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About Alzheimer’s
Alzheimer’s disease is
a complex disease that affects the brain. Although many things
about Alzheimer’s remain a mystery, research continues to bring us a
better understanding of the disease, more accurate diagnoses, and more
effective treatments.
source:
http://www.alz.org/
What Is Alzheimer’s
Alzheimer’s
disease (pronounced AHLZ-hi-merz) is one of several disorders that cause
the gradual loss of brain cells. The disease was first described in 1906
by German physician Dr. Alois Alzheimer. Although the disease was once
considered rare, research has shown that it is the leading cause of
dementia.
Dementia
Dementia is an umbrella term for
several symptoms related to a decline in thinking skills. Common
symptoms include a gradual loss of memory, problems with reasoning or
judgment, disorientation, difficulty in learning, loss of language
skills, and decline in the ability to perform routine tasks.
People with
dementia also experience changes in their personalities and behavioral
problems, such as agitation, anxiety, delusions (believing in a reality
that does not exist), and hallucinations (seeing things that do not
exist).
Disorders
that cause dementia
Several disorders that are similar
to Alzheimer’s disease can cause dementia. These include fronto-temporal
dementia, dementia with Lewy bodies, Parkinson’s disease,
Creutzfeldt-Jakob disease, and Huntington’s disease. All of these
disorders involve disease processes that destroy brain cells.
Vascular
dementia is a disorder caused by the disruption of blood flow to the
brain. This may be the result of a massive stroke or several tiny
strokes.
Some
treatable conditions such as depression, drug interactions, and
thyroid problems can cause dementia. If treated early enough, this
dementia may be effectively treated and even
reversed.
Causes and Risk Factors
No one knows yet
exactly what causes Alzheimer’s disease. Researchers are learning about
what happens to the brain as we grow older, what happens to brain cells
in Alzheimer’s disease, genes associated with Alzheimer’s, and many
other factors that may be important. Most researchers agree that the
cause may be a complex set of factors
Ten Warning
Signs
Some change in
memory is normal as we grow older, but the symptoms of Alzheimer’s
disease are more than simple lapses in memory. People with Alzheimer’s
experience difficulties communicating, learning, thinking, and reasoning
— problems severe enough to have an impact on an individual's work,
social activities, and family life.
The Alzheimer’s
Association believes that it is critical for people with dementia and
their families to receive information, care, and support as early as
possible. To help family members and health care professionals recognize
warning signs of Alzheimer’s disease, the Association has developed a
checklist of common symptoms.
1. Memory
loss. One of the most common early signs of dementia is forgetting
recently learned information. While it’s normal to forget appointments,
names, or telephone numbers, those with dementia will forget such things
more often and not remember them later.
2. Difficulty
performing familiar tasks. People with dementia often find it hard
to complete everyday tasks that are so familiar we usually do not think
about how to do them. A person with Alzheimer’s may not know the steps
for preparing a meal, using a household appliance, or participating in a
lifelong hobby.
3. Problems
with language. Everyone has trouble finding the right word
sometimes, but a person with Alzheimer’s disease often forgets simple
words or substitutes unusual words, making his or her speech or writing
hard to understand. If a person with Alzheimer’s is unable to find his
or her toothbrush, for example, the individual may ask for “that thing
for my mouth.”
4.
Disorientation to time and place. It’s normal to forget the day of
the week or where you’re going. But people with Alzheimer’s disease can
become lost on their own street, forget where they are and how they got
there, and not know how to get back home.
5. Poor or
decreased judgment. No one has perfect judgment all of the time.
Those with Alzheimer’s may dress without regard to the weather, wearing
several shirts or blouses on a warm day or very little clothing in cold
weather. Individuals with dementia often show poor judgment about money,
giving away large amounts of money to telemarketers or paying for home
repairs or products they don’t need.
6. Problems
with abstract thinking. Balancing a checkbook may be hard when the
task is more complicated than usual. Someone with Alzheimer’s disease
could forget completely what the numbers are and what needs to be done
with them.
7. Misplacing
things. Anyone can temporarily misplace a wallet or key. A person
with Alzheimer’s disease may put things in unusual places: an iron in
the freezer or a wristwatch in the sugar bowl.
