Gary Barg, Editor-in-Chief
Late one night, as I was returning from a whirlwind two days at the annual N4A conference in Nashville, I found myself sitting next to a retired pharmacist who was returning from his niece’s funeral. After some brief pleasantries, such as marveling at the lung capacity of the children traveling with us, I slipped on my headset and replaced the rest of the airplane noise with music.
Just after the flight attendant called for all seats to be raised to their upright positions, I resumed my conversation with my row mate. He related that he had been worried about his sister Lucy’s mental acuity even before her daughter had taken ill. Lucy had always picked him up at the local airport when he would visit her; but in recent years, she had stopped because now she frequently lost her way in the city where she had lived for more than thirty years and would have to call for someone to pick her up. Her family (another daughter is a clinical psychologist) was concerned, but no one knew what steps to take.
I had just spent time with the Area Agency on Aging director for his sister’s city at the conference, and told him that his first step was to call the organization, as well as the local Alzheimer’s Association, to see what services are available for his sister and her family. Luckily, Lucy’s city is also home to a leading Alzheimer’s diagnostics center, and I told him to make sure she went for an appropriate neurological evaluation as soon as possible. This family was aware, able and interested in taking the steps to help Lucy; but even with all of the healthcare professionals in the family, they were still paralyzed about what steps to take and in what order to take them.
It occurred to me that taking these first tentative steps to determining if a loved one has a cognitive disorder is very much like creating a medical plan of action. Diagnose, assess and prescribe. First, the diagnosis was made (there was something amiss with mom); then the assessment of what steps to take (what are the available diagnostic options and community resources?); and, finally, the prescription (how do you help your loved one realize that an assessment is made not to create a loss of independence, but to be able to retain as much independence as possible? who will go with mom for the testing? and what are the family plans if the test results shows signs of a cognitive disorder?).
Most important of all is to put a timeline to these steps. This family (including Lucy) has been discussing the signs of her possible memory challenges for at least four years. Our conversation must have crystallized things for him as he said that he was going to spend next week putting a plan in place.
Now, that’s music to my ears.
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