HELPFUL INFORMATION ON ALZHEIMER’S DISEASE AND DEMENTIA
Is a person close to you suffering from Alzheimer’s disease, or are you concerned that he or she may be? Alzheimer’s is an increasingly common disorder. Learn about its symptoms, what to do if someone you love may have Alzheimer’s, and what to expect as the disease progresses through its natural phases.
The person who used to care for you now needs care himself or herself. Family relationships are often flipped as parents become childlike and children take care of their parents. A caregiving spouse may also take on the all-consuming, full-time role of unpaid caregiver for a loved one with Alzheimer’s. More than 6 million Americans ages 65 and older are living with Alzheimer’s in 2023. By 2050, this number is projected to rise to nearly 13 million.1 Alzheimer’s is the most common form of dementia among the elderly. It usually affects people gradually. But, over time, it can take quite a toll on your loved one and his or her entire network of family members and caregivers.
Warning signs of Alzheimer’s
How do you know if someone has Alzheimer’s? Common signs of mild Alzheimer’s include:
- Repeating a question again and again
- Repeating a story word for word
- Forgetting how to do basic everyday activities, such as cooking, making repairs or playing card games
- Becoming unable to pay bills or balance a checkbook
- Getting lost in familiar places
- Neglecting to bathe or shower or wearing the same clothes repeatedly and insisting that this is not happening
- Becoming confused and forgetting the names of people, places, recent events or appointments
- Relying on others to make decisions previously made independently
Key Points
It is believed that staying physically and mentally active and eating nutritiously can ward off or delay Alzheimer’s.
Alzheimer’s disease is different from normal age-related slight memory loss. Look for a number of signs that could indicate Alzheimer’s before assuming anyone has the disease.
If someone close to you has a mild case of Alzheimer’s, now is the time to take legal and financial action, such as drawing up a power of attorney or a health care proxy, before the person’s mental capacity has declined.
Differentiating Alzheimer’s from normal memory loss
One of the first signs of the disease is the loss of short-term memory. For example, someone may forget recent conversations or events. But some loss of memory is common as we age. The normal, minor, age-related loss of memory is known as “age-associated memory impairment” (AAMI). AAMI is different from dementia, including Alzheimer’s, in that it does not progressively worsen, nor does it tend to disable people the way Alzheimer’s does.
Common changes as the disease progresses
Alzheimer’s is a slowly progressing disease. It starts with mild memory loss and ends with severe brain damage. The course of the disease varies, as does its rate of progression. On average, people with Alzheimer’s live for four to eight years after they are diagnosed, but can live as long as 20 years, depending on other factors.
Middle stage
As Alzheimer’s progresses, the changes become more noticeable. Those afflicted by the disease will need more help with day-to-day living. They may need to be reminded about eating, washing or changing clothes. They may fail to recognize people or confuse them with others. They may become easily upset, frustrated or aggressive.
Other middle-stage symptoms include:
Wandering off and getting lost
Mixing up night and day
Experiencing hallucinations, such as seeing, hearing, smelling or tasting things that are not there
Being restless, as exhibited by pacing, trying doorknobs or touching draperies
Becoming a safety risk when alone because of forgetfulness; forgetting, for instance, to light the stove after turning on the gas or forgetting to shut it off.
Severe or late stage
In the most advanced stage, a person with Alzheimer’s will become totally dependent on others for nursing care. He or she may be unable to recognize familiar objects, surroundings or even close relatives.
Other late-stage indications include:
- Being difficult to understand, speaking gibberish
- Being physically frail
- Losing weight
- Losing control of bowel and bladder
- Being too unsteady or weak to walk or stand alone
- Crying out, groaning, screaming or mumbling loudly
- Sleeping more
Diagnosis, treatment and care
No single factor has been identified as the cause of Alzheimer’s. A combination of factors may contribute, including age, genetics, environment, diet and overall health. A diagnosis is often made by ruling out other causes of symptoms. There is currently no cure for Alzheimer’s. But some drug treatments may ease the symptoms or slow the disease’s progress among people with mild or moderate dementia.
When caring for someone with Alzheimer’s, it is good to try to help him or her live as independently as possible for as long as possible. Although you may be tempted to do things for them, people with dementia are more likely to retain a sense of self-worth if they are given the chance to do things on their own. You can help by providing support if necessary, including emotional support and reassurance. As the dementia progresses, the person dealing with the disease may need more help with everyday activities, including washing, bathing and dressing. Eventually, you may have to consider external resources.
