Ask an Expert

Researching your senior living options can leave you with more questions than answers. MyGuide for Seniors is here to help you find the answers to your most important questions. Send your questions to Nancy Carman, MA, CMC, a Gerontologist and certified Geriatric Care Manager.

Ms. Carman won't be able to respond to individual e-mails, but she will be posting answers to commonly asked questions. Check out the questions and answers below - or click here to "Ask the Gerontologist" your own question.

Question: Please list all the tests that one should expect a family doctor to do to determine the diagnosis of dementia and Alzheimer's.

Answer: Dementia is a "catch all" term that is used to describe a decline in cognitive skills or mental function. There are a number of different types of dementia including Alzheimer's disease, which is the most common form of dementia. Other types of dementia include vascular dementia, often characterized by mini-strokes, Lewy body dementia, Parkinson's disease dementia, progressive supranuclear palsy dementia, Huntington's disease dementia, Pick's disease dementia, alcohol-associated dementia, dementia due to infections such as late stage AIDS, dementia due to a brain tumor, and normal-pressure hydrocephalus dementia. Some temporary conditions can resemble dementia such as delirium. There are also "Pseudo dementias". These are conditions that look like dementia, but are reversible such as depression, Vitamin B12 deficiency, an under active thyroid gland, and improper use of medications. Although not exhaustive, this list demonstrates that there are many types of dementia that can create memory loss, changes in personality, difficulty using language, and disorientation that can cause difficulties with everyday activities.

Because an accurate diagnosis of the type and cause of dementia is important, the National Alzheimer's Association recommends that a physician be consulted early on about any concerns with memory, thinking skills, and behavior changes. You may even want to ask for a referral to a physician who specializes in the diagnosis and treatment of Alzheimer's disease and other dementias. Your local chapter of the Alzheimer's Association can refer you to physicians and/or diagnostic centers in your area. The diagnostic process typically includes a medical history, a mental status evaluation, a physical exam, a neurological exam, laboratory tests, and a psychiatric evaluation. Other tests that may be ordered are an EEG (electroencephalogram), CT (computerized tomography) scan, MRI (magnetic resonance imaging), PET (positron emission tomography), and SPECT (single proton emission computed tomography). To learn more about the diagnosis of Alzheimer's disease and related dementias, visit the National Alzheimer's Association's web site at http://www.alz.org.

Question: What type of living arrangements would you suggest for a person who is very forgetful? What do you suggest we do for the person as far as living arrangements?

Answer: First and foremost I would suggest that you encourage your loved one to visit her primary care physician in order ascertain what is causing her forgetfulness. A thorough examination may point to any number of reversible causes such as depression, vitamin deficiency, improper use of medications, an under active thyroid gland, or irreversible memory loss caused by mild cognitive impairment, Alzheimer's disease, or other related dementias.

Should her physician come to the conclusion that her forgetfulness is permanent, establishing a living environment that is familiar and safe is of utmost importance. It may be necessary to provide a companion or a home health aide to assist with housekeeping, grocery shopping, meal preparation, transportation, and other supportive services. If necessary, around-the-clock care may need to be arranged. You should be able to get a list of local providers of supportive services from your county Office on Aging which is listed in your phone book, or on the Internet through the Eldercare Locator http://www.eldercare.gov/Eldercare/Public/Home.asp.

Another resource that could be of great help during the day is a local Adult Day Care Program with activities designed for individuals with memory impairments. The National Adult Day Services Association has listings of programs by state at http://www.nadsa.org/links/StateAssociations.htm. Your county Office on Aging should also have an up-to-date list of Adult Day Care Programs.

If you conclude that your loved one is unable to reside at home safely, it may be time to take a look at assisted living or supportive living alternatives. You can use the MyGuide to Communities for Seniors on-line database to find communities in your area that meet your loved one's needs. You also may want to consider engaging the services of a Geriatric Care Manager who can work closely with you and your loved one to make the best decision possible. You can locate a Geriatric Care Manager through the National Association of Professional Geriatric Care Managers at their web site http://www.caremanager.org

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