Part of dealing with the mind is dealing with confidence.
The confidence to ask questions, to ask for a particular assessment and the confidence that no matter the outcome, knowing what’s going on with our brains is always better than not knowing.
The recently released Alzheimer’s Association special report “Alzheimer’s Detection in the Primary Care Setting: Connecting Patients and Physicians” found that less than 16 percent of seniors receive regular cognitive assessments, although these brief exams are a required component of the Medicare annual wellness visit. The majority of senior patients have their blood pressure taken (91 percent), their cholesterol checked (83 percent) and are checked for diabetes (66 percent). Despite the vital importance of brain health as one ages, seniors simply are not all regularly checked for cognition.
It’s not that seniors and doctors do not value the need for a cognitive assessment – 82 percent of seniors say it’s important to have their thinking or memory checked. The majority, or 94 percent, of primary care physicians say they perceive brief cognitive assessments as important. The disconnect lies in the patient expecting the doctor to perform one and the doctor relying on the patient to ask for it. Other complicating issues are fear of a diagnosis of Alzheimer’s disease and lack of provider time during a typical visit to address all of a senior’s health needs.
In reality, whatever the exam finds is crucial for long-term brain health and allows for seniors to plan for the future.
Have confidence. A brief cognitive assessment performed during a Medicare Annual Wellness Visit is short, simple and noninvasive.
A brief cognitive assessment is a medical evaluation for cognitive impairment performed by a primary care practitioner that can take several forms. The practitioner may do one or more of the following:
• Ask the patient directly about cognitive concerns.
• Observe patient interactions and cognitive function.
• Seek input about cognitive function from a patient’s family or friends.
• Take physical exams, medical history and family history into account.
• Use one or more brief structured assessment tools to obtain objective measures of cognitive function.
Exams normally take 15 minutes or fewer and results are immediate.
As a caregiver, have confidence. If you are a concerned, steps can be taken to help in the exam process.
Being prepared for a doctor’s visit is essential in getting the most out of the time with the doctor and the annual wellness visit.
• Bring a list of symptoms and changes – be as specific as possible as to how often, when they began and if they interfere with daily life.
• Bring all of the prescription and over-the-counter medications that are taken.
• Create a list of all past and current medical problems and if other family members have or had similar memory and thinking problems.
• Lastly, be prepared to answer the doctor’s questions honestly and involve other family members to share what they have noticed.
If there are concerns or changes in memory and thinking, it’s important not to wait to tell the doctor.
When the results are in, have confidence.
Cognitive assessments give options. The screening may find that everything is fine and modest changes are due to normal aging. Sometimes, reversible causes of memory and thinking problems are detected. Then an individual can undergo further testing and treatment for these other causes such as depression, medication side effects or vitamin deficiencies. If the screening indicates the need for further evaluation when it comes to Alzheimer’s disease and related dementias, early diagnosis is the key.
Early diagnosis allows seniors to access treatment options, an opportunity to participate in clinical research trials, and a chance to prioritize lifestyle and other health conditions. There are emotional and social benefits as well, which include lessening anxieties about an unknown diagnosis and maximizing resources and support programs for the senior and family.
Additionally, an early diagnosis gives a senior more time to plan for their future. Most people want to make decisions about their future care. This can give seniors peace of mind and reduce the burden on families to make these decisions without knowing the senior’s preferences.
“Kern County Confidence”: Bakersfield is full of resources.
Several resources and organizations exist in Bakersfield support to those facing Alzheimer’s disease and related dementias, such as the Alzheimer’s Association California Southland Chapter and Alzheimer’s Disease Association of Kern County.
If the exam finds all cognition is in order, workshops exist – in person, via telephone and online – for tips on taking care of your brain going into the future, such as “10 Ways to Love Your Brain” on www.alz.org. If the exam leads to more questions, the Alzheimer’s Association helpline is available 24 hours a day, seven days a week and translates into 200 languages. Free, local support groups, educational programs and care consultations are available should you have questions going into an exam or after an exam is concluded.
A step to senior brain health is an assessment or the confidence to visit a primary care physician to speak up and to ask about the mind. Once that step is complete, planning for the future becomes clearer with many resources to guide you along the way. ￼
Susan Howland is the programs director for Alzheimer’s Association California Southland Chapter.