Diagnose and care Alzheimer's Disease

Johns Hopkins Health Alert

A New Tool to Diagnose Alzheimer’s Disease

For nearly a century, Alzheimer's destructive path in the brain could be seen only by directly examining the tissue during an autopsy after the patient died. Consequently, a diagnosis of Alzheimer's disease has been, and continues to be, based on results from a comprehensive evaluation that typically includes a medical history, a mental status evaluation, a clinical examination and laboratory tests. 

Last year, the U.S. Food and Drug Administration (FDA) approved a new radioactive dye (Florbetapir F 18 Injection, Amyvid) that, when used during positron emission tomography (PET), enables doctors to spot telltale signs of Alzheimer's while the patient is still alive. But spotting signs of Alzheimer's disease and making an accurate diagnosis are two different things. And while the Amyvid scan is a major step forward, researchers have yet to find the Holy Grail. In the meantime, here are answers to questions you may have about this important tool.

• How is the test performed and what does it reveal?

Amyvid is a radioactive dye that is injected into a vein prior to a PET scan. From there, the dye travels through the bloodstream and into the brain, where it binds to amyloid plaques. These plaques are abnormal clumps of brain cells mixed with beta-amyloid protein -- a type of protein that forms in some people, including individuals with Alzheimer's disease. The PET scanner produces three-dimensional images of the brain that show how much plaque is present and where it is located. The results of the scan are graded as positive or negative. 

• Should everyone suspected of having Alzheimer's have a scan?

No. While Amyvid is approved for use in adults who are being evaluated for Alzheimer's disease and other causes of cognitive decline, most of the time, the doctor can make an accurate diagnosis without the additional information provided by the scan. The test is likely to be most useful in difficult cases, such as in younger patients with dementia or in patients with dementia that is rapidly progressing.

• A word of caution.

A number of Alzheimer's disease experts have expressed concern that disreputable companies may begin offering Amyvid scans (or scans using other agents that may gain FDA approval in the future). Be wary of any providers claiming that they can diagnose Alzheimer's or predict one's risk of developing it or determine a person's prognosis based on scan results. Also, be sure that the radiologist who interprets the findings has successfully completed the Amyvid reader training program developed by the product's manufacturer, Avid Radiopharmaceuticals.

Posted in Memory on May 27, 2013

Introducing.

Caring for a Loved One with Alzheimer's Disease: A Guide for the Home Caregiver

NEW from Dr. Peter V. Rabins, acclaimed author and geriatric psychiatrist at Johns Hopkins - and one of the nation's leading experts on the care and management of patients with Alzheimer's disease and other forms of dementia.

A Frank and Intimate Conversation on Caring for the Dementia Patient

Do you know where most of the millions of people who have Alzheimer's disease live? At home -- where family and friends provide almost 75% of their care.

That's why caregiving has been called the fastest growing unpaid profession in the United States.

According to the National Alliance for Caregiving, during the past year more than 67 million Americans provided care to a family member, friend, or loved one, many of whom are suffering from different stages of Alzheimer's disease or some other type of dementia.

If you're a caregiver, you know first-hand what it's like: Getting swept up in a flurry of tasks - bathing, shopping, cooking, feeding, making arrangements for medical care, managing behavioral problems, making decisions for the ill person that you have never had to consider before -- while simultaneously trying to cope with your own anxieties and fears.

Or perhaps you're facing a situation where you're likely to become a caregiver -- and you're wondering how you can make the many difficult decisions that anyone who steps into this demanding role has to confront.

It's an extremely hard job -- and often it feels like you're in it alone. But you're not.

At Johns Hopkins we understand the emotional and physical challenges that come with dementia because we work with patients and caregivers JUST LIKE YOU every day.

With YOU in mind, we asked two world-renowned Alzheimer's specialists -- Dr. Peter Rabins and Dr. Ann Morrison -- to write this practical, no-nonsense guide, Caring for a Loved One with Alzheimer's Disease: A Guide for the Home Caregiver.  This comprehensive special report provides detailed, authoritative advice on how to successfully manage your day-to-day responsibilities - to your patient and to yourself.

