Alzheimer’s disease is a chronic, progressive illness and is the most common cause of dementia in older individuals. It is characterized by progressive intellectual deterioration together with declining activities of daily living. Most people with Alzheimer’s disease also exhibit psychiatric symptoms and behavioral changes.
As with other chronically ill people, those with Alzheimer’s disease often need some type of chronic care. Chronic care differs from the acute care people receive in hospitals and doctor’s offices. Chronic care is characterized by daily personal-care assistance, supervision, help with taking medications, meal preparation, companionship, shopping, cleaning and doing the laundry, for example.
Chronic care in America varies from community to community. It includes community-based and institutional care providers as well as state, federal, and private funding sources. Many Alzheimer’s patients are served by this system — in their homes, in special “dementia-care” programs, in adult day care facilities and in nursing homes. The health care professionals working in this system are typically social workers, nurses, therapists and case managers.
Alzheimer’s disease is fast becoming the most prevalent and the most disabling chronic illness in America. 2-3% of persons aged 65 show signs of the disease, while 25 – 50% of persons aged 85 have symptoms of Alzheimer’s and an even greater number have some of the pathological hallmarks of the disease without the characteristic symptoms. As our chronic care system strains to capacity, people with Alzheimer’s disease and their families need to understand how they can more effectively to ensure the quality of their loved ones’ care. Here are a few tips to help a person care and plan for someone with Alzheimer’s disease.
Creating Advance Directives
Alzheimer’s disease is a dementing illness. As it progresses, people will lose their memory, their ability to reason, and the ability to understand the consequences of their decisions. Once an individual with Alzheimer’s disease has lost competence, it is too late to designate the person he or she wants to make his or her health care, financial and estate-planning decisions.
This is why choosing a decision-maker in advance of incapacity can be critical to maintaining the quality of life for a loved one with Alzheimer’s disease, as well as for his or her family. It is one of the best arguments supporting early diagnosis, since most people in the early stages of Alzheimer’s disease can execute advance directives before their illness has progressed too far.
There are five advance directives to be concerned about:
- Power of attorney
- Health care proxy
- A will
- A living will
- Do Not Resuscitate (DNR) order
For individuals with Alzheimer’s disease, empowering family members or trusted friends to make health care decisions (health care proxy) and to do estate and financial planning (power of attorney) ensures that the caregiving effort won’t freeze up due to a lack of resources or the absence of a decision maker. The proper execution of advance directives by an estate-planning attorney is often a critical component of any Alzheimer’s care plan.