Seminars help families understand, prepare for future with Alzheimer’s


When patients come to see Dr. John Bertelson, they often are worried that they are forgetting things more than is normal for people their age. Even so, often they don’t realize how bad their forgetting is, but their loved ones do. “I don’t think it’s denial,” Bertelson says. “They forget what they forgot.”

Bertelson is a neurologist with the Seton Brain & Spine Institute. About once a quarter, Bertelson holds an education seminar on Alzheimer’s and dementia to answer questions for both caregivers and people who have or think they might have Alzheimer’s or dementia. His next seminar is Tuesday at Seton Medical Center Austin.

There can be a lot of fear about what might be happening and what the future will hold, and Bertelson goes through some of the stages and how to plan for them, as well as the recommended treatments to delay some of symptoms.

Everyone is different, but people often live five to 15 years with Alzheimer’s, he says. Sometimes people will actually die of something else, like a heart attack or stroke, before the Alzheimer’s kills them.

The biggest risk for Alzheimer’s is age, he says. “The risk goes way up the older you get.” People age 65 have about a 1 in 9 chance of having it. By 85, it’s a 1 in 3 chance.

About two-thirds of the people with Alzheimer’s are women — possibly because women live longer than men, or hormones could be a risk factor, Bertelson says.

When families come into his office seeking a diagnosis, he first looks for things that can rule out Alzheimer’s. Sometimes it’s something as simple as reviewing all the medications someone is taking to make sure memory loss is not a side effect or there’s not a drug interaction. It also could be something else like a tumor or a lack of blood flow to the brain.

If the patient is diagnosed with Alzheimer’s or another form of dementia after talking to the patient and family, ruling out other causes and doing tests, it’s usually a relief, Bertelson says. “They tend to be quite accepting. They now have a name. It may be hard to hear ‘Alzheimer’s disease,’ but there’s a sense of closure.”

When patients are in the early stages, he recommends a number of things to try to delay the end stages, such as medications and staying active physically and mentally. He also talks to patients about when they might need to have restrictions on driving and living alone. He encourages patients to make some end-of-life care decisions while they still can communicate their wishes to their family. Decisions like: If their family could no longer care for them at home, what senior living center would they want to go to; what are the stories behind some of their family treasures and to whom would they want to pass them on; and what kind of funeral and burial they would like.

The diagnosis usually doesn’t mean something drastic is going to happen right away. “Every person is different,” Bertelson says. “You hope for the best, but plan for the worse. They may be stable for a while, but some day things will get worse.”

He hopes by doing these educational seminars, families and patients can be more prepared and get their questions answered.



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