8. Changes in
mood or behavior. Everyone can become sad or moody from time to
time. Someone with Alzheimer’s disease can show rapid mood swings—from
calm to tears to anger—for no apparent reason.
9. Changes in
personality. People’s personalities ordinarily change somewhat with
age. But a person with Alzheimer’s disease can change a lot, becoming
extremely confused, suspicious, fearful, or dependent on a family
member.
10. Loss of
initiative. It’s normal to tire of housework, business activities,
or social obligations at times. The person with Alzheimer’s disease may
become very passive, sitting in front of the television for hours,
sleeping more than usual, or not wanting to do usual
activities.
If you
recognize any warning signs in yourself or a loved one, the Alzheimer’s
Association recommends consulting a physician. Early diagnosis of
Alzheimer’s disease or other disorders causing dementia is an important
step in getting appropriate treatment, care, and support services.
Getting a
Diagnosis
A physician should be
consulted about concerns with memory, thinking skills, and changes in
behavior. For people with dementia and their families, an early
diagnosis has many advantages:
+time to make choices
that maximize quality of life
+lessened anxieties about unknown
problems
+a better chance of benefiting from treatment
+more
time to plan for the future
It is also important
for a physician to determine the cause of memory loss or other symptoms.
Some dementia or dementia-like symptoms can be reversed if they are
caused by treatable conditions, such as depression, drug interaction,
thyroid problems, and certain vitamin
deficiencies.
Treatment Options
There is no cure for
Alzheimer’s disease. However, there are several drug treatments that may
improve or stabilize symptoms and several care strategies and activities
that may minimize or prevent behavioral problems. Researchers continue
to look for new treatments to alter the course of the disease and other
strategies to improve the quality of life for people with
dementia.
Standard
Prescriptions for Alzheimer’s
The primary symptoms of Alzheimer’s
disease include memory loss, disorientation, confusion, and problems
with reasoning and thinking. These symptoms worsen as brain cells die
and the connections between cells are lost. Although current drugs
cannot alter the progressive loss of cells, they may help minimize or
stabilize symptoms. These medications may also delay the need for
nursing home care. Cholinesterase Inhibitors
The U.S. Food and Drug
Administration (FDA) has approved two classes of drugs to treat
cognitive symptoms of Alzheimer’s disease. The first Alzheimer
medications to be approved were cholinesterase (KOH luh NES ter ays)
inhibitors. Three of these drugs are commonly prescribed—donepezil
(Aricept®), approved in 1996; rivastigmine (Exelon®), approved in 2000;
and galantamine (Reminyl®), approved in 2001. Tacrine (Cognex®), the
first cholinesterase inhibitor, was approved in 1993 but is rarely
prescribed today because of associated side effects, including possible
liver damage.
All of these
drugs are designed to prevent the breakdown of acetylcholine (pronounced
a SEA til KOH lean), a chemical messenger in the brain that is
important for memory and other thinking skills. The drugs work to keep
levels of the chemical messenger high, even while the cells that produce
the messenger continue to become damaged or die. About half of the
people who take cholinesterase inhibitors experience a modest
improvement in cognitive symptoms.
Treating Behavioral Symptoms
A number of
behavioral problems may be associated with Alzheimer’s disease. The word
agitation is often used as an umbrella term to describe these behaviors.
As Alzheimer’s progresses, most people with the disease experience
agitation in addition to memory loss and other thinking
problems.
Overview on
agitation
In the early
stages of the disease, people with Alzheimer’s may experience
personality changes such as irritability, anxiety, or depression. As the
disease progresses, other symptoms may occur, including sleep
disturbances, delusions (firmly held belief in things that are not
real), hallucinations (seeing, hearing, or feeling things that are not
there), pacing, constant movement or restlessness, checking and
rechecking door locks or appliances, tearing tissues, general emotional
distress, and uncharacteristic cursing or threatening
language.
Agitation may be
caused by a number of different medical conditions and drug interactions
or by any circumstances that worsen the person’s ability to think.
