Top Dementia Doctor Opens Up About What He Did when His Mother Was Diagnosed with Alzheimer’s
Top Dementia Doctor Opens Up About What He Did when His Mother Was Diagnosed with Alzheimer’s
Peter Garrard had been a consultant neurologist in London, England, for 12 years by the time his 78-year-old mother, Sheila, started showing signs of Alzheimer’s disease.
Garrard said he noticed his mother was not picking up on “subtle aural messages.” For example, Garrard said Sheila did not recognize his voice when he called her on the phone. She would also confuse similar-sounding but very different words like “Stoke” (a city in Staffordshire, England) with “stoat” (the mammal).
“Mum had always been well-read, but her language was degenerating, and she was using more simple words,” Garrard said in an interview with The Telegraph. “Everything would be ‘nice’ or ‘bad’ rather than attractive, enjoyable or unpleasant.”
Garrard’s first impulse was to “try and fix things” with his mother by developing a practical plan. “I wanted Mum to be assessed but not to be rebuffed, either with insensitive delivery of the truth or false reassurance that there was nothing wrong,” he said.
Sheila was taken to a neurologist who diagnosed her with Alzheimer’s disease, the most common form of dementia. More than 55 million have dementia worldwide, and Alzheimer’s disease may contribute to 60 to 70 percent of cases, according to the World Health Organization. The Alzheimer’s Association reports that nearly seven million people in the United States are living with the disease.
The progressive brain disorder disrupts a person’s life by causing mood and behavior changes, confusion about events, time and place, memory loss, and difficulty speaking, swallowing, and walking.
Garrard said his mother was prescribed memantine, a drug used to slow the loss of thinking and memory skills in people with Alzheimer’s disease. She also took specific doses of B vitamins that allowed her to walk, socialize, play tennis, and live independently for some time. Garrard was working at the time with a team from Oxford University who had found that the B vitamins reduced cognitive and brain scan progression in patients with mild cognitive impairment by inhibiting the production of a damaging amino acid known as homocysteine.
Garrard Takes a “Personal Approach” With His Patients
Garrard, 63, is now a professor at St George’s Hospital in London, England, where he specializes in neurodegenerative dementia, cognitive disorders, progressive language disorders, early onset dementia, and frontotemporal dementia. His experience with his mother has led him to take the “personal approach” when working with dementia patients, and that includes treating them with respect.
“My aim is to treat a person with dementia with dignity and respect,” Garrard told The Telegraph. “It’s not helpful to assume all is lost and rush straight to the end stages of the disease.”
Garrard gets frustrated when people say nothing can be done for someone with Alzheimer’s. “I immediately think, ‘keep those people away from my patients.’”
Before diagnosing a patient, Garrard looks for different signs of Alzheimer’s disease. For instance, Garrard notices that people in the early stages of dementia often ”lose their confidence and decisiveness in how they present themselves.”
He also looks at a patient’s use of language. For example, one of the first questions he asks new patients is “How did you get here today?”
“If they answer: ‘I came on the big thing’ [instead of the bus] or ‘I arrived at the place where people go in and out’ [instead of the station], then I’m afraid that’s a sign,” Garrard said.
Garrard sometimes uses humor, particularly with patients with frontotemporal dementia, who can be “irresistibly energetic and high-spirited.” Garrard recalled meeting a man for the first time who quoted a speech from his favorite movie and told Garrard that he reminded him of Anthony Hopkins, one of Britain’s most famous actors who was given the title of “Sir” in honor of his contribution to drama. At their next meeting, Garrad said the patient “bellowed out ‘Good afternoon, Anthony!’…’ That’ll be Sir Anthony to you’, I joked back.”
Garrard is pushing to keep dementia patients out of the hospital, which is why he joined the Geller Commission, an initiative in England to provide early interventions for people with dementia and reduce avoidable hospital admissions and occupancies of dementia patients. Health officials say that dementia-related hospital admissions worsen the symptoms for many dementia patients.
“An admission has an instant and deeply negative effect on a person’s wellbeing and cognition,” Garrad explained.
How the Alzheimer’s Diagnosis Affected Garrard’s Family
Before receiving an Alzheimer’s disease diagnosis, patients and their family members suspect that something is not right but aren’t sure how—or when—to bring up the issue. Garrard said he faced the dilemma of “whether it was right to share my suspicions with my family” about his mother. He first discussed the matter with his father and then approached his mother.
“At some level, she did ‘know’—once, when I went to visit, she took me to one side and asked, ‘Am I OK?’”
Because of his profession, Garrard said his sisters were convinced there was something he could do to stop their mother’s disease from progressing.
“I knew that everything possible was already being done, but it was still painful to have to explain this,” Garrard told The Telegraph.
In helping Sheila find treatment, Garrard described some of the existing dementia care as “depressing.”
“I went with my mother to a couple of memory clinics, and there didn’t seem to be a desire to get to know the patient, just to tick the box and prescribe the medicine.
As Sheila’s condition progressed, the family persuaded Garrard’s father to hire caregivers to help Sheila. Sadly, Garrard’s father died in October 2021, two months after he hired the caregivers. After his death, Sheila had to go to a residential care home.
When looking for a place for his mother, Garrard said some of the existing residential care was “not great.” For instance, one care home that Garrard and his sister visited had dementia patients “cordoned off in a special area.” Eventually, they found a “wonderful, small care home” run by a former high-ranking nurse, who could “not do enough” for his patients, he said.
When visiting Sheila, who worked as an actress when she was young, Garrard said he continued to entertain her with comic routines they had developed over the years. After all, “Nobody benefits from an atmosphere of doom and gloom,” he said. Sheila died in July 2022.
While efforts continue to improve the care and treatment of dementia patients, Garrard believes there are steps people can take to reduce their risk.
“My usual advice is: think of something you enjoy doing but would find challenging,” Garrard said. “This includes intellectual engagement, though not necessarily puzzles. Physical exercise is essential. A Mediterranean diet, supplemented with B Vitamins: they are simple, harmless and inexpensive treatments.”
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