Hi Larry
These are interesting questions I ask myself every time I'm with my mother.
After the third time I've told her what day it is, she asks yet again.  And
I so badly want to say "For the FOURTH time it's FRIDAY!"  It's very
tempting to remind her of each forgotten item.  Because I'm still trying to
prove to her that she needs to seek treatment.   But reminding her of what
she had forgotten was beginning to damage our relationship.  How could I get
her help if she kept throwing me out of the house everytime I said "Yes we
did discuss this Mom."?
In your situation, your loved one is already diagnosed.  So there isn't
really anything to prove by announcing each lapse.  It's my opinion that one
can be too diligent.
You might keep track of the subject of frequent lapses, and develop a way
for your partner to remind himself.  I read of a woman with AD who was
frequently asking what day it was.  Her husband then created index cards.
He put them in her pockets every morning.  They had answers to her most
frequent questions written on them.  She grew accustomed to consulting this
card, and it saved him alot of headaches.  It may be early for a solution
like this, but you get the idea.  Perhaps there is something practical you
can do to put a little responsibility back into your partner's hands.  He
may appreciate it greatly, since the recent diagnosis may have him feeling
unable to control anything.
Anyhow - just a suggestion.
Best of luck,
Kate

Hi Larry, I know your partner is concerned with how well he can
maintain his current function - but the answer is, other than take his
meds and take good physical care of himself, there is nothing either of
you can do. He will go down hill, that is inevitable, and there are no
mental gymnastics that will stop that process - and there is nothing
anyone can do to predict the rate of decline.

You have the diagnosis, and what you've got is right now, this minute.
My inclination is to not make each other crazy tracking lapses, but
take each day as it comes and try to squeeze as much joy out of it as
possible. Use today - take those vacations you've always wanted, visit
friends and family, try out new activities you've been putting off,
label the photos, see those movies, whatever. He has a terminal illness
that will destroy his mind before it takes his life, so the time is
short.

If you are continually pointing out deficits, correcting him etc. all
you do is constantly remind him he has this terrible illness - and for
what? Better to focus on the ability than the disability. Correcting
him is not going to change the outcome, slow the decline, or make him
any happier - it just rubs his nose in something he can't control. Make
this about having the happiest last years possible.

In short order, despite the fact he is high functioning now, he will go
through some humiliations you can't protect him from. He will start to
decline, he will be aware of it in the first stages, the will have to
stop driving, he will have to stop working, he will begin to lose his
independence.

Part of the brain damage that goes with this disease is merciful - he
will not always be aware of his deficits, or have insight into his
problems. Protect his dignity. As the person with the intact brain, you
will have to watch and change how you manage things as his deficits
arise. He may never see what is devastatingly obvious to you. Find face
saving ways to move in and support him doing the things he needs help
with - but try to do it in a soft way, so he isn't more embarrassed and
hurt by what he can no longer do. Have your back up plans in place long
before you need them. Think through what you can do when he has to stop
working, can't be left alone, etc. Check out resources, services and
facilities long before you even have a hint of needing them, so that
when that day comes you are ready to go with Plan B, and aren't in a
scramble at a time of crisis. See a lawyer and a financial planner and
get everything in place so you are ready for the worst.

I'd also get ready with supports and help for you, since this will be a
grinder for you as caregiver and partner. Right now, it probably has
not completely come home to you what this means - it certainly took us
a long time to get our heads around AD with our loved one.

Incidentally, early in the game, my mother in law lost her ability to
understand written text. She could read perfectly well, but
understanding what she read was another matter. You can demonstrate
this easily with someone in mid AD by giving them written instructions
and asking them to read them out loud, and then do what the
instructions say (i.e. pick up the book and put it on the table and put
on the red hat). She could read the text perfectly well, but not follow
the directions - reading and reading comprehension are two different
things. This meant she could not follow written notes and prompts - and
this happened fairly early in the game.

She also lost her understanding of sequences early in the disease, so
she couldn't understand that 1 was before 2, or that 4 was after 3, or
that January was before May, or Monday before Wednesday. This didn't
just translate into problems handling money or dealing with finances,
but problems understanding TV listings, reading a calendar,
understanding time etc. Just something to be aware of, since these
things happened when she appeared very high functioning - had you met
her, you'd have had no idea that she couldn't understand that 3 pm was
before 5 pm, or calculate that how much change she should get from a
$20 bill on a $5 purchase.

Mary G.

Larry,

Your partner might wish to look into some of the clinical trials for
new Alzheimer's drugs.  There are 115 trials listed at:

http://www.clinicaltrials.gov/ct/search?term=alzheimer%27s+disease

Not all of these are treatment trials.

The chance of getting benefit from an investigational drug is not
high.  Most of them do not pan out, or provide only a small and
temporary benefit.  Some may have negative side effects.  In some
studies, the patient may get a placebo instead of the real drug -
though the real drug may be offered to the placebo patients when
the study is done, if it turned out to be beneficial.

Still, participating in a trial offers a small chance at early access
to something that might turn out to be a breakthrough.  It also
enables the patient to contribute to research on the disease.  Even
patients who do not benefit themselves may be able to benefit
others by participating in trials.

Finally, participation in a clinical trial often provides good access
to the very best specialists who can provide the best available
advice and information to patients.

Good luck.

   Alan