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Highlight the patterns you’ve seen for the evaluation of the medical history. – Melissa Batchelor, PhD, RN, FNP, FAAN (05:32-05:44)
It can take years to be definitively diagnosed with Alzheimer’s disease or a related dementia. Getting to that diagnosis is not as easy as you think, because there are many symptoms of other illnesses that can look like Alzheimer’s disease but actually aren’t. If you see a provider and they tell you and/or your loved one in one 15-minute visit that you have Alzheimer’s disease ~ get a second opinion. This disease takes much more than 15 minutes to be diagnosed accurately.
In this week’s episode, you’ll learn how Alzheimer disease is diagnosed.
Part One of ‘How Is Alzheimer’s Diagnosed’
History of Home Life:
The first thing you need to do is make an appointment with your healthcare provider and take your journal of what behaviors you, family, and friends have been seeing.. Previously, we talked about looking for patterns over time so that you can provide a good history to your provider. Your role as family and/ or as a caregiver can help give insights into that person’s daily ability to take care of themselves at home that a provider can’t see in a 15-minute visit.
Discussing past medical history is crucial. If you’re the older adult who’s in need of assistance, the doctor will ask what are any illnesses that you’ve had in the past? Any injuries you’ve had? Any hospitalizations you’ve had? Also, knowing your surgical history would be significant. So that they’re going to ask you what types of operations you’ve had.
There must be a diagnosis to support why they’re taking their medications. – Melissa Batchelor, PhD, RN, FNP, FAAN
Brown Bag It:
It’s also essential for you to take ALL medications, supplements, herbal remedies, over-the-counter medications to the doctor to determine if it’s necessary for them to take it. This is called the “brown bag” approach (but it doesn’t matter what color bag you put it all in #lol). Have the provider go over all of them and make sure there is a diagnosis to support why they’re taking it? Are there any drug interactions that could be causing a problem? Is there a drug to supplement interaction? Those are all the different things that you can find out when you have everything that person could possibly be taking. It could be that they haven’t taken their anti-depressant for thirty days.
Lab Work and Other Testing:
The next thing that they should do is to run some lab work. We need to know what their hemoglobin is. Do they have anemia? Do they have an infection? Are they diabetic, or are they taking their diabetic medications the way they’re supposed to? They could look demented, but really just hypoglycemic. If they have low blood sugar, getting an analysis is super important. Have they been having adequate bowel movements enough? What’s their body weight? If somebody has unintentionally lost weight over the past six months, that could be an early symptom that they’re not remembering to eat or not remembering how to prepare their meals, or maybe they’re having a lot of anxiety.
Part Two of ‘How Is Alzheimer’s Diagnosed’
Physical Exam and Screening Tools:
So, the next thing would be doing a complete physical exam. And then, you can share some other things that you’ve been seeing. They’re not going to have time to read your whole journal. But you could put some highlights up of the patterns that you’ve been seeing so they can put that into the bigger picture as we’re trying to figure out what’s going on with this person. Another thing they should do is two different types of screening tools. But again, these are screening instruments. They’re not diagnostic. There will also be many mental state exams, known as MoCA Montreal – Cognitive Assessment.
The CT will tell us if you have what’s called
brain atrophy or has your brain shrunk in any way.
– Melissa Batchelor, PhD, RN, FNP, FAAN
Another part that’s going to be important is that you do have some brain scan, known as computerized tomography (CT) scan. What happens with Alzheimer’s disease is your brain begins to shrink and turns into a raisin. Alzheimer’s disease is brain failure, and we need to think of it as such. And everyone has a different course, which means if it takes a lot of years for someone to have the symptoms, somebody else could be at a different pace. Stay tuned for the next podcast episodes about different strategies that you can use for Alzheimer’s and how to handle it as the disease progresses.
I earned my Bachelor of Science in Nursing (‘96) and Master of Science in Nursing (‘00) as a Family Nurse Practitioner (FNP) from the University of North Carolina Wilmington (UNCW) School of Nursing (SON). I truly enjoy working with the complex medical needs of older adults. I worked full-time for five years as FNP in geriatric primary care across many long-term care settings (skilled nursing homes, assisted living, home and office visits) then transitioned into academic nursing in 2005, joining the faculty at UNCW SON as a lecturer.
I obtained my PhD in Nursing and a post-Master’s Certificate in Nursing Education from the Medical University of South Carolina College of Nursing (’11) and then joined the faculty at Duke University School of Nursing as an Assistant Professor. My family moved to northern Virginia in 2015 and led to me joining the faculty at George Washington University (GW) School of Nursing in 2018 as a (tenured) Associate Professor where I am also the Director of the GW Center for Aging, Health and Humanities.
Find out more about her work HERE.