This is a troubling issue and the answer depends on many variables including: patient’s age, stage of Alzheimer’s progression and current health.
If a person is diagnosed with Early-Onset Alzheimer’s at a young age, it’s especially devastating. However, symptoms are identified and the younger person learns of their disease much earlier, usually many years before middle-stage when the sufferer denies their disability exists altogether. So, for the younger sufferer, the earlier they are told of the diagnosis the better their future circumstances.
This person is able to make many of his/her own choices that the older sufferer, in a more advanced stage of dementia, is unable able to make.
- Which Medications to take to delay symptoms
- Voluntarily give-up their car, drivers license, etc.
- Decide who will take care of their finances/provide DPOA, etc.
- Decide when they will no longer live alone and choose where they will live (whether Nursing Home or Assisted Living) and make arrangements in advance
If many of these choices are planned in advance, it relieves the caregiver or other loved-ones from the burden of making all the decisions at a time when they are already stressed from providing personal care for the patient. Plus, there are fewer conflicts when the Patient has made their own decisions instead of every choice being made for him/her.
If the Patient is elderly and/or in poor health, it would probably not be wise to share the diagnosis with them. If their progression has moved beyond early-stage symptoms, they are probably no longer aware that they have issues with their memory but are in denial of all memory problems. In that case, it is best to follow standard advice and hints for coping with an Alzheimer’s sufferer without worry that they need be told of their condition.
A quote that I’ve repeated many times here, is from “The Forgetting,” by David Shenk, “The Alzheimer’s patient does not need the truth, but comfort and love.”
For the Elderly, many of the early symptoms are not recognized because of the tendency to lay blame for any odd behavior on the aging process. So diagnosis and treatment is delayed.
My mom was near middle-stage when diagnosed and I noticed little difference when she began the medications prescribed to slow Alzheimer’s symptoms.
By the time an elderly patient is diagnosed, it is usually too late for them to make healthy choices for their future. Most choices will be left to the family or caregiver. Some will be disturbing and blistering for the patient since their cognitive abilities to understand sound choices has waned.
- They don’t want to give up their driving privileges or the family car
- They don’t want to leave their home but to live alone
- They don’t want to move to a nursing home, though all the facts show that they can no longer be cared for at home
Mom was already in denial about having a memory problem when she was diagnosed and I faced the same issue. Do I tell her–or Not. I couldn’t decide.
Then one afternoon she began to cry and berate my brother for taking her car. She called him names that I’d never heard my mother say in my entire life. It broke my heart that she could feel that way about my brother who was only doing what was best for her. So, the choice was made. I would tell her–and she would understand.
I sat her down on the sofa and began talking, telling her every thing the doctor had told us about her disease in terms she would understand. “Her memory wasn’t as good as it use to be. She was forgetting some things, without realizing it. That was the sole reason my brother had taken her car.”
She squeezed my hand and said, “You guys were just thinking of me. You were trying to do what’s best for me. It’s Alzheimer’s? A memory disease?” She patted my hand.
I was so relieved I could hardly speak, my shoulders sagged and stress melted away. She understood. I knew she would.
Mom squeezed my hand again and stood. Then she walked into the kitchen, and as she reached for the refrigerator door, she turned, looked at me with a blank stare and said, “Did I tell you what your stupid brother did to me. He stole my car. I want it back too. You need to call him and tell him to bring my car back. If he doesn’t bring it back, I’m calling the Sheriff and reporting it stolen. Your stupid brother. I’ll have a gun waiting when he comes back!”
The memory span of an Alzheimer’s Patient beyond middle-stage is seconds. I knew that, yet I fully expected Mom to understand what I said and remember it. She Could Not!
I honestly think the larger Bewilderment with Alzheimer’s is that We Forget!
- The Alzheimer’s patient can not reason or learn anything new
- The Alzheimer’s patient can not remember beyond a few seconds
- The Alzheimer’s patient is no longer able to reason responsibly nor make responsible choices
Before you make your decision whether to tell them about their diagnosis, consider the above circumstances. Their age, their advanced state of dementia, their current health.
I still remember that day occasionally, and how broken-hearted I was when I realized she didn’t remember a single thing I told her. It will probably happen to you also, or other moments that are similar. All we can do is realize our mistake, take care of ourselves, and keep taking care of them.
If you’ve had a foolish moment like mine, I’d enjoy hearing it. The more we share, the more we help those who are struggling with these problems today. If you’re a caregiver–take care of yourself too!
Please feel free to leave a comment!
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