Alzheimer’s Disease and Other Dementias: Symptoms, Stages, and Communication Strategies Expanded ____
For patients with AD symptoms, receiving a diagnosis can improve their quality of life, giving them the chance to plan and share their thoughts (Wollney et al., 2022). About 34% of patients receive their diagnosis from their primary care physician (PCP), and 48% of patients receive their diagnosis from a specialist. Many symptomatic people do not receive a diagnosis. This can be due to the inaccessibility to a specialist, complacency, a lack of education, and a poor or nonexistent support network. Care partners and caregivers play an integral role in obtaining a proper diagnosis. Primary care physicians may be reluctant to provide a patient with a dementia diagnosis (Wollney et al., 2022). Some physicians lack training in this area and are uncomfortable with the few effective pharmacological therapies available. Other challenges include cultural/language barriers and a lack of education about the benefits of an early diagnosis. Self-Assessment Quiz Question 10. Which statement pertaining to providers and an AD diagnosis is true? A) Providers always have a full picture and history of patients’ manifesting AD symptoms. B) There are indications that primary care providers are reluctant to provide a patient with a dementia diagnosis. C) Physicians are comfortable with the treatments available to treat AD. D) Patients are better off seeing the physician alone. Once a patient does receive an AD diagnosis, they may experi- ence the following emotions (Alzheimer’s Association, 2022). • Anger • Resentment
ATTRIBUTES OF ALZHEIMER’S DISEASE A diagnosis of AD or other dementia can be an illogical chal- lenge. It is important to recognize that professional attributes and care include a sense of compassion, empathy, patience, and understanding. While symptoms can be addressed, manage- ment of AD is fluid and can be long term, especially because there is no cure (Shin & Habermann, 2022). If a person exhibits AD/dementia symptoms, trained providers may perform the following tests and examinations (on Table 4) to diagnose and determine a care plan, if necessary. TEST/EXAMINATIONS USED TO DIAGNOSE AD Examination Protocol Examination/Test Complete physical exami- nation • Check reflexes • Evaluate muscle tone/ strength
• Sit to stand • Evaluate gait Neurological examination • Evaluate balance, coordination
• Responsiveness to hearing and sight • Complete blood count (CBC) • Check liver function • Glucose • Thyroid function • HIV • Electrolytes • Folate test • Vitamin B12 concentration • Evaluate severity of brain degeneration • Deep insight into brain— looking for tumors, nerve damage, unusual marking • Measure/evaluate brain wave activity • Unveil AD amyloid proteins
Blood labs
• Relief • Denial • Depression • Fear • Social isolation • Grief
CT scan
Magnetic resonance imag- ing (MRI)
Electroencephalogram (EEG) Positron emission tomog- raphy (PET)
Addressing basic needs—lonely, angry, hungry, and/or tired— can provide insight for caregiver response. Patients in the earlier stages of AD may feel as though they are losing control of their environment. They may also be in denial, and their behavior may change. The middle stages of AD include anger and agitation as the person becomes frustrated and loses their ability to reason as well as think critically and logically. They may express shame and paranoia. The later stages include apathy, lethargy, and social isolation (Alzheimer’s Association, 2022). Understanding these stages will be beneficial to the individual affected as well as their caregiver.
Adapted from Alzheimer’s Association (2022)
Table 4
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