Q. It’s difficult caring for a family member who is experiencing cognitive decline. How do you advocate for a loved one when they’re no longer able to do it for themselves?
A. Being an advocate for a loved one who’s experiencing memory loss is so critical, because their own insight into their condition could be very low. We don’t necessarily recognize when we have a memory problem. Many times, a family member saying, ‘Hey, I’ve noticed a memory issue,’ is the first step in a patient receiving treatment. So being able to bring that up, and to be present with that person at a medical appointment, can help them enormously. We’ll then figure out how to keep that loved one as independent and autonomous as possible. But that’s often a tough conversation for many families, understandably. At some point, though, it comes down to keeping your mom, dad, or spouse safe. Are they falling prey to scams, clearly not taking their medicines the way that they’re supposed to, or is it no longer safe for them to be driving? One important step is to go back to conversations that you’ve had with that loved one in the past. Rely on your history with them to know and reassure yourself of what they’d want as a person. Part of the role of a caregiver is to be the one who says, ‘This is the point where they can’t live this way anymore.’ None of this is easy, of course. That’s why in my clinics, and through our other providers who take care of individuals affected by memory loss and dementia, a lot of time is spent taking care of the families themselves, making sure that they’re getting the resources that they need.
Q. You’re part of an initiative that leverages professionals called brain health navigators to help patients and families. How does that operate?
A. We work really closely with our primary care teams to give our patients resources to detect cognitive impairment early. In an effort created by Indiana University Health, brain health navigators work with primary care providers. These are registered nurses who are specially trained to perform cognitive testing, assess conditions like depression and sleep apnea, look for markers of cognitive decline, and evaluate patients’ medicines. Then they provide feedback to the primary care doctor. If we do find a person has very early Alzheimer’s disease, they can be fast tracked into the treatment program. We’re building out this training program for nurses internationally, so it’s an effort on a global scale.
