Get Well Wednesday: What Caretakers Need To Know About Alzheimer’s

Dr. Lisa Ashe is a Board Certified Internal Medicine physician and founder of Be Well Medical Group (Be Well). Be Well provides concierge medical services to patients in the Washington, D.C., Maryland, and Virginia metropolitan areas. Dr. Ashe launched Be Well based on years of experience as a traveling physician and her observations in multiple clinical environments.

She noticed that in the current healthcare climate, many of the critical needs of patients are not being addressed due to limitations imposed by physicians or insurance providers. With a primary focus on patient care and satisfaction, Be Well is a high touch membership practice that truly addresses the concerns of every patient by offering the convenience of same day and next day appointments at the patient’s desired location or her practice in Alexandria, VA.

Dr. Ashe completed her medical degree at the Philadelphia College of Osteopathic Medicine. Thereafter, she completed her internship at Georgetown University and her residency at George Washington University and Providence Hospital in Washington, D.C. She is a member of American Medical Association, American Osteopathic Association, and American College of Physicians. She is also a proud member of Delta Sigma Theta Sorority Inc. and is currently enrolled in the Masters of Divinity program at the Virginia Union University Samuel Dewitt Proctor School of Theology.

What Caregivers Need to Know about Alzheimer’s

What are some basic things caregivers can do to keep someone with Alzheimer’s healthy?

• Nutrition/exercise
• Establish a routine
• Activities

How do you keep them safe?

• Remove things that could endanger them

With Alzheimer’s, is the memory completely deteriorated or are there ways for caregivers to help their loved one’s remember friends/family or important information?

• Memory boost/reminders

Taking care of someone with Alzheimer’s can be very demanding. Do you have any advice for caregivers about maintaining their own health?

• Know your physical and emotional limitations

You can find Dr. Lisa Ashe on Twitter: @bewellmed, @drlisaashe

On Facebook: Be Well Medical Group

On Instagram: @bewellmed

Click over to see Dr. Ashe’s answers to your questions about Alzheimers’disease.

What is the difference between Alzheimer’s and dementia?

Often times, dementia and Alzheimer’s are used interchangeably, however, dementia is a brain disorder that affects communication and performance of daily activities. There are several types of dementia and Alzheimer’s disease is the most common form, which specifically affects memory and language.

Is there also any chance of younger onset Alzheimer’s?

There is a young onset type of Alzheimers, which affects accounts for about 5% of people with Alzheimer’s. It occurs in individuals under the age 65 and You can see it as young as 30.

Is Alzheimer’s hereditary or more environmental?

Alzheimers has both genetic (hereditary) and environmental components. The early onset Alzheimer’s is linked to chromosomal abnormalities. For late onset Alzheimer’s, there is no known cause but there is a gene that shows increased risk for Alzheimers.

But if the Alzheimer’s patient is elderly, how are you supposed to get them to do anything? I thought Dr. Ashe was going to address help for the caregiver.

Those living with Alzheimers should be encouraged to do as much as they can without frustration. So choosing foods that’s are easier to eat, changing to utensils that are easier to manage, encouraging walking with assistance are good ways to help maintain routine, exercise and nutrition. Give them choices, but limit the choices to things that are safe and within their capacity.

Are there test to see if you will develop the illness and is there anything you can do to help prevent it. It runs on my mom’s side of family. 

There is a specific genetic test that can be done to see if you are at risk, the Apolipoprotein E (APOE) 4. It does not mean you will get the disease but suggest increased risk. As you get older, your physician can do simple memory test to catch the disease early.

What factors contribute to the onset of Alzheimer’s? Do any nutrients help prevent it?

The biggest risk factor is age. Others include gender (women are more likely to get it because they live longer) and family history. If someone in your family has/ had it, you are at increased risk. There aren’t any specific foods that we can determine that aid prevention at this time. However, there are studies that suggest the following foods can help:

Vegetables, especially leafy greens like spinach, kale, turnip greens

Broccoli

Foods rich in omega-3 fatty acids: Salmon, beans, some nuts, flax seeds and healthy oils, like olive oil.