Situations that may lead to agitated behavior include moving to a new
residence or nursing home, other changes in the environment or caregiver
arrangements, misperceived threats, or fear and fatigue resulting from
trying to make sense out of a confusing world.
Agitated
behavior can be disruptive and painful to both the person with the
disease and the caregiver. Agitation may interfere with the ability of
the person with the disease to carry out the activities of daily living,
and it may increase the risk of harm to the affected individual and
others. Caregivers may be frightened, upset, or simply exhausted by the
demands of caring for a person who is agitated.
Medical evaluation for agitation
A person
exhibiting agitated behavior should receive a thorough medical
evaluation, especially when agitation comes on suddenly. The treatment
of agitation depends on a careful diagnosis, determination of the
possible causes, and the types of agitated behavior the person is
experiencing. With proper treatment and intervention, significant
reduction or stabilization of the symptoms can often be
achieved.
The symptoms of
agitation often reflect an underlying infection or medical illness. For
example, the pain or discomfort caused by pneumonia or a urinary tract
infection can result in agitation. An untreated ear or sinus infection
can cause dizziness and pain that affects behaviors. In some cases,
prescription medication can cause agitation. This is most likely to
occur when multiple medications are used, and the medications interact.
Uncorrected visual or hearing loss may also lead to agitated behaviors.
Treating the underlying medical condition may lessen the
agitation.
Behavioral interventions for agitation
There are two
distinct types of treatments for agitation: behavioral interventions and
prescription medications. Behavioral interventions should be tried
first. In general, steps to managing agitation include (1) identifying
the behavior, (2) understanding its cause, and (3) adapting the
caregiving environment to remedy the situation.
Correctly
identifying what has triggered agitated behavior can often help in
selecting the best behavioral intervention. Often the trigger is some
sort of change in the person’s environment:
change in
caregiver
change in living
arrangements
travel
hospitalization
presence of
houseguests
bathing
being asked to change clothing
A key principle
of intervention is redirecting the affected individual’s attention,
rather than arguing, disagreeing, or being confrontational with the
person. Additional intervention strategies include the
following:
simplifying the
environment
simplifying tasks and routines
allowing adequate rest
between stimulating events
using labels to cue or remind the
person
equipping doors and gates with safety locks
removing
guns
using lighting to reduce confusion and restlessness at
night
Medications to
treat agitation
Medications can
be effective in the management of some symptoms of agitation, but they
must be used carefully and are most effective when combined with
behavioral or environmental changes. Medications should target specific
symptoms so that improvement can be monitored. People with Alzheimer’s
disease are susceptible to side effects that require close observation.
In general, it is best to begin treatment with a single medication and
with low doses.
Alternative Treatments
Several herbal
remedies and other dietary supplements are promoted as effective
treatments for Alzheimer’s disease and related disorders. Claims about
the safety and effectiveness of these products, however, are based
largely on testimonials, tradition, and a rather small body of
scientific research. The rigorous scientific research required by the
U.S. Food and Drug Administration for the approval of a prescription
drug is not required by law for the marketing of dietary
supplements.
Concern about
alternative therapies
Although
many of these remedies may be valid candidates for treatments, there are
legitimate concerns about using these drugs as an alternative or in
addition to physician-prescribed therapy:
Effectiveness
and safety are unknown. The maker of a dietary supplement is not
required to provide the U.S. Food and Drug Administration (FDA) with the
evidence on which it bases its claims for safety and
effectiveness.
Purity is
unknown. The FDA has no authority over supplement production. It is
a manufacturer’s responsibility to develop and enforce its own
guidelines for ensuring that its products are safe and contain the
ingredients listed on the label in the specified amounts.
Bad reactions
are not routinely monitored. Manufacturers are not required to
report to the FDA any problems that consumers experience after taking
their products. The agency does provide voluntary reporting channels for
manufacturers, health care professionals, and consumers, and will issue
warnings about products when there is cause for concern. Dietary supplements can
have serious interactions with prescribed medications. No supplement
should be taken without first consulting a physician.
