Brain Awareness Month: Coping with Alzheimer's Disease

Alzheimer's Disease, a progressive brain disorder, is a condition facing millions of older adults and the caregivers who tend to them. It often begins to appear in a person's sixties and is the most common cause of dementia in older adults. Patients with Alzheimer's gradually lose their cognitive functioning, which includes memory, thinking skills, reasoning ability, and in later stages the ability to complete even simple tasks.

The Stages of Alzheimer's Disease

Mild Alzheimer's Disease - Early Stage:

In the early stages of Alzheimer's Disease, a person may still be able to function independently - they may still be able to drive, work, and be a part of social events and activities. However; the person may feel as though they are having memory lapses, such as: forgetting familiar words, the locations of familiar places, or the location of every day objects. 

During this stage, friends or family members close to the person may begin to notice the person having difficulties and urge them to see a doctor. The doctor will preform a detailed exam to detect if there are any problems in memory or concentration. Symptoms of mild Alzheimer's include:

1. Short term memory loss.
2. Problems finding words, or remembering names.
3. Trouble remembering new information, such as remembering the names of people who you were just introduced to.
4. Challenges performing tasks in social or work settings.
5. Trouble remembering material that was just read. 
6. Losing and/or misplacing a valuable, every day object.
7. Increased difficulty with planning or organizing.

Although the onset of Alzheimer's Disease cannot yet be stopped or reversed, an early diagnosis allows the person to have an opportunity to live well with the disease for as long as possible, and to plan for the future.

Moderate Alzheimer's Disease - Middle Stage:

This stage is typically the longest stage and cast last for many years. As the disease progresses, the person with Alzheimer's may require a greater level of care. During the moderate stage, individuals may have greater difficulty performing ever day, normal tasks, such as: paying bills, cooking, or driving, but they still may remember important details about their life. Symptoms in this stage will be noticeable, and include:

1. Forgetfulness of events or one's own personal history.
2. Feeling withdrawn or moody, especially in socially or mentally challenging situations. 
3. Inability to recall every day information, such as: address, telephone number, high school or college that they graduated from. 
4. Confusion about where they are.
5. Inability to recall what day it is.
6. Inability to dress properly for an occasion, event, or season.
7. Incontinence in some individuals.
8. Changes in sleeping habits or patterns, such as sleeping throughout the day, and feeling restless at night. 
9. An increased risk of wandering and becoming lost.
10. Changes in behavior and personality, including: suspiciousness, delusions, compulsive and repetitive behavior, such as hand-wringing or tissue shredding.

Severe Alzheimer's Disease - Late Stage:

The final stage of this disease can be some of the hardest symptoms for families of their loved one to witness. In this last stage, individuals may need around the clock care and assistance, as they lose the ability to respond to their environment, carry on a conversation, and control movement. As memory and cognitive skills continue to worsen, individuals experience significant personality changes. Symptoms in this stage include:

1. Losing awareness of recent experiences.
2. Losing awareness of their surroundings.
3. Changes in physical abilities, such as the ability to walk, sit, and swallow. 
4. Changes in mood, such as consistent paranoia, anger, aggression, confusion, and depression.
5. Increased difficulty communicating, especially regarding pain. Individuals may still say words or phrases.
6. Becoming susceptible to infections, specifically pneumonia.  

Late-stage care decisions can be emotionally, financially, and physically demanding for the individual and the caregiver. If you or a loved one are experiencing any of the stages of Alzheimer's, there is help. Your local Alzheimer's Association chapter will connect you with all of the resources that you need to cope with the challenges and symptoms of this disease.

Daily Caretaking Tips

Coping with Alzheimer's-related changes in personality and behavior is difficult, but can be made manageable through a well-structured daily routine and patience.

Daily Routine: A familiar daily routine is comforting to an Alzheimer's patient. You should give a visible reminder of a change in the routine, like an upcoming appointment.

Simplicity: Clear, one-step communication is key. Say or ask one thing at a time in conversation. Provide simple choices, between two distinct options. Make suggestions in situations where they have multiple choices.

Prevent Overstimulation: Minimize background noise like TVs during conversation or mealtime. Go to less crowded public places or during less busy hours. Have smaller family groups visit at different times to avoid visits being overwhelming.

Create Involvement: Find ways for your loved one to still practice favorite activities safely and with support. Strong visual cues to remind them how to complete a task independently can allow them to do as much as possible with little assistance. Ask for help on specific household tasks and find ways they can assist you without trouble.

Manage "Sundowning": Nighttime is often more difficult for Alzheimer's patients, a phenomenon called "sundowning." Limit naps so they do not confuse night and day. Turn on more lights at night for comfort. Provide reassurance during the night and show them how you are checking entrances to safeguard your home.

Safeguard Your Environment: Clear hallways and floors, especially for patients who pace. Prevent wandering with alarms and signs or tape to block off certain rooms or exits.

Reassurance and Patience: Reassure your loved one that they're safe, and that you're here to help them. Don't try to argue or reason with them. Make discrete adjustments for them if they have disruptive habits.