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Ask Dr. Gott 12/14

Who helps the helpers?

    DEAR DR. GOTT: My mother-in-law suffers from Alzheimer’s disease. I am her primary caregiver. That’s 24 hours a day, seven days a week. She no longer recognizes her family and friends. She can’t dress or bathe herself. All she does all day long is sit in front of the television. She can still walk and talk, but it’s constantly rambling words. I have heard that people go through different stages with this disease, and eventually go back to their childhood years. She talks about her mom and dad all the time. They have been deceased for years. My health is not good, and I worry about her having to go to a nursing facility.     
    DEAR READER: Alzheimer’s dementia is progressive and incurable. In my practice, family members welcome the opportunity to care for demented relatives, but there are limits. No matter how much they care, the situation invariably deteriorates to the point at which exhaustion and frustration set in, and — without professional help — family members simply cannot cope.
    From your brief description, I believe that you are a saint for having assumed the responsibility of home care. Now it’s time to be realistic: Your own health is at risk, and your life has been put on hold. Therefore, I urge you to review the situation (and your admitted burnout) with your mother’s doctor. I believe that at the least she needs assisted home care by medical personnel; at most, she is probably a candidate for placement in a skilled nursing facility. In such an environment, she will have most of her basic needs met. You can visit her on whatever schedule you choose. Both she and you will be better off. Her doctor — if he or she is kind, considerate and caring — should be able to arrange for a brief hospitalization (for testing and stabilization), followed by permanent placement in an appropriate facility, the cost of which should be borne by Medicare. At the same time, the doctor should insist on a Do Not Resuscitate status, and he or she ought to reduce her medications, leaving in place only those that will maintain — as much as possible — your mother’s quality (not length) of life.
    To give you related information, I am sending you a copy of my Health Report “Alzheimer’s Disease.” Other readers who would like a copy should send a long, self-addressed, stamped envelope and $2 to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title.

    DEAR DR. GOTT: Is it true that if people who have recently sustained a concussion fall asleep, they will never wake up, or, in other words, die? I know several people who believe this strongly, but I don’t trust their reasoning. What do you think?
    DEAR READER: A concussion is brain bruising caused by trauma. It will not ordinarily lead to prolonged unconsciousness or death. However, if the bruise continues to bleed, it can be associated with serious and permanent brain damage. Therefore, concussion patients must temporarily discontinue activity that can cause further bleeding, such as contact sports, and should undergo repeated medical monitoring for several days. Most concussions heal within a matter of months, but further injury may lead to dangerous consequences.

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