Research and Clinical Trials
Alzheimer
research is advancing at an accelerating pace and is being tackled from
many sides. Pharmaceutical companies, the U.S. federal government, and
the Alzheimer’s Association are funding research to learn more about the
disease process and to find compounds that will alleviate symptoms and
prevent the disease. Individuals may elect to participate in research
efforts by enrolling in clinical drug studies. If you are interested in
enrolling in a clinical drug study, you should discuss the matter with
your physician and understand what to consider and
expect.
Talking
with Your Physician
The medications
currently approved by the U.S. Food and Drug Administration for treating
mild to moderate Alzheimer's disease belong to a single class of drugs.
This means that although the key ingredient is different in each of the
drugs, they are all designed to perform the same function in the body.
Therefore, it is not always easy to answer the question, "Which
Alzheimer medication is the best?"
Variation in outcomes and side effects
Responses to
most medications vary for reasons that we do not fully understand. This
circumstance is common in all drug treatments. For example, many common
over-the-counter pain medications belong to the same class of drugs.
Ibuprofen may work better for one individual, while naproxen may be
better for another, and neither of these drugs may be as effective for a
third individual.
These same
variations also happen with Alzheimer medications. If a drug has little
or no effect on a patient's symptoms, a physician may recommend trying
one of the others.
Side effects can
also vary from one patient to the next. For one individual, one drug may
be more effective but have greater side effects. For another patient,
the same drug may be less effective but have no side
effects.
Questions for your physician
Clear
communication between the physician and the patient or caregiver is
essential. Ask your physician the following questions when you discuss
any treatment options.
What
kind of assessment will you use to determine if the drug is
effective?
How much time will pass before you will be able to
assess the drug's effectiveness?
How will you monitor for possible
side effects?
What effects should we watch for at home?
When
should we call you?
Is one treatment option more likely than
another to interfere with medications for other conditions?
What
are the concerns with stopping one drug treatment and beginning
another?
At what stage of the disease would you consider it
appropriate to stop using the drug?
These questions
will not address all treatment needs, but the answers to these questions
will help you understand the options and make informed
decisions.
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Stages of
Alzheimer's
Experts
have documented common patterns of symptom progression that occur
in many individuals with Alzheimer’s disease and developed several
methods of “staging” based on these patterns. Progression of
symptoms corresponds in a general way to the underlying nerve cell
degeneration that takes place in Alzheimer’s disease. Nerve cell
damage typically begins with cells involved in learning and memory
and gradually spreads to cells that control every aspect of
thinking, judgment, and behavior. The damage eventually affects
cells that control and coordinate movement.
Staging
systems provide useful frames of reference for understanding how
the disease may unfold and for making future plans. But it is
important to note that all stages are artificial benchmarks in a
continuous process that can vary greatly from one person to
another. Not everyone will experience every symptom and symptoms
may occur at different times in different individuals. People with
Alzheimer’s live an average of 8 years after diagnosis, but may
survive anywhere from 3 to 20 years.
The
framework of this section is the Global Deterioration Scale, a
system that outlines key symptoms characterizing seven stages
ranging from unimpaired function to very severe cognitive
decline.
Within
this framework, we have noted which Global Deterioration Scale
stages correspond to the widely used concepts of mild, moderate,
moderately severe, and severe Alzheimer’s disease. We have also
noted which stages fall within the more general divisions of
early-stage, mid-stage, and late-stage
categories.
