Alzheimer's Navigation

When your sessions fall

The program is built in four-week modules. Sessions come thickest at the start, when what you decide matters most, and step down as things settle. That is 5 sessions of 45 minutes across 8 weeks, counting the visit before week 1.

Week by week

1. Before you begin
   Before you begin

   This is the reading before your first visit. Alzheimer's disease is unusual among the conditions we build pathways for, because it produces two people who need support at once: the person living with the diagnosis, and the family member or partner carrying the load.

2. Week 1
   What the diagnosis does and does not mean

   A diagnosis of Alzheimer's disease tells you what is happening and roughly what direction it moves in. It does not tell you the speed, and it does not tell you what any given month will look like.

3. Week 2
   Movement, for both of you

   This week you meet Alexandra Chamorro, MBA, FMCHC, NBC-HWC, the Brain Health Coach, for 45 minutes. The session covers both of you, because physical activity is the lifestyle intervention with the best evidence for the person with the diagnosis and it is also the thing caregivers give up first.

4. Week 3
   Cognitive stimulation and the shape of a day

   There is a version of "keep the mind active" that is evidence-based and a version that is an app subscription. This week is about telling them apart, and about the more useful finding underneath: what helps is structured, social, enjoyable mental activity done with other people, on a schedule.

5. Week 4
   Mid-program, and the new drugs

   Week 4 is your second 45-minute visit with Cindy, using the same measures as week 0. It is also where we deal with the anti-amyloid antibodies, because they are the loudest thing in this field and the reporting on them swings between a cure and a scandal. Neither is accurate.

6. Week 5
   The caregiver's sleep

   This week's reading is addressed to the caregiver. Night-time is where dementia care becomes relentless: waking, wandering, calling out, needing the bathroom, being awake at 3am and convinced it is morning. Caregiver sleep goes first, and everything else gets harder in its absence.

7. Week 6
   Caregiver burden, named and measured

   This week you meet Lucy Paulise, the Stress Coach, for 45 minutes. The session is for the caregiver.

8. Week 7
   Behavior, distress and safety

   Agitation, repeated questioning, resistance to washing, calling out, accusations, night-time restlessness. These are the parts of dementia that families find hardest and that most often lead to a placement decision. They are also where the fastest available answer is frequently the worst one.

9. Week 8
   Making it hold

   Week 8 is your third 45-minute visit with Cindy and the last of the scheduled program. It is a handover rather than an ending, because this is a long illness and eight weeks is a small part of it. What you leave with is a written plan naming who you contact, for what, and at what point.