Q. My older brother, Chris, just turned 40. He is a successful businessman, and the father of three. My family sees him and his wife often, as we are very close and they live nearby. Five years ago, I began seeing memory slips from Chris. For instance, he couldn’t remember our families going skiing, when it happened the month before. He forgot to pay his water bill for a couple of months and his family’s water was shut off. His memory and ability to understand words seems to be getting worse. His wife is convinced that it is due to stress, since he has a stressful job. Chris always knew how to handle stress, so I think it could be something worse. Could my brother have Alzheimer’s Disease at 40 years old? My mother died of Alzheimer’s at an early age, and my aunt has it, as well. What are the symptoms of early-onset Alzheimer’s and if confirmed, what can his family do to plan? Thanks for your help!
A. Of the more than 5 million people across the U.S. who have Alzheimer’s, 5% are believed to have the early-onset form, striking people under the age of 65. According to the Alzheimer’s Association, many people with early-onset are in their 40s and 50s. They have families, careers, or are even caregivers themselves when Alzheimer’s strikes.
Symptoms of Early-Onset Alzheimer’s Disease
If your brother is experiencing the symptoms described below, it would be a good idea for him to see his doctor. Accurate diagnosis is critical so that he can explain his condition to his employer and perhaps arrange a lighter workload or more convenient schedule. For family reasons and planning purposes, it is even more crucial.
Memory Loss: Your brother may begin to appear more forgetful than normal. Forgetting important dates or events can occur, questions may become repetitive, and frequent reminders may be required.
Difficulty Planning and Solving Problems: Your brother may have difficulty developing and following a plan of action. Working with numbers may also become difficult. This can be seen if he begins to demonstrate problems maintaining monthly bills or a checkbook.
Difficulty Completing Familiar Tasks: He may have a difficult time concentrating. Routine day-to-day tasks requiring critical thought may take longer.
Getting Lost: The ability to drive safely may be called into question. If your brother gets lost while driving a commonly traveled route, this may be a symptom of Alzheimer’s.
Difficulty Determining Time or Place: Losing track of dates and misunderstanding the passage of time as it occurs are also two common symptoms. Planning for future events can become difficult since they aren’t immediately occurring. As symptoms progress, people with Alzheimer’s can become increasingly forgetful about where they are, how they got there, or why they’re there.
Vision Loss: Vision problems can also occur. This may be as simple as an increased difficulty in reading, judging distance, and determining contrast or color.
Difficulty Finding the Right Words: Initiating or joining in on conversations may appear difficult. Conversations may randomly be paused in the middle, as he may forget how to finish a sentence. Because of this, repetitive conversations can occur. Your brother may have difficulty finding the right words for specific items.
Misplacing Items Often: Your brother may begin putting items in unusual places, and it may become more difficult to retrace the steps to find any lost items.
Difficulty Making Decisions: Financial choices may demonstrate poor judgment, which in turn can cause detrimental financial effects. An example of this is donating large amounts of money to telemarketers.
Physical Hygiene Becomes Less of a Concern: Your brother may experience a rapid decline in bathing frequency and a lack of willingness to change clothing on a daily basis.
Withdrawing from Work and Social Events: As symptoms appear, he may become withdrawn from common social events, work projects, or hobbies that were previously important. Avoidance can increase as the symptoms worsen.
Experiencing Personality and Mood Changes: Extreme swings in mood and personality may occur. A noticeable change in moods may include confusion, depression, anxiety, and/or fearfulness. You may notice that your brother is increasingly irritated when something outside of a normal routine takes place.
Causes of Early-Onset Alzheimer’s
Some people with early-onset Alzheimer’s have the common form of the disease, and experts don’t know why these people get the disease at a younger age than others do.
For most, however, early-onset Alzheimer’s runs in the family. They’re likely to have a parent or grandparent who also developed Alzheimer’s at a younger age. In a few hundred families worldwide, scientists have pinpointed several rare genes that directly cause Alzheimer’s. People who inherit these rare genes tend to develop symptoms in their 30s, 40s, and 50s. When Alzheimer’s disease is caused by these deterministic genes, it is called “familial Alzheimer’s disease,” and many family members in multiple generations are affected.
Diagnosing Early-onset Alzheimer’s
Doctors generally don’t look for Alzheimer’s disease in younger people, so getting an accurate diagnosis of early-onset Alzheimer’s can be a long and frustrating process. Symptoms may be incorrectly attributed to stress or there may be conflicting diagnoses from different health care professionals. There is no one test that confirms Alzheimer’s disease. A diagnosis is only made after a comprehensive medical evaluation.
If your brother is experiencing the symptoms described above, he should:
•Write down symptoms of memory loss or other cognitive difficulties to share with his health care professional.
•Have a comprehensive medical evaluation with a doctor who specializes in Alzheimer’s disease. Getting a diagnosis involves a medical exam and possibly cognitive tests, a neurological exam and/or brain imaging. His primary care physician can likely give him a referral.
Early Detection is Key
Research suggests that the process of Alzheimer’s disease begins more than a decade before clinical symptoms appear. Early detection is important for planning for long-term care and participating in trials to help stave off the disease and possibly find a cure. Early detection may also have a major impact on the course of the disease, and in successfully treating symptoms.
Medicaid Planning for Alzheimer’s and Other Types of Dementia
Alzheimer’s is the biggest health and social care challenge of our generation, and a diagnosis of the disease is life-changing. When it comes to planning for long-term care needs, generally, the earlier someone with dementia plans, the better. But it is never too late to begin the process of Long-term Care Planning, also called Lifecare Planning and Medicaid Asset Protection Planning.
Medicaid planning can be initiated by an adult child acting as agent under a properly-drafted Power of Attorney, even if you are already in a nursing home or receiving other long-term care. Please understand that you never need to spend-down all of your assets and go broke in order to get Medicaid.
Medicaid Asset Protection
People with Alzheimer’s live on average four to eight years after they’re diagnosed, but some may live 20 years or more beyond their initial diagnosis. Persons with Alzheimer’s or any other type of dementia and their families face special legal and financial needs. At Farr Law Firm, P.C., we are dedicated to easing the financial and emotional burden on those suffering from dementia and their loved ones. We help protect the family’s hard-earned assets while maintaining comfort, dignity, and quality of life by ensuring eligibility for critical government benefits such as Medicaid and Veterans Aid and Attendance. As always, please call us at any time for an initial consultation:
Fairfax Elder Law: 703-691-1888
Fredericksburg Elder Law: 540-479-1435
Rockville Elder Law: 301-519-8041
DC Elder Law: 202-587-2797
About Evan H Farr, CELA, CAP