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|
Stage
1: |
No
cognitive impairment |
|
|
Unimpaired
individuals experience no memory problems and none are evident to a
health care professional during a medical
interview. |
|
Stage
2: |
Very mild
cognitive decline |
|
|
Individuals
at this stage feel as if they have memory lapses, especially in
forgetting familiar words or names or the location of keys,
eyeglasses, or other everyday objects. But these problems are not
evident during a medical examination or apparent to friends, family,
or co-workers. |
|
Stage
3: |
Mild cognitive decline
Early-stage Alzheimer's
can be diagnosed in some, but not all, individuals with these
symptoms |
|
|
Friends,
family, or co-workers begin to notice deficiencies. Problems with
memory or concentration may be measurable in clinical testing or
discernible during a detailed medical interview. Common difficulties
include:
Word- or
name-finding problems noticeable to family or close
associates
Decreased ability to remember names when introduced
to new people
Performance issues in social or work settings
noticeable to family, friends, or co-workers
Reading a passage
and retaining little material
Losing or misplacing a valuable
object
Decline in ability to plan or
organize |
|
Stage
4: |
Moderate
cognitive decline
(Mild or early-stage Alzheimer's
disease) |
|
|
At this
stage, a careful medical interview detects clear-cut deficiencies in
the following areas:
Decreased
knowledge of recent occasions or current events
Impaired
ability to perform challenging mental arithmetic-for example, to
count backward from 100 by 7s
Decreased capacity to perform
complex tasks, such as marketing, planning dinner for guests, or
paying bills and managing finances
Reduced memory of personal
history
The affected individual may seem subdued and withdrawn,
especially in socially or mentally challenging
situations |
|
Stage
5: |
Moderately severe cognitive decline
(Moderate or mid-stage
Alzheimer's disease) |
|
|
Major gaps
in memory and deficits in cognitive function emerge. Some assistance
with day-to-day activities becomes essential. At this stage,
individuals may:
Be unable
during a medical interview to recall such important details as
their current address, their telephone number, or the name of the
college or high school from which they graduated
Become
confused about where they are or about the date, day of the week,
or season
Have trouble with less challenging mental arithmetic;
for example, counting backward from 40 by 4s or from 20 by
2s
Need help choosing proper clothing for the season or the
occasion
Usually retain substantial knowledge about themselves
and know their own name and the names of their spouse or
children
Usually require no assistance with eating or using the
toilet |
|
Stage
6: |
Severe
cognitive decline
(Moderately severe or mid-stage Alzheimer's
disease) |
|
|
Memory
difficulties continue to worsen, significant personality changes may
emerge, and affected individuals need extensive help with customary
daily activities. At this stage, individuals may:
Lose most
awareness of recent experiences and events as well as of their
surroundings
Recollect their personal history imperfectly,
although they generally recall their own name
Occasionally
forget the name of their spouse or primary caregiver but generally
can distinguish familiar from unfamiliar faces
Need help
getting dressed properly; without supervision, may make such
errors as putting pajamas over daytime clothes or shoes on wrong
feet
Experience disruption of their normal sleep/waking
cycle
Need help with handling details of toileting (flushing
toilet, wiping, and disposing of tissue properly)
Have
increasing episodes of urinary or fecal incontinence
Experience
significant personality changes and behavioral symptoms, including
suspiciousness and delusions (for example, believing that their
caregiver is an impostor); hallucinations (seeing or hearing
things that are not really there; or compulsive, repetitive
behaviors such as hand-wringing or tissue shredding
Tend to
wander and become lost |
|
Stage
7: |
Very
severe cognitive decline
(Severe or late-stage Alzheimer's
disease) |
|
|
This is the
final stage of the disease when individuals lose the ability to
respond to their environment, the ability to speak, and, ultimately,
the ability to control movement.
Frequently
individuals lose their capacity for recognizable speech, although
words or phrases may occasionally be uttered
Individuals need
help with eating and toileting and there is general incontinence
of urine
Individuals lose the ability to walk without
assistance, then the ability to sit without support, the ability
to smile, and the ability to hold their head up. Reflexes become
abnormal and muscles grow rigid. Swallowing is
impaired. |
Dispelling
Myths
1. Myth: Memory
loss is a natural part of aging.
Reality: In the past people believed memory loss was a normal part
of aging, often regarding even Alzheimer’s as natural age-related
decline. Experts now recognize severe memory loss as a symptom of
serious illness.
Whether memory
naturally declines to some extent remains an open question. Many people
feel that their memory becomes less sharp as they grow older, but
determining whether there is any scientific basis for this belief is a
research challenge still being addressed.
2. Myth:
Alzheimer’s disease is not fatal.
Reality: Alzheimer's is a fatal disease. It begins with the
destruction of cells in regions of the brain that are important for
memory. However, the eventual loss of cells in other regions of the
brain leads to the failure of other essential systems in the body. Also,
because many people with Alzheimer’s have other illnesses common in
older age, the actual cause of death may be no single
factor
3. Myth: Head
injury can lead to Alzheimer’s disease.
