An Often Misdiagnosed Dementia

Lewey body dementia is an often misdiagnosed dementia.
Lewey body dementia is an often misdiagnosed dementia.

Many people had never heard of Lewy body dementia until it was reported in 2014 that this was the disease that afflicted Robin Williams. While Lewy body dementia and Alzheimer’s disease are the two most common types of dementia, those who have Lewy body dementia are often misdiagnosed as having Alzheimer’s disease or depression. As a result, they do not get the treatment and support they need.

Considerable’s recent article entitled “The second most common type of dementia often goes unrecognized” reports that in one study, nearly 70% of people diagnosed with Lewy body dementia visited three consultants before receiving the diagnosis. For 33% of people with the disease, the dementia was misdiagnosed and getting the correct diagnosis took over two years.

There are two different conditions associated with Lewy body dementia: dementia with Lewy bodies and Parkinson’s disease dementia. In dementia with Lewy bodies, problems with memory and thinking occur simultaneously with problems involving movement, like those associated with Parkinson’s disease. In Parkinson’s disease dementia, a person who has had movement problems resembling Parkinson’s disease for several years, then develops difficulties with memory and thinking.

In addition to memory, thinking, and movement problems, symptoms of Lewy body dementia include issues with alertness and concentration, hallucinations and paranoia, acting out dreams during sleep, low blood pressure when standing, daytime sleepiness and depression.

Because the symptoms of Lewy body dementia often resemble other conditions, research reveals that the first diagnosis is commonly incorrect. For example, in one study 26% of people who had Lewy body dementia were misdiagnosed as having Alzheimer’s disease, and 24% were determined to have a psychiatric diagnosis like depression.

We saw this first hand at our firm when a family member was suffering with this kind of dementia. It went undiagnosed until it was too late to treat it properly. We feel it’s important to get the word out to family members who might think their loved one is suffering from depression, Parkinson’s disease, or another kind of dementia.

Failure to properly diagnose a person with Lewy body dementia can result in delay in treatment specifically targeted for that condition. Also, with the correct diagnosis, patients and families can seek out resources, such as the Lewy Body Dementia Association, an organization dedicated to helping people living with this disease. This group provides education on Lewy body dementia, helps patients and families know what to expect, connects patients and families to support and resources and helps them find research opportunities.

For more information on dementia issues see https://www.galliganmanning.com/some-common-drugs-may-increase-risk-of-dementia/

Reference: Considerable (Aug. 14, 2020) “The second most common type of dementia often goes unrecognized”

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Some Common Drugs May Increase Risk of Dementia

Some common drugs may cause increased risk of dementia.
Some common drugs may cause increased risk of dementia.

Research conducted in 2019 has strengthened the connection between the risk of dementia and a common class of drugs used to treat a variety of symptoms.

Anticholinergics are a type of medication that blocks the action of acetylcholine. That’s a chemical messenger (or “neurotransmitter”) in the brain that help coordinate breathing, digestion, urination and other functions.

Anticholinergics can treat a variety of ailments, including urinary incontinence.

Considerable’s recent article entitled “These common prescription drugs could boost your risk of dementia” reports that anticholinergics include a roster of drugs for depression (such as Paxil), psychosis (such as Thorazine), Parkinson’s disease (such as Cogentin) and bladder disorders (such as Ditropan).

The 2019 study found a nearly 50% increase in chances of dementia in those people who received more than 1,095 daily doses of these drugs in a 10-year period.

The research was published in JAMA Internal Medicine.

The study, sponsored by the University of Nottingham, monitored 284,343 patients age 55 and older between 2004 and 2016. The researchers examined the total standardized daily doses (TSDDs) of anticholinergic drugs during that time period.

The researchers said that this was the equivalent to a senior taking a strong anticholinergic medication daily for at least three years.

