Have a loved one diagnosed with Alzheimer’s? Here’s what you need to know

In honor of National Alzheimer’s Awareness Month, experts share their take on how to understand and cope with the neurological disease.

elderly couple talking to man at desk
© fizkes / stock.adobe.com

As of this year, an estimated 5.8 million Americans are living with Alzheimer’s—the most common form of dementia—with the majority being over the age of 65, according to data from the Alzheimer’s Association. While there is no cure for the disease, researchers, scientists and psychologists alike are consistently developing new ideas and techniques for coping with the symptoms, for both those directly affected and their caretakers. 

Mike Behrmann, CEO of Arlington-based IT service management company Segue Technologies, Inc., is one of the many who recently took an interest to the topic, ultimately creating the company’s subsidiary, Caring Village, LLC, which creates products and services for caregivers of the elderly. And this past July, Behrmann and his team worked with experts in the field to publish, Enduring Alzheimer’s, providing readers with educational resources and personal perspectives surrounding all phases of the disease. 

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From the medical diagnosis to preparation necessary for a caregiver, there are a lot of misconceptions and essential details those affected by Alzheimer’s need to be aware of. Here, co-author of Enduring Alzheimer’s Bruce A. Kehr, MD, of Potomac Psychiatry and Behrmann share their take on it all.  

Medical details with Dr. Kehr

Tell me about the progression of the disease and how it affects the brain.
It begins 20-25 years before it is diagnosed. It’s based on an accumulation of abnormal proteins in the first phase, which is called the biochemical phase. The proteins begin with accumulation of one called amyloid beta, and at a later stage it begins with an accumulation of tau. The tau almost behaves a bit like a virus, in that it moves from cell to cell. So in this early biochemical phase, we have an accumulation of what is called misfolded proteins that trigger inflammation, and as you can imagine that inflammatory response begins to damage the brain cells and its connections. It also triggers a disruption of cellular machinery. For example, there are elements in a cell that are like a structural support—a frame of a house—and they transport molecules, genetic material and ions within and between cells. So as the proteins accumulate, they damage the transport system, moving into the cellular phase of the disease. The cells become damaged and they try to compensate for the damage, overtime overwhelming and destroying the cells. When enough have been harmed, that’s when the diagnosis is made. 

Are there ways to treat Alzheimer’s?
The best treatment is to prevent the biochemical phase in the first place with a healthy, Mediterranean diet, lots of intellectual stimulation, social engagements and cardiovascular fitness exercise. Also, getting a good night’s sleep. The glymphatic system in the brain is the brain’s waste management system, it takes away a lot of waste products, and 80% of the glymphatic activity occurs during sleep. The other way to prevent Alzheimer’s is to effectively treat high blood pressure, high cholesterol, reduce insulin resistance and lower weight. Each of those factors independently is associated with higher rates of Alzheimer’s disease. 

Caregiving tips with Mike Behrmann

There’s a chapter in the book titled, “How to Prepare to be a Caregiver for a Loved One with Alzheimer’s.” Can you tell me some key points and revelations on that subject?
First and foremost is the need for a primary caregiver, usually a spouse or a daughter, to understand the immense impact the care will take on themselves personally. Often the caregiver’s health will deteriorate, and the challenges are then compounded even further. So it’s necessary to understand that you need help and need to dole out tasks to others to lessen the load. We describe the need to pull together key documents (insurance policies, medical prescriptions, wills, medical appointments/locations, financial accounts, power of attorney, etc.).  It becomes extremely burdensome to confront the organization of these documents as they are confronted, rather than understand and prepare in advance. Family members will be impacted both mentally and physically, in some situations for quite a long period of time, so often the family will experience guilt, frustration, and even anger. It is normal to have these feelings and we try to explain the need to understand it will happen, so they are aware. 

What are some of the biggest misunderstandings people have surrounding care of a loved one with Alzheimer’s?
The single greatest misunderstanding people have when confronting care of a loved one with a diagnosis of Alzheimer’s is that they think the patient will be incoherent and non-communicative from day one of the diagnosis. This couldn’t be farther from the truth! Alzheimer’s is an extremely insidious disease and stages progress in no predictable way.  Caregivers can learn the symptoms of stage progression and educate themselves on these in advance. 

Other misunderstandings involve treatment options and safe keeping of medications, when and how to alter patient independence (driving, living alone, cooking, etc.), and lastly most caregivers don’t anticipate the life-changing commitment and financial costs associated with care.

How do you suggest people go about talking to an individual with Alzheimer’s about the next steps in care and approach to the disease?
People who are confronting Alzheimer’s disease as a family need to continually remind themselves that the loved one with the diagnosis is a gift to them and will always be loved as they continue the journey. It is paramount to communicate with the loved one from this foundation. Everything that will be done as next steps should be described in as much detail as possible, without scaring the loved one, and it should always be done in a calm, firm and loving tone. Communication with medical professionals should be interpreted by the caregiver to the loved one, always.  


Want to get involved? Here are a few opportunities to help those affected by Alzheimer’s this November. 

National Family Caregivers Month
Nov. 1-30
Throughout November, the Alzheimer’s Association is honoring the millions of family members, friends and neighbors alike who serve as Alzheimer’s caregivers. Do you know someone who deserves recognition for his work? Make a tribute, today. // Click here to leave a tribute

Partnership with CVS Health
Nov. 3-23
This month, CVS Health joined the Alzheimer’s Association as a corporate partner by making a three-year, $10 million commitment to the fight against the disease. In honor of the partnership, CVS Health is offering a three-week, in-store fundraising campaign at all its locations, giving you the chance to donate upon check out. // Locations vary 

2019 RivALZ
Nov. 16, time to be announced
Since 2005, this volunteer-driven, flag football event has taken place across the country in an effort to inspire fundraising, awareness and action in the fight against Alzheimer’s disease. While the Blondes vs. Brunettes competition originated in Washington, DC, the event has since grown to more than 40 cities, raising over $13 million for the cause. // Georgetown University Cooper Field: 37th Street NW and O Street NW, Washington, DC; $25 donation to play

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