Reality: Several studies have found that Alzheimer’s disease is
more common among individuals who have sustained a severe head injury
(accompanied by loss of consciousness) during the course of their
lives. Additional research is needed, however, to understand
what happens to the brain in such injuries and how those changes in the
brain are related to Alzheimer’s disease.
4. Myth:
Drinking out of aluminum cans or cooking in aluminum pots and pans can
lead to Alzheimer’s disease.
Reality: Based on current research, getting rid of aluminum cans,
pots, and pans will not protect you from Alzheimer’s disease. The exact
role (if any) of aluminum in Alzheimer’s disease is still being
researched and debated. However, most researchers believe that not
enough evidence exists to consider aluminum a risk factor for
Alzheimer’s or a cause of dementia.
5. Myth:
Aspartame causes memory loss.
Reality: Aspartame’s role in memory loss is a health concern that
has been associated with artificial sweeteners. Several studies have
been conducted on aspartame’s effect on cognitive function in both
animals and humans. These studies found no scientific evidence of a link
between aspartame and memory loss.
Aspartame was
approved by the U.S. Food and Drug Administration (FDA) in 1996 for use
in all foods and beverages. The sweetener, marketed as Nutrasweet® and
Equal®, is made by joining two protein components, aspartic acid and
phenylalanine, with 10 percent methanol. Methanol is widely found in
fruits, vegetables, and other plant foods.
6. Myth: There
are therapies available to stop the progression of Alzheimer’s
disease.
Reality: At this time, there is no medical treatment to cure or
stop the progression of Alzheimer’s disease. FDA-approved drugs may
temporarily improve or stabilize memory and thinking skills in some
individuals.
I Have
Alzheimer’s
A diagnosis of
Alzheimer’s disease may be the last thing you wanted to hear. But the
first thing you should know is that you are not alone. There is a lot of
help and support available, and our Web site is a great place for you to
learn about the disease and what you can expect as it
progresses.
In this section,
you will find tips and resources to increase your comfort, allow you to
remain active, and help you cope. But more important, we hope you will
find the inspiration to make your years ahead the best that they can
be.
Taking Care of
Yourself
If you
have Alzheimer’s disease, it’s important to understand that your life is
not over. Living with Alzheimer’s means dealing with some life changes
sooner than you had anticipated. You can live a meaningful and
productive life by taking care of your physical and emotional health, by
engaging in activities you enjoy, and by spending time with family and
friends. This page has suggestions for how you can take care of
yourself.
Caring for your physical health can improve the quality of your
life for years to come.
Get regular
checkups.
Take your medication.
Eat healthy foods.
Exercise
every day.
Rest when you are tired.
Drink less
alcohol.
After receiving
a diagnosis, you may experience a range of emotions,
including:
denial about
having dementia
fear of losing people important to
you
loneliness because no one seems to understand what you are
going through
frustration with not making yourself
understood
loss of the way you used to see yourself
depression
or anger about the way your life is changing
The feelings you
may be experiencing are normal. But it is important to find ways to deal
with those feelings. The following suggestions may help you take care of
your emotional needs:
Write in a
journal about your experiences and feelings.
Join a support
group.
Talk to your physician, who can determine if there is an
appropriate treatment.
See a counselor.
Talk to a clergy member
or other person who can help with your spiritual needs.
Share your
feelings with your friends and family.
Do the activities you enjoy
as long as you are able.
Helping Family and Friends
When you learn
that you have a diagnosis of Alzheimer’s disease, you may hesitate to
tell others. You may be coming to terms with the diagnosis yourself or
fear that others may feel uncomfortable around you. It is true that your
relationship with family and friends will change. But it is important to
talk to the people in your life about Alzheimer’s disease and about the
changes you will all experience together.
Talking about
your diagnosis is important for helping people understand Alzheimer’s
disease and learning about how they can continue to be a part of your
life. The following suggestions may be helpful:
-
Explain that
Alzheimer’s disease is not a normal part of aging but a disease of the
brain that results in impaired memory, thinking, and
behavior.
-
Share
educational information on Alzheimer’s disease or invite family and
friends to attend Alzheimer education programs.
