HomeMy WebLinkAboutHuron Expositor, 2009-11-11, Page 12Page 12 The Huron Expositor • November 11, 2009
News
Doctor explores complexities of dementia
Sgrah McDonald
Recognizing and coping with differ-
ent types of dementia was the sub-
ject of a presentation by Dr. Geoffrey
Daniel during the Alzheimer's Soci-
ety of Huron Dementia 2009 dinner
last week.
One of the biggest challenges re-
lated to the disease from where Dr.
Daniel sits is the fact that symptoms
of Alzheimer's -related dementia are
so often initially chalked up to regu-
lar signs of aging or misdiagnosed as
depression.
Daniel explained that it is vital to
educate healthcare workers about the
differences between depression and
dementia. "Although we don't have a
cure, we can slow down progression if
it's diagnosed early," he said.
"We can't call everything depression.
Sometimes there are issues of greif, in
terms of loss or issues of adjustment,"
Dr. Daniel explained. "A really good
example would be someone comes
into a retirement home and they have
a really rough first month, we're not
going to say, 'hey that's depression
let's get them on anti -depressants,'"
An important distinction to make
during diagnosis is between apathy
and depression, said Dr. Daniel.
"The number one behaviour in al-
zheimer's is apathy. It can be very
frustrating for the person with de-
mentia• for sure. So it's important to
help the families understand that ap-
athy is not laziness and to help physi-
cians understand that apathy is not
depression."
"It's kind of like , we all have an en-
gine in our brain and when we want
to do something we step on the gas
pedal, rev the engine and go do it,"
he explained. "So apathy is where
you have a cut in that accelarator
cord, in that connection. The person
wants to do things but they step on
the gas and nothing happens. It's dif-
ferent with depression where they're
irritable and they don't even want to
step on the gas pedal."
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In the two years before alzheimer's
takes hold, a person might look like
they're simply depressed.
Doctors should talk to the family
about issues with day to day func-
tion. However, Dr. Daniel
cautions, it is important to put ques-
tions regarding day to day function to
someone other than the patient.
"You don't ask the person with Al-
zheimer's with the chainsaw, 'how are
you doing with that?' because they'll
say 'Oh fine!'. You have to talk to the
family."
Dr. Daniel added that it's a good
idea for doctors to speak with spouses
seperately to avoid being put in the
positiion of marriage counsellor.
A functional activities questionairre,
availabe through the alzheimer's so-
ciety can also assist in diagnosis. Dr.
Daniel recommends family members
who suspect dementia keep an eye out
for red flags such as problems with
shopping alone for groceries, keeping
track of current events, spoiled food
in the fridge and burnt pots.
It's important to look at the pa-
tient's strengths, Dr. Daniel said. For
example, if a woodworker starts mak-
ing sloppy. mismeasured projects, or
an accountant has trouble with num-
bers, those are red flags
to watch for.
One of the major concerns for care-
givers of someone with dementia and
alzheimers is the habit of wandering,
which is common to the disease. Dr:
Daniel said it's important to realize
that something as seemingly harm-
less as leaving outerwear and boots
by the door can actually act as a cue
to someone with dementia to leave
the house.
In terms of prevention, although
little is known about why alzheimer's
occurs, quitting smoking, decreas-
ing trans fats and high sugar intake
and wearing a helmet are all recom-
mended.
Dr. Daniel also said it's important to
meet people who have been diagnosed
on the level where they are currently
at when encouraging them to do ac-
tivities that may combat the progress
of Alzheimer's. "Instead of insisting
that they start doing crosswords,
which might freak them out if they
can't complete it, start with some-
thing like a word search. Or instead
of saying, 'Go out and garden! We
know you love gardening!' you might
have to lay out the seeds and tools for
them the first couple of times."
Day programs can also be a great
help for both patients and caregiv-
ers of people with Alzheimer's, said
Dr. Daniel. "Not only do they provide
some respite for the caregiver and
enjoyment for the patient, but it's an-
other set of eyes on the patient," he
said.
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