Tag: dementia neurologist

Understanding the Best and Worse Case Options

bestworstcase

After caring for two parents with dementia, what I believe is that most doctors lean toward life extending measures and often don’t stop and consider the outcomes beyond the immediate resolution to an issue.

I watched as my Dad recovered from hip surgery and was cognitively a different man. He was in great physical health before the surgery (he broke his hip playing racquetball), but we all noticed a decline in his ability to hold a conversation or discuss the finances afterward. He was eventually diagnosed with Alzheimers but the years leading up to his diagnosis was filled with dozens of visits to primary care physicians, and even a neurologist, who dismissed all of our concerns about the changes in our Dad’s thinking and behavior. There really wasn’t a choice about the surgery to make since he was in good shape and had not been diagnosed cognitive issues, but the drastic change has me wondering about surgery later in life. My Dad was 76 when he had this surgery.

A recent report Major surgeries linked to small decline in mental functioning in older age confirms that a decline has been proven. However, they do believe for patients who are developing a brain disease the outcome would be more pronounced. That was definitely true with my Dad.

When Mom fell at 83 and the orthopedic surgeon demanded I lift Mom’s “Do Not Resuscitate” order so she could perform surgery, I balked. I had to ask for the social worker and an internist so I could convey that there is no way my Mom would be in a better place after surgery. She was living in a Memory Care community, had clearly had another stroke and had no idea who I was any longer, and mending her hip would most likely be too difficult for her to survive. As I was pushing back for them to give me options, they worked on getting my mom approved for surgery. Thankfully, the testing ultimately proved she would most likely never make it through the operation. I was able to follow the wishes she conveyed to me over decades as well as spelled out in her medical directives. Mom was moved into hospice care and died two weeks later.

What frustrated me was that there were no discussions about outcomes, just a swift recommendation to fix what was broken.

Too many families have found they end up with increased medical expenses and loved ones that are living, but don’t have the quality of life they expected after surgery in later life. Some admit that they wish they had know both the good and bad possible outcomes — but that isn’t currently how most medical consults currently work.

A few Emergency Rooms are now adding in a “Geriatric Team” to better serve those individuals coming into their hospitals and have a lot more to consider than just fixing the obvious medical emergency. The most important consideration is the what could happen and the life to be lead after.  Should you be in this situation, please demand you get both the best- and worst-case options. Recommended.

Little Proof that Supplements Improve Brain Health

brainfitness

When you have two parents with dementia, you start to worry about your own cognitive outlook. I poured over the research and have been exposed to a host of “supplement plans” proposed to families throughout my work and personal life. I have yet to have anyone emerge from these plans, that typically cost over ten thousand dollars, with a noticeable change. I’m not a doctor, and I don’t really know if there is peer-reviewed research supporting this … I know the claims are made that they are proven. I just haven’t seen them positively impact anyone yet. And I’m very well connected to hundreds of individuals with dementia … so you think a great result would be freely shared.

The Washington Post carried a snippet of the story, but you can read the full summary that Supplements for Brain Health Show No Benefit – a Neurologist Explains a New Study. Everything I have read and seen play out jives with the explanation. However, it feels better to think that a simple pill can be a cure-all.

I believe that the food we eat makes a difference and even more so, the habits we develop now can make a huge difference to how long we can manage if we start to have cognitive issues.

If you use a calendar system and a to-do list, you could find life much easier to manage should you start to have short-term memory issues. In working with a variety of clients I have found those that have a habit of using the calendar and making to-do lists have an easier time of continuing to manage and control their own affairs. They don’t make your brain lazy and are actually recommended in the classes taught by Total Brain Health.  After going through the program, I highly recommend it. If you can’t find a class, maybe consider getting Dr. Cynthia Green’s book Total Memory Workout. You will find a host of ways to rev up your recall and be more educated about what you can do to improve your own brain health. Recommended.