Alzheimer’s Disease is a progressive neurological disorder that causes brain cells to die and the brain itself to atrophy. The disease brings memory loss and loss of functionality. Watching a loved one suffer from Alzheimer’s Disease and adjusting to the roll-reversal—children taking care of parents or one spouse taking care of another—can be emotionally difficult as years of a certain relationship dynamic are shifted. For those who take on responsibility for a patient’s care, the burden can also be physical and can become a full-time commitment.
Those managing the care of loved ones with Alzheimer’s Disease should know that they are not alone in the battle. Roughly 70% of patients with Alzheimer’s are cared for at home, and 15 million Americans provide care for loved ones with the disease. During this difficult time, here are some brief things to consider during each stage of the disease.
Early Stage Alzheimer’s Disease
In the early stages of Alzheimer’s, most patients can typically continue to live independently. While the mind still has the aptitude for management of personal, financial, and
medical affairs, legal considerations should be addressed so that Alzheimer’s patients make sure their preferences are accounted for. An incapacity plan allows patients to authorize someone they trust to make important decisions about finances and health care on their behalf. Such a plan should include durable power of attorney and an advance health care directive, which includes durable power of attorney for health care and a living will.
Middle Stage Alzheimer’s Disease
As the disease progresses, confusion sets in and basic daily functions like eating, dressing, and bathing often require assistance. Alzheimer’s middle stage is the longest and often the most challenging. It is during this stage that many patients live with family and everyone must adapt to a new reality. Having a routine is key to mitigating anxiety, agitation, and boredom for both patients and their loved ones.
Understanding the Circumstances
As the disease takes its course, Alzheimer’s patients may act irrationally, unkindly, or frustratingly. Sometimes they repeat stories or questions, even incessantly. Sometimes they say false things or are unkind. Though it is heartbreaking, in such times, loved ones must remember that these are not conscious or rational choices. Though a challenge, try to be patient and refrain from taking things personally.
Basic necessities such as eating and staying hydrated can prove difficult during the middle stage of Alzheimer’s. The disease can alter senses of taste and smell due to perception changes caused by Alzheimer’s combined with the reduced natural taste ability associated with aging. If patients do not like the taste of food or if it is too hot or cold, instead of communicating that (which can be difficult), they may simply refuse to eat.
Alzhiemer’s disease may also distort patients’ vision, making food similar in color to the plate it is served on difficult to recognize. Too much on a table or plate can be distracting, so caregivers should use plates that are different colors from the food being served and not make the setting too busy. Keep things simple; keep the television off and remove cluttering and confusing centerpieces.
As intaking enough water can prove to be a challenge, caregivers can offer foods with high water content, things like soups and smoothies, cucumbers, oranges, watermelon, and other fruits. Loved ones should steer away from offering caffeinated drinks or beverages high in sugar. As the disease progresses, patients will be less capable of keeping track of their own medications. Caregivers should keep an updated list and administer them on schedule.
Often, basic steps to maintain hygiene are difficult for patients with Alzheimer’s Disease. Generally, cognitive or perception problems are to blame for this. Bathing can be disorienting, and the muscle memory of such efforts as brushing teeth fades with other memories. Those with Alzheimer’s simply don’t remember why maintaining hygiene is important. Loved ones should look for engaging ways to help keep the habits up, such as brushing their own teeth at the same time.
Spending time with people can cause more anxiety as the disease progresses. Loved ones should pick their battles so as not to overstimulate patients. Prioritize outings that need to be completed (including medical appointments), and schedule appointments during the days and times when the patient is generally more lucid or alert. Allow plenty of time to get ready: rushing will only add anxiety. At medical appointments, loved ones should remain attentive and take notes if needed.
Late Stage Alzheimer’s Disease
The last stage of Alzheimer’s Disease usually leaves patients unable to speak or to walk on their own. When Alzheimer’s has progressed this far, patients need 24-hour care. This can be difficult, especially if loved ones have cared for their patient for years. However, when deciding if your loved ones need to go into residential care, the health and safety of both patients and their loved ones should be considered. Consult your doctor.