Joanne Koenig Coste

Caring.com Expert

About

Joanne Koenig Coste is a nationally recognized expert on Alzheimer's care and an outspoken advocate for patient and family care. She is author of the award-winning Learning to Speak Alzheimer's. She currently is in private practice as an Alzheimer's family therapist. Ms. Koenig Coste also serves as President of Alzheimer Consulting Associates, implementing state-of-the-art Alzheimer care throughout the United States.

Recently Published on Caring.com

  1. Sunday October 30, 2011

    1. I'm really concerned that my husband's behavior isn't from normal decline that comes with age, what should I do?

      Answer - Get a new doctor! The symptoms your husband is demonstrating are not usually associated with natural aging but are commensurate with a dementia such as Alzheimer's (AD), Pick's, Lewybody disease, Frontotemporal Lobe or a Vascular dementia...

  2. Friday October 21, 2011

    1. How do we get my mom with dementia to stop trying to walk when she can't?

      Answer - Your mom sounds quite typical of most dementia folks in the mid-stage of disease. I'm sure each time you remind her that she can't walk, she immediately forgets what you've told her and tries to walk again. The information about not walking simply didn't get stored and so is not retrieved moments later when she attempts to stand again...

    2. How can I balance my life and my fear of my mother passing away without me with her?

      Answer - It often feels like an eternity while living with anticipatory grief and waiting for a loved one to die. We experience many of the stages of grief that have been written about for a very long time - most notable may be Elizabeth Kubla Ross's work which I encourage you to read to help make sense out...

    3. What kind of floor covering would be best for an Alzheimer's patient who spills things every day?

      Answer - I would definitely install 'fake' or laminate hardwood floors for two reasons: 1. they are very easy to care for and wipe clean with a little soap and water. 2. hardwood floors are most likely what is in her long term memory as they were the primary floor covering when most current AD folks were younger...

    4. What can I do to minimize the negative atmosphere that my uncle creates when he visits my aunt with Alzheimer's?

      Answer - It must be so disheartening to be doing so much for your aunt and to have your uncle be so negative toward you. I hope you have folks who do know how much care you give and who support you. I think your idea to 'not say anything when he says something bad' is probably the best solution...

  3. Tuesday October 18, 2011

    1. How necessary is an eye exam for someone with dementia?

      Answer - I have such mixed emotions answering this question. My first response relates to having the eye exam to rule out problems that could cause discomfort. Since it is sometimes difficult for a person with dementia to report the discomfort, an exam may be the only way to diagnose such medical problems as Glaucoma,etc...

  4. Monday October 17, 2011

    1. How can I get additional caregiving help for someone who doesn't like stranges in her home?

      Answer - It sounds to me as if your friend is more work than you can handle. She needs a great deal of nursing care related to her multiple medical conditions that seem beyond what you could possibly do alone. Take your pals' advice and get some additional help...

    2. What can I do to protect our dogs from my husband's dementia related aggressiom?

      Answer - It is difficult enough to be the caregiver of a family member with Frontal Temporal Dementia (FTD) without the added anxiety of having to protect your pets. This must be so discouraging for you since caring appropriately for your husband will most likely mean putting your dogs in harm's way...

  5. Sunday October 16, 2011

    1. How can I get my husband with dementia to let me help him when he has "accidents"?

      Answer - My heart goes out to you as I read of your frustration that so obviously stems from your love for him. More important than his incontinence, is the need to take care of yourself. If something were to happen to you, who then would be the caregiver for your husband...

  6. Tuesday October 04, 2011

    1. If Alzheimer's medications slow the progression of Alzheimer's for 6-12 months in 50% of patients, what happens in the other 50%?

      Answer - Now that's a really logical question! In the other 50% there is generally no change noted in cognitive, physical or behavioral function. This may mean the diagnosis is a related disease and not 'true' Alzheimer's disease(AD) or, that the change is too insignificant to be measurable...

    2. How should you go about getting a diagnosis for memory loss?

      Answer - Diagnosing a memory problem is a complex task and involves specific psychological and neurologic testing. In the early stages of progressive neurological disease such as Alzheimer's, blood work is generally done to rule out underlying medical causes for the change in his memory and cognition. The results of the MRI may be different in another year...

    3. Is Alzheimer's medicaiton also effective for other types of dementia?

      Answer - You have done your research well! The only way that Alzheimer's disease can be accurately diagnosed is with a complete neurologic work-up performed by a team of specialists. The testing includes medical exam, brain scan, family/social history, and neuro-psych testing; in 2011, the results of diagnostic accuracy are extremely high...

