Dee Dee Harris and Peggy Smith are the primary responders to family calls to Alzheimers North Carolina, Inc. They deal with a wide variety of caregiving issues in helping individuals and families handle diagnosis and caring for their loved one. They both offer insights to how they help families when they first come in concerned about a possible diagnosis of Alzheimer's or related disorder. Both are social workers with years of hands-on experience in dealing with dementia and coping skills.

Dee Dee:

Many of my calls begin with people concerned about changes in themselves or their loved ones. I begin by asking them to give me some examples of what they are noticing.

Many times I will ask them questions to see if this has been a sudden change or an ongoing problem. We try to determine if there has been a change recently like a new medication or a life change or loss of someone.

Either way we know that our next step is to see a doctor. This is where the challenge comes in. Knowing where to send someone is not always easy. When trying to determine a diagnosis of any kind, a specialist in neurological disorders is the best option. Many primary doctors are not trained for the detailed evaluations needed to diagnose many dementias.

I encourage families to go to one of the Memory Clinics if possible. Many of them cannot do this for a number of reasons so we then either suggest a local neurologist or geriatric doctor if there is one in their area.

The wait time can sometimes be a couple of months so we suggest they be put on a waiting list as well. We also encourage families to be writing down things that they need to address with the doctor. I find that families are so stressed themselves that the more they have written down the better they can communicate with the doctor.

We discuss ways of helping them know how to be involved but also allowing the person who is experiencing the problem to be a part of the process. I will also provide the family with written material on warning signs of Alzheimer's and steps to take in getting a diagnosis.

I encourage families to educate themselves, ask questions and be advocates for their loved one. My goal is to hopefully ease their fears and to give support and information that can help them step-by-step in this process.


In my first meeting with families, they often tentatively mention a primary care physician suggesting either dementia or Alzheimer's. Knowing that not all physicians are familiar with or comfortable in dealing with dementia, I will then ask what procedures or diagnostic tests were used to support such findings.

With over 70 types of dementia, it is important that medical history, mood/mental status evaluations, physical examination, diagnostic testing and a neurological exam are completed. A skilled physician completing such steps will be able to make an “accurate” diagnosis 90 percent of the time.

In working with families, I provide emotional support, as well as education. For example, until someone is faced with this disease, they may not make a distinction between dementia and Alzheimer's.

By clarifying dementia as the umbrella term and Alzheimer's disease, vascular dementia, fronto-temporal dementia as being some of the most common types of dementia, we can better guide families in their understanding and planning. Ultimately, I want to ensure that families obtain the most accurate diagnosis. Several reversible conditions, such as a vitamin deficiency, which can mimic dementia, need to be ruled out prior to a diagnosis.

If families are unable to seek the expertise of a specialist, I provide them with information they can discuss with their primary care physician. I encourage families to seek an accurate diagnosis for their loved one as early as possible. This allows for earlier intervention and treatment to have a positive effect on quality of life. The person with a diagnosis of dementia can then take an active part in decision-making about current and future care.

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