United States Department of Veterans Affairs

Milwaukee VA Medical Center

Milwaukee VA answers your Qs and As about dementia and Alzheimer's

 

Fear.

It’s one of the main reasons people who may have dementia are hesitant to get help or let a loved one know.

“We see people all the time for dementia,” said primary care social worker Maria DeMaio. “A lot of times, by the time people get help, they’ve been dealing with this for a long time. The sooner it it diagnosed, the better. If someone has the signs, they might be afraid of the unknown. They’re afraid of losing their ability to drive or live alone. They’re afraid of losing that independence.

“The funny thing is we see caregivers who are afraid to ask for help. They’ve been helping their (loved one) for so long, and they might be the least likely to accept or request help when there are a lot of resources available,” DeMaio added.

The Milwaukee VA offers a well-rounded care team that is unlike many others in the community. This combination of physicians, social workers and care providers can help those suffering from dementia, as well as the loved ones who must take care of them.

While some may think it’s just an “old person” disease, the truth is early onset dementia can occur in people in their early 40s. But while some people may forget a name or lose their keys, that might not mean they have dementia, DeMaio said.

"It's normal to forget a name or forget something, and that can be caused by stress," she said. "If you forget you have a car, or where you parked your car, and this is a consistent problem, that may be an indication of something more serious."

In addition to the care we provide at the VA, we provide information on support groups in the community run by the local Alzheimer’s Association, DeMaio said.

“We would rather see people get help right away. There is training and workshops available that can help those who have the disease, as well as support groups for family members. This can be a very isolating disease, and these support groups provide comfort and let you know other people are going through the same thing.”

For a list of support groups in the area, call DeMaio at 414-384-2000, ext. 42668. You can also get information from the Alzheimer’s Association at 414-479-8800. A national line is also open 24/7 for caregivers at 1-800-727-3900.

We care about you and the care you and your loved ones get at the Milwaukee VA. The questions and answers below address many concerns people have about dementia:

Q: What services does the Dementia Clinic offer at the Milwaukee VA?
A: The Dementia Clinic consists of a multi-disciplinary team, which consists of neurology-dementia specialists, psychiatry, medicine and neurology residents rotating through, post-doctorate fellow in gerontology, psychiatry-geriatric fellow, neuropsychologist, and an Alzheimer Association liaison.

Q: Where is it located?
A: Fourth floor of the Milwaukee VA Medical Center.

Q: What is the difference between dementia and Alzheimer’s?
A: Alzheimer’s is actually one form of dementia. Alzheimer's is the most common form of dementia, a general term for memory loss and other intellectual abilities serious enough to interfere with daily life. Alzheimer's disease accounts for 50 to 80 percent of dementia cases.

Q: I think a loved one may have dementia or Alzheimer’s. Is there a test that can be done to find out?
A: A neurologist can assess a patient during a clinic appointment, and then refer to neuro-psych for full testing.

Q: What are some signs that I should look for?
A: Changes in behavior, getting lost driving, forgetting to take meds or appointments, personality changes, changes in personal habits (hygiene), suspiciousness/paranoia, and a decline in retaining new information. For more information, here are 10 warning signs.

Q: My loved one seems to have memory problems, and I’m afraid it’s going to get worse, but I don’t know how to bring up the discussion with him. What advice can you give me?
A: Don’t start by saying. “I have noticed your memory is getting worse.” Instead, ask, “Have YOU noticed … ” This can be a very delicate matter that can cause people to get upset. If the person you ask becomes defensive, enlist someone else to approach him or her, such as a trusted friend, child or parent.

Q:  Do you offer any services to family members suffering from dementia or Alzheimer’s?
A: The VA can offer in home healthcare that includes a home health aide, homemaker, and in-home respite. The VA  also offers Adult Day Healthcare or fee services for a community adult day care center that is contracted with the VA. In-patient respite at a VA contracted community nursing home is another option. The home telehealth program is another service that is now being fully endorsed through the VA for caregivers of dementia patients.

