My mother is showing early signs of Alzheimer’s. What should we anticipate and how can we plan for her care needs as the disease advances?
Sam Katz, MD, and Maureen McGilly, MD
Alzheimer’s is a progressive disease that gradually and steadily robs individuals of their capacity to interact with others and to care for themselves. Medications may slow the progress of the disease and can ease some of the associated symptoms, but the person’s increasing dependence and need for caregiving is typically the challenge that families will confront.
Given that you may be facing a time when your mother will be unable to make decisions about her own medical care, Sam Katz, MD, suggested that “it is important for you to talk with her in these early stages about the kind of medical care she wants so that you will know how to direct healthcare professionals when that becomes necessary.
“For example, what if she were to develop pneumonia? How aggressively would she want that treated? Would she prefer that medical care focus only on relieving her discomfort? If she puts her preferences in writing through advance directives, you will be able to use the written documents as a guide when you make decisions on her behalf. And both of you will feel more confident about dealing with future healthcare issues.”
“Those early signs of Alzheimer’s,” according to Maureen McGilly, MD, “usually progress at a slow pace. You may begin to notice, though, that your mother has difficulty dressing herself. You may notice changes in her appetite or ability to carry on a conversation. She may lose interest in what’s going on around her. A community day care center specifically for Alzheimer’s patients can encourage socialization and may be helpful in maximizing her ability to care for herself.”
As your mother’s caregiving needs increase, you may want to consider a senior care facility as a safe, comfortable alternative. When your mother’s Alzheimer’s progresses to the point that she is bedridden, hospice care may be appropriate. The National Hospice and Palliative Care Organization has developed general guidelines to help physicians determine when an Alzheimer’s patient is eligible for hospice care. McGilly emphasized that “Midwest CareCenter staff can work with you and your mother’s physician to decide if hospice is the right care option for her. If so, we can help you and other caregivers focus completely on symptom control and comfort care rather than life-prolonging measures that can lead to repeated hospitalizations.”
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