The Herald Bulletin

February 28, 2013

Blankenship: Cognitive decline with age not normal

By Rebecca R. Bibbs
For The Herald Bulletin

ANDERSON, Ind. — Many forms of dementia remain under-diagnosed, leaving those who have it without treatment until they are moderately advanced. Though dementia can’t be cured, many associated symptoms can be reduced and even slowed with treatment at early onset, said certified neurologist Dr. Larry Blankenship, Jr., of Central Indiana Neurology.

“There’s a lot of denial out there. People don’t want to think their loved one has dementia,” he said. “I think one of the solutions is public education. The public needs to understand that cognitive decline with age is not normal.”

Ideally, Blankenship said, doctors would start screening patients for dementia-related conditions at age 70. Bu he admitted over-scheduled family physicians  already spending significant time to control a patient’s diabetes, arthritis and high blood pressure  often don’t properly diagnose causes of dementia unless pressed by caretakers.

“Physicians often don’t have time to diagnose the disorder. It requires a long discussion with the family and the patient,” he said.

Even with current medications, Blankenship said, cognitive decline can only be slowed, not cured.

“There’s nothing I think we’re going to see come to market in the next few years or so, but I think in the future we will see some dramatic treatments,” he said.

Caregivers also must be prepared to ensure the physical safety of individuals with dementia and act as advocates to protect their wards’ financial futures, said those who work with caregivers.

Sandy Zentz, who runs a number of caregiver support groups through Community Hospital, agreed many people wait until their loved ones condition has advanced before asking for help, which often puts the patient in danger.

“They’re always desperate by the time I get the call,” she said. “It happens so quickly, but when you live with someone, you don’t notice it as much.”

In one instance, Zentz said, a caregiver she knew went to Florida for several months, as they did each year. But the woman’s husband grew increasingly confused, driving onto the exit ramp and becoming combative with his wife.

Zentz, who was a caregiver to her father who had Alzheimer’s disease before he died 17 years ago, said she can tell when a senior should have a caregiver, such as when an older person is left in a car in a parking lot. As with a small child, she stressed, it’s never acceptable to do that, even though the person is an adult.

“I can tell that caregiver has gone in for a prescription or a loaf of bread or a gallon of milk. And it freaks me out,” she said. “It’s about safety. When you are leaving your loved one alone, that is not safe.”

Though it’s uncomfortable to do, caregivers also must take legal responsibility for a loved one with dementia. That means removing their names from the checkbook, transferring title to a home or other property and taking away the car keys.

Melanie Morris, senior care navigation coordinator at St. Vincent Anderson Regional Hospital, said developing a cooperative plan for the care of a family member can be shared rather than shouldered by one individual.

“A lot of times, the family has to piecemeal the care of a person with dementia together,” she said. “When families are successful, a lot of times, it’s that they have managed to share the responsibility.”

Even if a family member is placed in a skilled nursing facility, Morris said, the family should schedule frequent times to drop by and check on him or her. It’s the family who must make sure dentures fit, that hair is styles and that exams are performed.

“The more you’re able to be visible and involved, the better the outcome,” she said. “It’s some of those dignity issues that only the family knows. If the family isn’t there, who is looking out for the dignity issues?”