Q: Once someone is diagnosed, what is the normal treatment?
A: Prescribing medication through neurology, gerontology and psychiatry clinics.

Q: Is there a cure or medicine that can stave off the effects?
A: Research shows that in many cases, medication can cause stability of symptoms, but there is no cure. There is a lot of research taking place in this area.

Q: What is the typical age of someone diagnosed with dementia or Alzheimer’s?
A: As early as the 40s and as late as 80s to 90s.

Q: What things should I be aware of now that I’ve been diagnosed, or my loved one has received the diagnosis?
A: Realize that dementia is a progressive disease and there is no cure at the present time. In most cases, the better you take care of yourself, the slower the decline. Safety is primary!

Q: Can I live on my own if I have dementia or Alzheimer’s?
A: This depends on the type of dementia you are diagnosed with and the stage you are in. We recommend you speak candidly with loved ones and medical providers, and not become defensive. We understand this can be a very emotional topic, and we have social workers on staff who can help you, and help set up your affairs. If a loved one suggests you shouldn’t live by yourself, it is probably because he or she is worried about your safety.
 
Q: What resources does the VA offer those with this diagnosis or their loved ones?
A: We have adult day healthcare, and options in the community. Please talk about your concerns with your spouse’s social worker, and he or she will help outline all the options available.

Q: If I want to be checked for this, or I know someone who should be tested, what is the first step?
A: Make an appointment with your primary care provider, or encourage your friend to also make the appointment. The next step is a referral to the neurology/dementia clinic.

Q: How many people are diagnosed with dementia or Alzheimer’s every year?
A: While exact numbers aren’t available, the Alzheimer’s Association states 5.4 million people are currently living with Alzheimer’s, and that includes one in eight older Americans.

Q: What is the life expectancy of someone who has been diagnosed?
A: It depends on the type of dementia and is variable based on health, stages and progression of the disease. It is best to speak with your healthcare provider if you or a loved one is diagnosed.

Q: Is it true that crossword puzzles and other brain teasers can keep my mind sharp so I don’t get dementia or Alzheimer’s?
A: Yes! The more stimulation and activity the brain receives, the more neuro-activity takes place.

Q: What about gingko biloba and other over-the-counter supplements?
A: Gingko biloba does not seem to have a pharmaceutical effect, however, it is a blood thinner and antioxidant, so it MIGHT have some positive value with memory. THERE IS NO SCIENTIFIC EVIDENCE supporting the use of supplements. There is growing evidence of a healthy Mediterranean diet and routine physical activity as having a protective effect from the development of dementia.

Q: What advances have been made in the field of dementia and Alzheimer treatment?
A: Diagnostically, we can now measure with a PET scan the amount of protein that leads to Alzheimer’s. Therapeutically, there are vaccines against dementia that are also currently being investigated.

Q: Can you recommend support groups or other literature for family members?
A: Yes! The Alzheime Association has extensive literature available as well as schedule of current support groups. For more information, go to: www.alz.org.

Q: Now that my family member has been diagnosed, what steps should I take to oversee his/her health, welfare, finances, etc.?
A: Make sure they have a DURABLE POWER OF ATTORNEY FOR HEALTHCARE in place; have them take a driving evaluation if driving is a concern; and make sure he or she doesn’t cook (if there is concern) unless supervised. There should be no use of guns, firearms or power tools, unless supervised, and protect them from scams taking place in the community.

Q: Is this a bigger problem in people who have served in war?
A: No. Research that has been conducted shows war was not a causative factor. There is no proof thus far to indicate otherwise.

Q: Is there anything else that I should know?
A: We would like to emphasize the importance and value of the multi-disciplinary team that is offered in our clinic. Each team member brings their expertise and consults and collaborates with others. This type of team is not a common occurrence in other neurology clinics, and is one more example of the world-class care we provide at your Milwaukee VA Medical Center.