Safety First

If most people are not diagnosed with Alzheimer's until after age 65, and if most people diagnosed are already progressed to the moderately severe stage of the disease, by which time there are no effective treatments . . .doesn't it make sense that we should be more aggressive in checking younger people for the disease? Maybe we could catch it in its earlier stages, and possibly treat it or prevent it from progressing past the point of no return. Frankly, I think that doctors' natural dismissiveness of so-called "normal forgetfulness" after age 40 is negligent, and may be missing diagnoses of Alzheimer's at a stage when it could still be slowed. What do you think?

Charles in Illinois, 46

My father-in-law recently had his thyroids removed.  He now must take a daily medication.  What would be the best way to set him up for remembering his daily pill?

Stephen in Wisconsin, 48

How can you tell if someone is coming down with alzheimer's or is just confused? My parents are constantly having me repeat myself after a matter of minutes or are trailing off mid-sentence and I am not sure what is going on! Is this just a normal consequence of aging?

Gilles in Florida, 49

My father is only 55 years old, but I have noticed in the past year or so that his memory is almost non-existent in many cases.  He forgot that my oldest son was named after him.  He has been very, very depressed since his mother, my grandma, passed away in 2000.  He's in therapy and on medication now, but he just doesn't seem able to heal from that event.  Dad is always trying to be strong for me, and doesn't like the idea of needing my help in any way...do you have any suggestions?

David in New Mexico, 29

My mom has been diagnosed with early onset Alzheimer’s and is also taking lipitor for her cholesterol.  My dad mentioned to me that he had seen something on tv about people who stop taking the lipitor or statins regaining more memory.  I've googled to try and find out more, but there is a lot of info on taking and not taking the drug and if either improves memory in Alzheimer’s patients!

Sheila in Washington, 48

Hi Doctor Marion,

I’m in serious need of help.  My mother fell and broke her hip almost 5 years ago.  She went into a convalescent home for 10 days and was sent home, with therapy.  She

kicked out the therapist and refused to use a walker.  This was went she decided tosell her home and move in with my husband and I.

She fell 2 years ago and broke the other and it took several weeks for her to recover (refusing therapy again) so she now uses the walker because without therapy

and exercise she doesn't get around well.  Both trips to the convalescent home shefought about meds and the pills they brought for her, the food wasn't fresh etc.

She has always been stubborn and things go her way...even if she is living in myhome.  I don't cook right or do laundry correctly.  She knows it all...even when it

comes to health her theory is you go to the doctor when there is a problem.  Neverhad a mammogram or anything she says that is what causes the problems.

Recently she fell and her idea of getting better is lying flat and healing.  She also was drinking a cup of coffee in the morning (decaf) and a hot mug of instant milk at lunch with a banana.  Since the fall (she says was from the coffee) she has stopped her only 2 cups of fluid resulting in weakness and fatigue to the point where I was feeding her, and she couldn't bath herself.  She also refuses any in home safety bars/equipment or help from an aide.

I ended up calling an ambulance after she was hallucinating about a cat being in her room.  She was taken to the hospital screaming and hollering.  The found she had a UTI and put her on IV with antibiotics.  They wanted to send her home but I said not to release her since she normally doesn't take meds.  The next day she was totally out of it and not in her right mind.  The next day she was back to her old self.  Saying how could I put her there she wasn't sick and if she was it was from my cooking etc.

She was sent against her will to a convalescent home for 20 days to recooperate...Well she's been there for 3 days she said she isn't paying for it.  She isn't staying there she is going to talk to a lawyer, and it's pretty good to send her there because I wanted her out.  She refuses to talk to me, she has 20% hearing in one ear and refuses to be checked for a hearing aid that might help.  She has cateracts and refuses to get her eyes checked.  The people at the convalescent home said she was in bad shape hygiene wise (because of her poor eyesight and lack of balance)...what am I to do...she is in her right mind, stubborn, and is her own worst enemy...Please advise me.

Kim in Georgia, 67

Is there an anxiolytic drug that is safe to use for a patient who has
glaucoma?  My mother is living in a skilled care home and is generally fine. However, she has recently had an episode that was characterized to me (her out-of-state daughter) as "acting out." The result was a Rx for Ativan. So far, I have been unable to pry out the details of prescribed dosage or whether or not the Ativan has actually been given to Mother. However, I am concerned that it will aggravate her glaucoma. She is completely blind in one eye already.  I would appreciate your reply.

Parker in New York, 48

Dear Dr. Marion,

I just saw you on a Sunday morning TV program. You are an answer to my prayer. I am going to get your book as soon as I can get out of the house for a short time to go to the bookstore. Like the lady in Texas, my dad also has Parkinson’s. He realizes, most of the time, that he has limitations. However, it still falls to me to be his caregiver. I have diabetes and at times I find it difficult to meet his needs while still trying to take care of myself as you suggested. I feel tied to the house and my job. He refuses to have anyone in the home when I am at work. He is extremely paranoid and feels that someone is always out to take advantage of him. My employer is aware of the situation and has been very tolerant of the times when I need to leave work to go home and take care of him.

Dad falls quite a bit and will not take his cell phone with him to call for help. There are times when I have come home from work and found him on the floor calling out for help. I can’t lift him anymore and I am afraid Emergency Services are going to stop coming by to help out. I have contracted with an in-home health agency on an as needed basis but dad refuses to call them. I have family but they can't take care of dad as he needs to be taken care of. My sister (she lives in East Texas) comes in and tries to rearrange things to suit her. My brother tries to help with things like lawn care and tree trimming but he has no patience when it comes to taking care of dad.

I guess what I am asking is what can I do to lessen the strain on me. I am burned out and feel like running away. I know I can’t and this only fuels my frustration. I can't go anywhere without feeling fearful that something could happen. I feel trapped. Any suggestions that you can offer would be a blessing.

Barb in Texas, 53