This information is so crucial that Caring for a Loved One with Alzheimer's Disease  is available instantly as a digital PDF download. Just click the order button below and in a few moments your guide will be delivered to your email address. It's that simple!

Advice That's Practical, Compassionate. and Authoritative

Reading Caring for a Loved One with Alzheimer's Disease  is like sitting down with a wise and trusted friend and talking about the many issues you face: how to organize your home so it's safe. proper methods for managing your patient's personal care, like bathing. strategies to handle aggression and other behavioral problems.

You will also find guidance on some of the larger decisions you may face as a caregiver -- from confronting the need to curtail a loved one's driving to the many considerations that surface in deciding whether to move someone to a nursing home or other residential care facility.

You'll quickly discover that what sets Caring for a Loved One with Alzheimer's Disease  apart from other books is its warmth and deeply personal tone.

This 134-page report provides in-depth discussions on every essential topic where you can benefit from expert advice, including:

• When It's Time to Take Away the Car Keys
• Modifying the Home for People With Dementia
• Personal Care for the Dementia Patient
• Dealing with Alzheimer's Troubling Behavior Problems
• Caregiving From Afar
• When Caring Takes Its Toll on the Dementia Caregiver
• Deciding to Move a Loved One into Residential Care

Aggression, Agitation, Shouting, Hallucinations. . .
How to Handle Aberrant Behaviors

Many people think of Alzheimer's as strictly a memory-stealing ailment. But as a caregiver, you know that it may also unleash difficult-to manage behaviors. In our guide, Dr. Rabins addresses frequently asked questions on troubling Alzheimer's behaviors. For example:

• What happens when an Alzheimer's patient becomes overwhelmed?
• What environmental changes can trigger a negative reaction?
• As a caregiver, what can you do to minimize catastrophic incidents?
• How can you safely manage a patient who becomes physically aggressive?
• Should you ever use physical force to deal with a behavior problem?
• What causes vocalizations, such as yelling or constantly calling out?
• What are the best tactics for handling delusions or hallucinations?

Caregiver Burnout Takes a Toll
Here's Help From Dr. Rabins.

Feeling overwhelmed? Caregivers have been described as "hidden patients" because many of their own emotional and physical needs go unattended while they provide care to others. Perhaps you've wondered:

• Will my bottled up feelings of frustration and anger lead to "stress-related illness"?
• Is it wrong for me to feel angry while providing care for a loved one with dementia?
• What should I do when my patient acts out in an embarrassing way in public?
• Should friends and neighbors be told that a loved one has Alzheimer's?
• How can I get over my feelings of guilt for wishing I didn't have this big responsibility?
• I sometimes feel sad and discouraged and even begin to cry. What can I do?
• I feel like I'm facing this all alone. Where can I find support?
• I have trouble concentrating and don't sleep well. Could I be depressed?
• Should my patient be included in the decision to move to a long term care facility?
• How do I get over my feelings of grief now that I've placed my loved one in a nursing home?

Caring for a Loved One with Alzheimer's Disease  discusses these and other caregiver concerns. And that's just the start.

When is it time to take away the car keys? Dr. Rabins explains why Alzheimer's patients lose the ability to drive and how you should address the driving issue. He explores:

What the car represents to an older person. signs you should watch for when determining a loved one's driving competence. how to find a driving rehabilitation specialist in your area. how to initiate the conversation about driving competence with the Alzheimer's patient.

Modifying the home for patients with dementia. In this important chapter, Dr. Morrison discusses caregiver concerns, such as:

Is it safe to leave a person with dementia home alone. why do so many people fall at home. and how you can minimize chances of falling. safety precautions in the bathroom and kitchen, two of the most dangerous rooms in the house.

