What sorts of questions should I ask the doctor about my wife's dementia?

A fellow caregiver asked...

My wife has mild dementia, As per her Dr. She's only seen Dr 2 times. Dr. did an MRI found no problems with her brain no masses no bleeding. She has her 3rd appoint July 6th 2011. What should I ask Dr? I'm finding out that out of her 13 siblings still living all the girls have some form of dementia. And My wife told me that her Mom suffered from the same forgetfulness. Is this going to take my wife of 42 years???? Please respond Sparky in wichita

Expert Answer

Jytte Lokvig, PhD, coaches families and professional caregivers and designs life-enrichment programs and activities for patients with Alzheimer's disease and related dementia. Her workshops and seminars help caregivers and families create a healthy environment based on dignity and humor. She is the author of Alzheimer's A to Z: A Quick-Reference Guide.

The good news is that your wife is not going to change drastically in the near future. With a family history of dementia, she's probably correct that she's on that track as well, but the progressing is usually slow and if you learn to adapt your communication and approaches to her changing needs, you can have many good years together. Many relatives of people with Alzheimer's and dementia have reported that the last years of their lives together were in a strange way the most rewarding and fulfilling.

I have to assume that her doctor has already given her a thorough physical examination to eliminate reversible dementias, which could be caused by vitamin deficiencies, dehydration, minor infections, drug interactions, or NPH (normal pressure hydrocephalus or fluid on the brain "“ MRI would have picked that up.)

Her doctor will likely discuss the medications currently available for Alzheimer's and dementia. They do work for some people, helping them with focus and also slowing down progression of aphasia (difficulty with speech.) However they are not miracle drugs and they may have side-effects that outweigh benefits. As with all elective medications, you'll want to educate yourself really well on possible side effects and decide if they are the right choice for your wife. She may not need them.

If your wife does indeed have Alzheimer's or one of related chronic dementias, there are things you can do to help her: Socializing, music, exercise, laughing!!! Ballroom dancing is particularly effective brain exercise, especially Tango! All four elements are involved.

A healthy diet is very important, preferably "heart healthy" with lots of vegetables, fruits, and berries, the darker the better, fish and nuts rich in omega3, lots of fluids, little or no white flour, white rice, white sugar.

Keep your lives as normal as possible and keep her involved in your daily routines. Her demeanor will signal her need for simplification. Example: if she likes to cook, she can probably still keep that up for quite a while. As her dementia progresses she may start feeling uncertain about the processes or the handling of knives and hot stoves. At that point shift her over helping with less risky preparations like setting the table or tossing the salad.

Most importantly: Celebrate each beautiful day together.