Researchers looked at each person’s anticholinergic exposure and found the most frequently prescribed anticholinergic drugs were antidepressants, drugs to treat vertigo, motion sickness or vomiting and an overactive bladder.

The researchers at the University of Nottingham discovered that some other anticholinergic antihistamines and gastrointestinal drugs failed to correspond to a higher incidence of dementia.

The UK study shows a correlation between these specific anticholinergic drugs and increased chances of dementia. However, the researchers cautioned that seniors shouldn’t stop taking any medications without talking with their doctor.

Reference: Considerable (July 1, 2020) “These common prescription drugs could boost your risk of dementia”

 

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Estate Planning Issues Affecting the Sandwich Generation

If you're a member of the Sandwich Generation, make sure your parents and adult children have the necessary estate planning documents in place.
If you’re a member of the Sandwich Generation, make sure your parents and adult children have the necessary estate planning documents in place.

July is National Sandwich Generation Month, a time to honor those who are caring for both their children and their aging parents. This is a particularly stressful time for members of the Sandwich Generation who may not only be parenting their children but also spending the last few months homeschooling them. Older children who have lost their jobs or were unable to return to college after spring break due to the coronavirus may now be living at home. At the same time, members of the Sandwich Generation may be acting as caregivers for parents who are no longer able to look after themselves, or who are at a higher risk for contracting COVID-19.

Some of the stress of caregiving can be alleviated by making sure your aging parents and adult children have legally valid and up-to-date estate planning documents in place, and if they do not, encouraging them to have these important documents prepared. This is a relatively simple step to ensure that there will be no delays or uncertainty if you have to take action in an emergency to make medical and financial decisions for them. If they have the necessary estate planning documents in place, you will have the peace of mind in knowing that you will be able to avoid delays when you need to act quickly to preserve their safety and well-being.

What estate planning documents should you have for any person in your care?

  • A financial power of attorney – This will allow you to pay bills, manage financial accounts, file tax returns, talk to insurance companies, deal with issues related to benefits, hire a caregiver, and sell property on behalf of your parents. A financial power of attorney is also helpful in the event you need to handle financial matters on behalf of your adult child (over the age of eighteen), for example, cashing a paycheck for your child or signing a new lease on your child’s behalf.
  • A medical power of attorney – A medical power of attorney enables you to make health care decisions for your parents, if they are unable to do so themselves.  A medical power of attorney is also important for your children who are 18 or older. Once your child reaches age 18, you no longer have the authority to make medical decisions for your child.
  • A HIPAA Authorization – The Health Information Portability and Accountability Act (HIPAA) requires medical records to be kept private unless an individual consents in writing to sharing of protected health information with a named individual. If you are your parents’ caregiver, they should fill out a HIPAA authorization permitting your parents’ health care providers to keep you informed about their medical conditions and treatments. You should also keep in mind that you are not authorized to receive any medical information regarding a child of yours who is 18 or older. If your adult child wishes you to be involved in his or her health care you need a HIPAA authorization signed by the child allowing you to receive his or her medical information.

It is crucial for your parents to put these estate planning documents in place before they develop any cognitive loss that would prevent them from having the capacity to sign a legal document. If they develop dementia, for example, and are not able to understand the objective or content of a power of attorney or other document, they will be legally unable to execute the document. In that case, you will have to go to a court and ask to be appointed your parents’ guardian to manage their health care and financial affairs.

It is also important that these documents be put in place by your adult child, regardless of any health conditions, because once your child is a legal adult, you can no longer automatically act on your child’s behalf. The worst case scenario is that your adult child is unconcious or in an accident and you are unable to quickly get information from your child’s health care providers.

Members of the Sandwich Generation do not always remember to take steps to lighten their load. But one important step that can make things easier for you as a caregiver is to make sure that your parents and adult children have the necessary estate planning documents in place so that you can quickly make decisions on their behalf if you are called upon to do so.

For more information see https://www.galliganmanning.com/everyone-needs-an-estate-plan/

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