Case Management in Patients With Early-Onset Alzheimer’s Disease

Patients with early-onset AD and their families face great obstacles—medically, socially, and psychologically. Depending on the age at onset, they may also face financial hardships. Helping patients and families cope with this disorder requires special skills in evaluating, counseling, applying for disability benefits, helping to shore up social networks, and more. Read how you can help develop a full care plan for these patients.

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Substance Abuse and The Elderly

How do I know if my loved one is having a problem with abusing prescription drugs and or alcohol?

Alcohol and substance abuse rank third among the leading mental disorders in older adults, and the rates of alcohol abuse range from 2 to 10% . These percentages are considered to be underestimated due to the large amount of substance abusers who deny they have a drinking problem, and family members who are unable to recognize when it really is a problem.

If not dealt with in treatment, severe alcoholism can lead to severe depression and suicide in older adults. The alcoholic elderly are particularly vulnerable because their risk of suicide is five times higher than that of the nonalcoholic elderly (this is because alcohol acts as a depressant on the central nervous system). This means that heavy drinking produces feelings of sadness, anxiety, guilt, and remorse (1).
Long term alcohol abuse can do damage to the brain, and may cause behavioral and memory changes that resemble Alzheimer’s disease. Bottom line, if the underlying reason as to why the individual is drinking is not addressed, drinking puts a bandage on the problem and it becomes difficult for families as well as physicians to understand and address a treatment plan.

When a person has both chronic alcoholism and Alzheimer’s, it is difficult to tell which condition is the cause of which symptom (2).

The Reasons that Older Adults Resort to Alcoholism:
• Depression
• Low self-esteem
• Attempting to manage pain from medical conditions
• Genetic predisposition
• Loneliness
• Isolation
• Retirement roles
• Loss of friends/spouse

Medication overuse

The correct medication and dosage can increase quality of life with by managing medical conditions, However, sometimes there is a price to be paid. Part of that price is experiencing how some drugs can interfere with memory skills, mood, alertness, and ability to take in new information.
Thousands of older adults suffer from severe mental impairment, including memory loss, which is either caused by drugs, or worsened by them. Recent studies indicate that drugs greatly diminish or inhibit chemicals in the brain (e.g., neurotransmitters, such as and hormones) which can produce significant memory loss (3). This is especially dangerous if your loved one still drives or lives on his or her own and will not accept help.

Drugs Associated With Alcohol Interactions

(adapted from WebMD)

Hundreds of commonly used prescription and over-the-counter drugs may adversely interact with alcohol. These include medications used for:

• Allergies, colds, and flu
• Angina and coronary heart disease
• Anxiety and epilepsy
• Arthritis
• Blood clots
• Cough
• Depression
• Diabetes
• Enlarged prostrate
• Heartburn and indigestion
• High blood pressure
• High cholesterol
• Infections
• Muscle pain
• Nausea and motion sickness
• Pain, fever, and inflammation
• Seizures
• Severe pain from injury, post-surgical care, oral surgery, and migraine
• Sleep problems

Geriatric Care Managers can help!

A skilled professional such as a geriatric care manager can quickly assess the situation and work with the family to put an action plan in place, addressing the medical, psychological and social issues that may be interfering with the older adult getting the help they need. Geriatric Care Consultants LLC has a breadth of knowledge of trusted professionals and we can be an invaluable resource to help take the burden off the adult child and get the senior the help they need.

1. Osgood, N.J., Wood, H.E., & Parham, I.A. (1995) Overview. Alcoholism and Aging (pp. 14-19).
2. Rosenfeld, I.R. (1999) Live Now Age Later: Proven Ways to Slow Down the Clock.
3. Schaie,K.W., Willis, S.L. (1996). Alcoholism and Drug Misuse. Adult Development and Aging (pp.487-490).