mptoms that are often associated with depression may be observed in patients who are cognitively impaired but not depressed. Professionals must be aware of all the symptoms the patient is experiencing, and reports from family members must also be taken into account. The patient usually reports fewer negative feelings or mood problems than are identified by caregivers.
             Patients often attempt to cover up their disease by modifying the behaviors of others, rather than identifying their own inevitable retrogression. Fears of the unknown, fears of abandonment, lowered frustration tolerance, and loss of impulse control may result in problematic behavior. Also, appropriate behavior may simply be forgotten, and faces of family members and friends unfamiliar. However, the victim of Alzheimer's often denies these symptoms. More obvious, even to themselves are the expression of emotions such as panic and deprivation. Experiences such as early retirement and anticipated changes in the responsibilities of daily life are never realized. The inability to drive a car is especially painful and frustrating for some. Self-esteem and sense of worth plummet. Individuals with Alzheimer's lose their capability to plan, postpone, wait, or predict the outcomes of their actions. Family members very often fail to attribute losses similar to those previously mentioned to a disease. They tend to deny the existence of the disease.
             Family members may go through a period of denial in which they make excuses for the patient, attributing the problems they encounter to normal aging, stress, etc. Alzheimer's disease creates new demands on the family, who have to adopt numerous roles. The parent, once the primary caregiver to their children, is now like a child receiving care. Each family member defines the situation differently, but display common management behaviors that will be discussed further. Within these similar stages of management, reflect...