Preparing For Life’s Transitions When
Dementia Is Involved
Reprint from: A VOICE for Dementia Newsletter
T
here are several predictable transitions in the course of dementia and care is often provided by friends or
family members in the earlier stages. When someone enters later stages, more support and care is needed,
and additional personnel, resources and even a change in location of care may be needed. These changes
frequently involve a move to one or more care settings. One t ransition that can cause a tremendous amount
of distress and conflict is when and how to restrict driving. This is such a hot button topic that it is being
addressed as a separate article. Other important transitions for those living with dementia and their families
and/or care partners include the initial diagnosis of dementia, advanced planning for financial concerns and
healthcare considerations, cooking cessation, changes in where and how care is delivered and preparing
for end of life and life after loss.
Dementia Diagnosis: Why is seeking a diagnosis important?
An accurate diagnoses is important in order to
rule out other conditions that may have similar
symptoms and may be treatable. There are three
major categories of possible mistaken identities:
1. Mental health and emotional health problems
– examples: depression, anxiety, social
isolation, grief and loss related to people,
animals, places or health
2. Physiological health problems – examples:
undiagnosed or poorly managed health
problems (hypothyroidism, diabetes,
hypertension, Chronic Obstructive Pulmonary
Disease (COPD), auto-immune conditions,
drug or alcohol addiction, medication toxicity,
interactions or side-effects, mineral or
vitamin deficiency or toxicity, sleep apnea,
various infections, organ system issues and
dehydration
3. Sensory changes – examples: loss of vision,
loss of hearing, peripheral neuropathies,
tremors, vestibular problems, reduced senses
of smell or taste
An accurate diagnosis can provide the person or
their support system with an explanation for their
symptoms, removing uncertainty and allowing
them to begin to adjust to their situation, seek
treatment, seek legal/financial support and plan
for the future.
In seeking a diagnosis, the first step is to consult
with the person and their primary care provider. If
the individual is unaware of the changes and is not
willing to share your concern with the provider, it
would be important to consider three things:
1. With HIPAA/medical information privacy
guidelines, you can offer information to the
care provider, however, the care provider can
offer nothing back.
2. Who is the person’s designated durable
surrogate for health care? If there is not
someone appointed, that may be the first
step to consider taking. If there is someone
appointed, voicing your observations and
concerns to that person might be an initial
action.
3. How you offer your concerns could impact your
relationship with both the provider and the
person for whom you are concerned. Consider
trying to be objective and consider the value of
a private conversation.
(Continued)
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Adviser a publication of LeadingAge New York | Spring 2017