Personal Care and the Dementia Patient. Bathing and dressing are two of the most demanding daily chores for the caregiver. Dr. Morrison provides practical, straight-talking advice, including:

How to prepare the patient. what's better: bath or shower. how to bathe the resistant patient. washing "private parts". getting over the embarrassment factor. when is the best time to wash hair. techniques to trim toenails and fingernails. how often should you brush the teeth. managing incontinence. and much more.

Deciding to Move a Loved One into Residential Care. This is surely one of the hardest decisions a caregiver will face, and Dr. Rabins steers you through it with empathy and wisdom.

• How can you deal with the guilt you may feel when it comes time to place your loved one in a facility?
• How do you know when the time is right?
• What are your options?
• Internet resources
• What happens if your loved one refuses to go into a facility?
• What options exist to cover the cost of nursing home care?
• Will Medicare or Medicaid cover the cost of a nursing home?
• What are the key questions you should ask when choosing a nursing home?
• How often should you visit?

All This -- PLUS Get a FREE Bonus Report With Your Order

As a special bonus when you order Caring for a Loved One with Alzheimer's Disease,  you'll receive a second volume,Caregivers Ask the Expert: Questions from Alzheimer's Caregivers Answered by Johns Hopkins Expert Peter V. Rabins, M.D., M.P.H. -- absolutely free!

In this 36-page compendium, Dr. Rabins confronts head on the common special concerns, issues, and stresses of caregiving. You'll read more than 65 real-life questions from caregivers -- the same questions that are on YOUR mind now as you search for practical advice on living with a dementia patient.

Caregivers Ask the Expert presents questions on a wide range of topics, including:

Caregiving in perspective. coping with caregiver depression. easing bedtime agitation. confusion about place. Alzheimer's medications and hypersexuality. sedating the patient. love versus sense of duty. the doll effect. "chemo brain". daily brainquizzes. coping with urinary incontinence. hallucinations and night terrors.and much, much more.

We believe this information is so vital that we want you to have Caregivers Ask the Expert as an extra bonus gift from Dr. Rabins.

Expert Advice From Johns Hopkins Medicine

Caring for a Loved One with Alzheimer's Disease is designed to give you unprecedented access to the expertise of the hospital ranked #1 of America's Best Hospitals for 21 consecutive years 1991-2011 by U.S. News & World Report. Your report draws on the extensive experience of two leading Alzheimer's specialists who understand the concerns of patients like you. You'll meet:

Peter. V. Rabins, M.D., M.P.H., the Richman Family Professor for Alzheimer's and Related Diseases, is Professor of Psychiatry and Director of the Division of Geriatric Psychiatry and Neuropsychiatry at the Johns Hopkins School of Medicine. He is also a member of the Berman Bioethics Institute of the Johns Hopkins University. Dr. Rabins' research is focused on a study of the recognition and treatment of Alzheimer's disease in the community and late-stage care for Alzheimer's disease patients. Dr. Rabins is Medical Editor of the Johns Hopkins Memory Bulletin and the co-author of The 36-Hour Day (Warner Books), the best-selling guide for caregivers of patients with Alzheimer's disease.

Ann S. Morrison, Ph.D., R.N., C.S., a faculty member of the Johns Hopkins School of Medicine, Division of Geriatric Psychiatry, is Director of The Johns Hopkins Memory Center Caregiver and Family Program, the Millicent Radlick Nurse Scholar at The Copper Ridge Institute (Sykesville, Maryland), and an Education Specialist for the Alzheimer's Disease Research Center at Johns Hopkins. Since 1986, she has been providing care for dementia patients and caregivers and lecturing nationally and internationally on the topic of Alzheimer's disease research and care of the Alzheimer's disease patient, caregiver, and family. Her research efforts have focused on dementia treatment, risk factors, and prevention of Alzheimer's disease as well as on family and caregiver studies.

Still not sure you'll benefit from this Special Report? Caring for a Loved One with Alzheimer's Disease comes with a risk-free guarantee of satisfaction: if you're not satisfied for any reason, simply contact Customer Service for a prompt refund of your full purchase price of $49.95.

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