Susan Scanland, MSN, CRNP, GNP-BC, CDP: The Challenges of Living at Home with Alzheimer Disease
September 22, 2019
There are several challenges patients suffering from Alzheimer disease must overcome, especially when living at home. Everyday tasks like driving, cooking, and just walking throughout the house can be difficult, if not impossible.
In an interview with MD Magazine® during the 2nd Annual Advanced Practice Collaborative on September 7, Susan Scanland, MSN, CRNP, GNP-BC, CDP, a gerontology nurse practitioner at Dementia Connection, explained just how difficult it is for these patients.
MD Mag: What are the most effective ways of supporting care for people Alzheimer disease living at home?
Scanland: The most effective ways to help peopleat home is again education because when a person's living at home there are safety factorsto consider. Things like driving forexample, 1 should not be driving oncethere is a diagnosis even inthe early stages. We used to think it wassafe to drive in the early stages ofAlzheimer's disease and other dementias, but now we're finding the availabilityis impaired and understanding what's on.
A sign the ability to read words isimpaired and that certainly caninterfere with driving. So, driving is 1,adverse drug reactions is another, so wewant to highly educate and be surethere's a system in place for thatperson taking their medication toprevent accidental underdose or overdosebecause what happens then itprecipitates problems with all the otherchronic illnesses diabetes. They'redealing with blood thinners and you knowif someone's not giving their medicine or supervising their medicine that could result in a problem.
MD Mag: What is needed to better serve this segment of the population?
Scanland: House calls would be wonderful. If therewere enough resources for primary careproviders to come in and do thatprevention. You know someone's livingalone there's the risk of dehydration, malnutrition. Often adult children areliving far away and in that case Irecommend them getting a case manager and there's a national association of case managers that can come in and besure, almost like a coordinator for thecare.
They can speak with a physician,they can help them find places for the next stage of their illness. For example, the progression from living alone, which are going to assisted living or living at home and getting increasing amounts of homecare because probably half of the people stay or even more than half stay at home to the edge of their illness. So, whatever direction they choose to go in making sure home is safe or assisted living if especially if the adult children are far away and not able to be directly supportive is very important.
So, safety issues you know getting the right care not being afraid to hire someone, an agency to come into your house as long as they've been checked and bonded and all that so many older people don't want anybody to come into their house and that leads to the person being at risk. The other thing we need to prevent is caregiver burnout and stress because often it falls on one person in the family and that person ends up trying to do everything and then often the caregivers get depression and they're sicker than the person with Alzheimer's. From a physical standpoint because they're not going for their own health maintenance of their own health screening so caregiver burnout is huge and that's something we want to prevent when the patient is at home.
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