’s Association, to discuss the basics of memory loss and dementia and answer questions regarding the challenges the disease poses for individuals, caregivers and doctors alike.

“Dementia is slow in developing,” said Dr. Lesage. “We can offer a diagnosis based on symptoms, but even under the broad umbrella of dementia, there are multiple types, including Alzheimer’s, vascular, Lewy body, frontotemporal and others, and some patients may be living with more than one.”

Doctor’s advice

Even with the uncertainty surrounding dementia, and specifically Alzheimer’s, Dr. Lesage counsels her patients and their families that there are specific steps they should take to ensure the best care for loved ones who are either dealing with a dementia diagnosis or have concerns about the disease:

  • Be proactive – “At the primary care level, people must be proactive with their doctors,” said Dr. Lesage. “There is a huge spectrum among doctors regarding their comfort level with dementia. Some feel – because there’s currently no cure – that there’s not much they can do.”

Because some doctors may be reluctant to issue a dementia diagnosis, there is a risk that they will not provide the guidance that families need to take appropriate steps.

“A diagnosis gives hope and clarity to the patient,” Dr. Lesage said. “At least they know what they’re dealing with.”

  • Free 24/7 Helpline – A referral to a neurologist can lead to a proper diagnosis, she said. The Alzheimer’s Association’s free 24/7 Helpline (800-272-3900) is another resource for direction.
  • Rapid Referral – Dr. Lesage is a strong advocate for the Alzheimer’s Association Rapid Referral program, which enables doctors to put the individual and their caregivers in touch with a full range of services – all at no charge – that physicians are not in a position to provide.

If there is concern about or discussion of dementia, or Alzheimer’s in particular, Dr. Lesage said there are specific subjects that she raises with her families that should be addressed with the primary care physician, including:

    • Medications that may provide some benefits
    • Counseling for the individual and family
    • Driving considerations and potential restrictions
    • Medical power of attorney and when it should be transferred
    • Types of in-home and residential care that families can consider
    • Opportunities for financial assistance
    • Referrals to support groups, like those provided by the Alzheimer’s Association of Colorado
  • Get support – Caregivers need to understand that they do not have to face this situation alone. In addition to support groups, families can reach out to their regional Alzheimer’s Association of Colorado office or call the free 24/7 Helpline to schedule a Care Consultation. In addition, there is a broad range of resources available in terms of educational information, message boards, classes, clinical trials and newsletters from the Alzheimer’s Association, all provided to the public at no charge.

In addition, Dr. Lesage said that individuals should rely on their primary care physician for medical information and guidance.

  • Continue living – Dr. Lesage emphasizes that an Alzheimer’s diagnosis doesn’t mean the person’s life is over. She stresses that there can be significant quality of life, even later in the disease’s progression. She notes that she has helped devise travel plans for families where a loved one has advanced Alzheimer’s. “Even if they don’t remember the trip, they can enjoy the day,” she said, adding that new memories are created for loved ones.

“The goal I set is for my patients with dementia to stay in the home until it’s time for them to move into hospice care,” said Dr. Lesage. “It’s not appropriate for all, since caregiving capacity is very individual but, for many, there is still good quality of life close to its end.”

 

2 thoughts on “A Doctor’s Guide to Dealing with Alzheimer’s Disease

    • I would like for this message to be forwarded to Dr. Lesage for her reply. Thank You.

      Dr. Lesage: My husband has been treated for Alzheimer’s Disease for over a year by a Neurologist in Denver. In February, 2017 he was enrolled in a test program and had a PET scan. His test turned out negative for Alzheimer’s. But, when we went to the Doctor for the follow-up he was told he had MCI – amnestic type. Possibly dementia vs psych or other type of dementia. He thought in February that it is now more psych, OCD and anxiety. I asked what kind of dementia and the doctor said he did not know. Only when he died would they find out. Well that was not reassuring to me. He has been on memantine and donepezil , escitalopram and trazadone for quite some time. Prior to seeing the doctor in Denver, we had been through three other doctors with no help. This was over at least three years. Diagnosis from depression to complex partial seizures. Had several EEG’s and MRI’s. Even had a 48 hour EEG in Denver. I am to the point that I need some guidance to deal with Dr. Jekyle and Mr. Hyde. I have received no guidance from our doctor in Denver. Doctors seem to forget the caregiver. They don’t care. If not for the caregiver, the person with the disease would be lost. As, sometimes, the caregiver feels! He puts on such a good front people seem to think there is nothing wrong with him. He acts perfectly normal around other people. The doctor appointments turn up no problems. The one verbal test he took with the doctor came out okay. But I see him stare into space, forget numerous things, become extremely angry, moody, suspicious of what I am doing, no confidence, no energy, talking to himself, screaming out when things go wrong, chewing on his fingernails until they bleed, and I could go on and on. I requested that he not drive. He does only drive to town with me in the car. We live between Walsenburg and LaVeta. There are no doctors here and the ones we went to in Pueblo, we might as well not have gone. The doctor we are going to in Denver came highly recommended. So we went and now we are at another plateau. I know there is some kind of dementia and I want to know what it is. All we get is, well it might be this, or it might be that, or I don’t know. When I came across this email, I thought I would give you a try. Thank you for your concern and I await your reply. Our home phone number is 1-719-738-9962. Mary Alice Kemper

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