What you can do to maintain the brain
Although Alzheimer’s has no cure yet, research has indicated that lifestyle changes can lessen the chances of developing the disease or delay its onset. The Alzheimer’s Association’s “Maintain Your Brain” campaign advocates physical and mental exercise, good nutrition and generally healthy habits.
- Physical exercise – Stay active, walk every day, work out.
- Mental stimulation – Read, converse, work on crossword puzzles, play Scrabble, play cards, take a class.
- Nutrition – In addition to maintaining a well-rounded diet, take a multivitamin that includes folic acid and vitamins E and C and eat foods rich in omega-3 fatty acids.
- Good health habits – Maintain a healthy body weight, keep your blood pressure and cholesterol level low and avoid smoking.
What you can do medically
If you are concerned that you or someone close to you could have Alzheimer’s, see your family doctor. Your general practitioner may ask a specialist, such as a psychiatrist or neurologist, for help in the diagnosis. An early diagnosis could help you or your loved one plan and identify sources of advice and support and may lead to earlier access to treatments.
There is no single diagnostic test for Alzheimer’s. But a complete medical and neurological evaluation will help rule out other possibilities such as infection, vitamin deficiency, depression, thyroid problems or brain tumors. A brain scan — such as computerized tomography (CT) or magnetic resonance imaging (MRI) — may help indicate what is happening in the brain. Other types of medical tests include a blood test, urinalysis and an electroencephalogram (EEG), along with memory and thinking skills tests.
Medical care for people with Alzheimer’s can be provided at home by relatives or by health care professionals such as social workers, nurses, therapists and case managers. It also can be provided in an adult daycare or nursing home. As the disease progresses, you or the person close to you may explore all of these options.
Medicare and Alzheimer’s (if in the U.S.)
Medicare Part A will cover:
- In-patient hospital stays, after deductible is met
- Up to 100 days of Skilled Nursing Home Care in a limited set of circumstances
- Hospice care for those in their homes, a Skilled Nursing Care Facility, in-patient hospice for those that a doctor has deemed at the end stages of life.
Medicare Part B will cover:
- 80% of the approved cost of treatment after the yearly deductible is met.
Every 12 months, a Medicare recipient can go for an Annual Wellness Appointment and Health Risk Assessment. Conducting the Health Risk Assessment prior to the Annual Wellness Appointment may allow for important considerations and discussions with your health care provider.
Medicare also covers Cognitive Assessment and Care Plan Services for those diagnosed with Alzheimer’s or other cognitive impairments.
Medicare Recipients may also want to consider Part D Prescription Drug plans for their medication or additional insurance such as Gap/Supplement plans, Medicare Advantage (Part C) Plans, or Special Needs Plans. Please work with a Medicare Specialist to understand your choices.
What you can do legally and financially
Because Alzheimer’s involves a predictable decline in a person’s mental capacity, it is important to use the time wisely before you or your loved one is no longer able to make important decisions. Once a person with Alzheimer’s is no longer mentally competent, it is too late to designate someone to make decisions regarding health care, financial planning and estate planning.
Consider taking these steps soon:
Advance directive – This could be a power of attorney or a health care proxy. A power of attorney will allow someone else to make key decisions regarding financial and estate planning. A health care proxy will empower family members or close friends to make health care decisions as needed.
Estate inventory – Before conducting estate planning, take an inventory of the resources available, including income and assets, health insurance and community resources.
Estate planning – Have an estate planning expert create or update a will and other estate planning documents such as a living will or trust.
MFS ADVISOR EDGE® Alzheimer’s Disease
This material should be used as helpful hints only. Each person’s situation is different. You should consult your investment professional or other relevant professional before making any decisions.1 Source: Alzheimer’s Association. 2023 Alzheimer’s Disease Facts and Figures. *Medicare does not cover long-term or custodial care Source: medicare.gov. MFS does not provide legal, tax, Medicare, or accounting advice. Clients of MFS should obtain their own independent tax and legal advice based on their particular circumstances. Issued in the United States by MFS Institutional Advisors, Inc. (“MFSI”) and MFS Investment Management.