What is a TIA and what causes it?

Ask the Doctor
Leslee B. Cochrane, MD.
Medical Director

Ramona Visiting Nurse Association and Hospice

Question: “My father recently developed the sudden onset of weakness and numbness in his right arm and we rushed him to the hospital. At first, we thought it might be a stroke; but after a couple of hours, the symptoms totally resolved and we were told that this was likely a TIA. What exactly is a TIA and what causes them?”

The term TIA stands for “transient ischemic attack” and refers to a condition in which the blood flow to the brain is temporarily blocked. TIA’s are sometimes referred to as “mini-strokes” because they produce the same symptoms as a stroke; but then resolve within 1-2 hours. Unlike a stroke where the blockage is permanent, a TIA is caused by a temporary blockage and there is no permanent residual damage.

Common symptoms of a TIA may include the following:

• Weakness, numbness or tingling (usually affecting one side of the body)
• Confusion, loss of coordination or balance
• Difficulty speaking or swallowing
• Sudden loss or blurring of vision
  

The most common cause of a TIA is a blood clot and there are several risk factors for TIA’s including high blood pressure, smoking, diabetes, obesity and elevated cholesterol. Ten percent of patients who have a TIA will have a stroke within three months and 50% of those patients will have their stroke within 48 hours of the TIA. Because it is impossible to distinguish a TIA from a stroke at the onset, you should call 911 and seek emergency evaluation at the first sign of symptoms. The goal of treatment is risk factor reduction to reduce the chances of having a stroke.

In summary: do not ignore your TIA (transient ischemic attack), unless you want your brain to go MIA (missing in action).

If you are interested in receiving more information regarding any general health-related issues, please call our HELP line at 1-888-983-5337 begin_of_the_skype_highlighting 1-888-983-5337 end_of_the_skype_highlighting or visit us on the web at www.help4elders.info. If you would like to submit a question for the newsletter, please contact Jennifer Trebler at jtrebler@ramonavna.org.

What exactly is the difference between dementia and Alzheimer’s disease?

Ask the Doctor
Leslee B. Cochrane, MD.
Medical Director

Ramona Visiting Nurse Association and Hospice

Question: “My father was recently diagnosed with dementia and we saw a specialist who told us he has Alzheimer’s disease. What exactly is the difference between dementia and Alzheimer’s disease?”

Answer: Alzheimer’s disease is the most common type of dementia and accounts for 60-80% of all cases of dementia. Other common types of dementia include vascular dementia, Lewy-Body dementia, Parkinson’s disease and Pick’s disease. The term “dementia” refers to a loss in mental function lasting greater than 6 months that is significant enough to interfere with daily life. In other words, all patients with Alzheimer’s disease have dementia; but not all patients with dementia have Alzheimer’s disease.

Because there are many conditions that cause dementia-like symptoms, it is important to have a comprehensive evaluation by a physician to determine the cause of the symptoms. Several treatable conditions such as thyroid disorders, depression, drug interactions and vitamin deficiencies may cause dementia-like symptoms that respond favorably to treatment. A comprehensive evaluation includes a review of the medical history, mental status testing, physical examination, neurological evaluation and diagnostic testing. Other specialists such as neurologists or psychiatrists may also be consulted to confirm the diagnosis.

There is no cure for Alzheimer’s disease so early detection is important because the treatments currently available for Alzheimer’s are more effective when used earlier in the course of the disease. For more information including “The 10 Warning Signs of Alzheimer’s”, please see the Alzheimer’s Association website at www.alz.org. Do not worry; losing your car keys is not one of the warning signs, unless you discover that you put them in the toaster to turn it on.

Ramona VNA and Hospice in conjunction with Hemet Hospice Volunteers is currently hosting an Alzheimer’s Caregiver Informational series to help support families coping with this devastating illness. The next session will be held from 10am – noon on Thursday, May 5th at the Seventh Day Adventist Church on the corner of Girard and Stetson Avenues in Hemet. For more details, please contact Parisha Burd at 951-652-8309 - extension 3609. If you need assistance with any general health-related issues, please call our HELP line at 1-888-983-5337; or visit us on the web at www.help4elders.info.

Financial Power of Attorney - Immediate or "Springing Power"?

Elder Law Office of George F. Dickerman Attorney and Counselor at Law
3879 Brockton Avenue
Riverside, CA 92501
(951) 788-2156
http://www.elder-law-advocate.com

ELDER LAW NEWSLETTER

Financial Power of Attorney - Immediate or "Springing Power"?

I've written on this topic before, but I still receive questions about whether an "immediate" financial power of attorney is recommended vs. a "springing power".

Generally speaking, you should advise your clients against the granting of an immediate power of attorney.

The difference is simple: An immediate power grants your agent just that - the authority to immediately access your financial accounts and to do whatever you could do with your finances and property.

A "springing power" does not grant your agent any financial authority until, and unless, you become incapacitated and are no longer able to make sound financial decisions. The determination of "incapacity" generally requires that two qualified medical doctors sign a declaration, under penalty of perjury, that you suffer from some mental deficit that prevents you from making sound financial decisions.

Once these two declarations are obtained, your agent can then take them (along with the power of attorney) to any of your financial institutions and, with full legal authority, transact business for you.

If your client is mentally capable of making sound financial decisions, then there is no reason to allow someone else the authority to do so. There may be some exceptions to this; for example, a client may be going on an out of country vacation and needs to conclude a real estate sale that is time sensitive. Under this scenario, it may make sense to execute a limited - special power of attorney that grants the agent the immediate authority to sign all necessary real estate documents to conclude the sale. However, this special power of attorney would be drafted very narrowly in scope, to include only the specific authority needed to close the sale.

Financial powers of attorney are an important estate planning document that every adult should have. However, a red-flag warning should arise if you learn that one of your elderly client's children insists that their parent sign a power of attorney that grants that child/agent an immediate power to transact financial business. Placed into the wrong hands, a financial power of attorney can become a license to steal ( http://clicks.aweber.com/y/ct/?l=5gtZx&m=1h7DA.aGbz04AX&b=f9yf9XvwcGSuZq6WxTfJQA).

Unless some extenuating circumstances warrant the granting of an immediate authority, the safe approach is to grant only a "springing power" to an agent.