  7. Monday October 03, 2011

    1. How can I help my husband while traveling without telling out tour group about his Alzheimer's?

      Answer - I have a friend who, like you, cares for her husband with AD and, facing the same issues you mention, travels with him as much as possible...with one major exception. My friend wrote a note to fellow travelers explaining that hubby has AD and stated that "Bill loves to chat about the Boston Red Sox and was a former plumber who loves telling 'plumbing jokes'...

  8. Sunday October 02, 2011

    1. Does my mother have Alzheimer's or just dementia?

      Answer - Your instinct is probably quite right. Research does show that geographic moves can have a negative effect on an AD person. Keeping mom in familiar surroundings may be best for her even though being away from her is emotionally draining for you. Be well jkc

    2. How can I get my mother to remember that my sister and I are visitng her home, not the other way around?

      Answer - WOW! First of all, I want to complement you on the heroic effort you and your family are putting into your parents' care. Please don't be so hard on yourself Debbie but try instead to focus on the monumental task of caring that you have been successfully managing for a very long time...

    3. Does my mother have Alzheimer's or just dementia?

      Answer - "Is it Alzheimer's or is it dementia?" is the most frequently asked question I've heard in more than 3 decades of advocating for this population. The best way to clarify this is to state that dementia is a symptom while Alzheimer's (AD) is a disease...

  9. Tuesday September 27, 2011

    1. How do I get my mother with Alzheimer's to eat better?

      Answer - Encouraging an Alzheimer (AD) person or someone with a related disorder to eat can be extremely frustrating for the caregiver. Particularly since we continually hear about trying to maintain proper nutrition throughtout the disease process. How does one do this when the affected person refuses to cooperate or is incapable of understanding what is expected...

  10. Friday September 23, 2011

    1. How can I stop my mother with dementia from biting her nails?

      Answer - There are so many manifestations of dementia in the elderly and, most particularly, in the progressive type such as Alzheimer's disease (AD). Putting objects in the mouth is known as hyperorality as is generally noted in some elderly dementia patients who have been diagnosed with Lewy Body disease or the lesser known Kluver Bucy Syndrome...

    2. How can I stop my mother with dementia from biting her nails?

      Answer - There are so many manifestations of dementia in the elderly and, most particularly, in the progressive type such as Alzheimer's disease (AD). Putting objects in the mouth is known as hyperorality as is generally noted in some elderly dementia patients who have been diagnosed with Lewy Body disease...

  11. Tuesday September 13, 2011

    1. Is it wrong to not want to take care of your loved one with Alzheimer's?

      Answer - Although there may be family members in our not-so-perfect world who become caregivers in name only and may be doing so for purely selfish reasons, most are well-meaning people wanting to do the care because of a long term relationship and family history that may have been rocky at times...

  12. Monday September 12, 2011

    1. How does one deal with someone who's memory is declining and insists nothing is wrong or has changed?

      Answer - It is truly difficult to handle obvious declining memory and denial from the person who is showing cognitive decline. The difficulty is compounded when the elderly person in question is a parent! I would strongly suggest you try searching behind what she is saying and grasping onto the feeling she is experienceing at the time...

  13. Friday September 09, 2011

    1. Is it wrong to water down the alcohol my dad with Alzheimer's drinks?

      Answer - It may surprise you to hear that this is not an unusual question. Accolades to you for seeking ways to keep his alcohol consumption at a minimum. I am in complete accord with you about watering the whiskey and suggest you continue to do so while increasing the amount of water...

    2. When I visit my Alzheimer's-suffering wife at the nursing home, she gets very upset as I leave; Is there anything I can do?

      Answer - This must be so heart-breaking for you. Even though you recognize this placement as being the most appropriate caregiving solution, I'm sure you must be devastated at each visit when you hear her plea to leave with you. The difference between your emotional pain and that of your wife is that it remains...

  14. Monday June 27, 2011

    1. Is my behavior enabling my with with dementia to keep asking the same questions?

      Answer - To strongly answer your query about whether or not your behavior is enabling your wife to keep asking questions, let me say with great certainty, NO! it is not! Her questions are repeated because of the disease and the brain's inability to store the information regarding having asked the question and therefore not being able to recall your answer...

    2. What is a good book to read if I want to learn more about Alzheimer's disease?

      Answer - There are many wonderful resource / support books out there right now. I would check with the local chapter of the Alzheimer's Association in a town near you - they can offer suggestions on particular topics such as the doctor's perspective on the disease. One of the very best resources is right here at caring...