Fruits rich in antioxidants: blueberries, blackberries, strawberries, raspberries, plums, oranges, red grapes and cherries.

Coffee and chocolate, cinnamon, olive oil and curry.

Hi, Doc, I have a sister that has dementia. My sister does not remember to eat, or take her medication, and she lives alone. My question is do you think it’s safe for her to be alone? 

It’s difficult to determine is she is safe living alone without seeing her. I would suggest someone, whether it be family or hired help, check on her daily to make sure she is eating and taking her medications. Meal services are available.

Set medication remainder and use pill boxes to organize medications. If you are concerned about her safety, I would suggest taking her to her physician and having he or she do a safety evaluation. Your doctor can also send a nurse to the home to perform a home safety evaluation as well.

What can you do to prevent Alzheimer’s?

There is no specific prevention method as we don’t not know a definitive cause for Alzheimer’s. However, studies show that living a overall health lifestyle can help.

• Exercise
• Diet rich in vegetables and fruits
• lower high blood cholesterol levels
• maintain a healthy weight
• Avoid smoking
• Managing depression
• Avoid consuming large amounts of alcohol
• Participating in brain stimulating activities such as reading and puzzles
• Life-long learning

Dr. Ashe, a friend went from seemingly normal behavior to completely incapacitated within 1 year. How common is this? 

The disease progression for Alzheimer’s varies from person to person. Alzheimer’s can progress slowly over several years and can even progress over decades. Signs and symptoms can be so subtle that no one notices. Additionally, there are other types of dementia that progress quicker. We don’t frequently see complete decline in 1 year, but it does happen.

My mom is 84 years old. Three months ago she just started falling. If she just stands up to start walking, she drops and can’t get up.  She’s in the hospital rehab and they can’t find out what makes her just fall. They check her back, knees, all of these things. Now she needs help to the bathroom. She has four sons, no daughters. It’s a problem. I don’t know what to do next. Please help me.

I’m not sure what her cognitive capacity is but factors like hearing loss, sensory deficits, nerve damage, and dementia can all lead to recurrent falls. If she’s losing consciousness during the falls, than her heart should be checked as well. Medications are a huge cause of recurrent falls, so a thorough evaluation of her medication list can prove useful. Keep her moving and active with physical therapy. For her safety, walking assistance devices and fall precaution should be used at all times. The following can help:

• Wearing sensible shoes
• Side rails on beds
• Remove boxes, newspapers, electrical cords and phone cords, coffee tables, magazine racks and plant stands from high-traffic areas.
• Secure or remove loose rugs from your home.
• Keep clothing, dishes, food and other necessities within easy reach.
• Use nonslip mats in your bathtub or shower as well grab bars
• Armrests on toilet seats

What is the youngest documented age of onset for Alzheimer’s? 

The youngest is about 30, but this very rare.

 What is the average age of onset?

Average age of onset is after the age of 65.

What race is most impacted?

African-Americans and Hispanics  are more likely to get Alzheimers than Whites.

 What gender is most impacted?

Women.

What are ways to relieve sun-downing?

• Keeping a routine. Sun- downing occurs most when routine and comfort are disturbed. So a routine for bedtime, meals and activities are helpful.
• Limit daytime napping as well evening caffeine and sugar to promote sleep good sleep hygiene.
• Letting light in during the day to help internal balance and circadian rhythm.
• Keep a night light on to reduce agitation that occurs when surroundings are dark or unfamiliar.
• Reduce background noise and stimulating activities at night.
• In unfamiliar settings, bring familiar items like photographs and music  to create a more relaxed, familiar setting.
• Reassurance
• You can speak with your Doctor about Medications that help with sleep / anxiety / and combativeness

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