-
Be honest
about how you feel about your diagnosis and allow other family members
to do the same.
-
Assure friends
that although the disease will change your life, you want to continue
enjoying their company.
-
Let family and
friends know when and how you may need their help and
support.
If you have
Alzheimer’s disease, you will find that eventually there will be many
changes in your relationships with family members and friends. Planning
for these changes and talking about them honestly will help
everyone.
Working with your
spouse
Most people with Alzheimer’s
disease continue to live at home even as the disease progresses. As a
result, your spouse may have to manage the household and your care. He
or she may feel a sense of loss because of the changes the disease
brings to your relationship. The following suggestions may benefit your
relationship.
-
Continue to participate in
as many activities as you can.
-
Modify activities to your
changing abilities.
-
Talk with your spouse about
how he or she can assist you.
-
Work together to gather
information about caregiver services and their costs, such as
housekeeping and respite care, and start a file you can consult when
they are needed.
-
Seek professional counseling
to discuss new factors in your relationship and changes in sexual
relations.
-
Continue to find ways in
which you and your spouse can fulfill the need for
intimacy.
-
Encourage your spouse to
attend a support group for caregivers.
Helping children and
teens
Children often experience a
wide range of emotions when a parent or grandparent has Alzheimer’s
disease. Younger children may be fearful that they will get the disease
or that they did something to cause it. Teenagers may become resentful
if they must take on more responsibilities or feel embarrassed that
their parent or grandparent is “different.” College-bound children may
be reluctant to leave home.
-
Reassure young children that
they cannot “catch” the disease from you.
-
Be straightforward about
personality and behavior changes. For example, you may forget things,
such as their names, and say and do things that may embarrass them.
Assure them that this is not their fault or intentional but a result
of the disease.
-
Find out what their
emotional needs are and find ways to support them, such as meeting
with a counselor who specializes in children who have a loved one
diagnosed with Alzheimer’s.
-
School social workers and
teachers can be notified about what the children may be experiencing
and be given information about the disease.
-
Encourage children and teens
to attend support group meetings and include them in counseling
sessions.
-
Record your thoughts,
feelings, and wisdom to "be with them" as they experience important
events in their lives (graduations, dating, marriage, births, and
deaths).
-
To help children and teens
learn more about Alzheimer's disease and understand how it affects you
and them, we have a special Kids & Teens section. It includes
printed resources, book reviews and links to sites that explain how
the brain works.
Coping with Changes in Daily
Life
Alzheimer’s disease will bring
significant changes in your day-to-day experiences. Things you once did
easily will become increasingly difficult. The following suggestions may
help you cope with changes in your daily life and plan for changes that
will occur in the future.
You may find familiar
activities such as balancing your checkbook, preparing a meal, or doing
household chores more difficult. Try the following tips:
-
Do difficult tasks during
the times of the day when you normally feel best.
-
Give yourself time to
accomplish a task, and don’t let others rush you.
-
Take a break if something is
too difficult.
-
Arrange for others to help
you with tasks that are too difficult
You may begin to experience
difficulty understanding what people are saying or finding the right
words to express your thoughts. The following tips are important in
communicating:
-
Take your time.
-
Ask the person to repeat a
statement, speak slowly, or write down words if you do not
understand.
-
Find a quiet place if there
is too much distracting noise.
Driving:
-
Understand that at some
point it may no longer be safe for you to drive. Discuss with your
family and physician about how and when you will make decisions about
driving.
-
Make plans for other
transportation options, such as family members, friends, or community
services.
Dealing with memory
changes
-
Post a schedule of the
things you do every day, such as meal times, regular exercise, a
medication schedule, and bed time.
-
Have someone call to remind
you of meal times, appointments, or your medication
schedule.
-
Keep a book containing
important notes, such as phone numbers, people’s names, any thoughts
or ideas you want to hold on to, appointments, your address, and
directions to your home.
-
Post important phone numbers
in large print next to the phone.
-
Have someone help you label
and store medications in a pill organizer.
-
Mark off days on a calendar
to keep track of time.
-
Label photos with the names
of those you see most often.
-
Label cupboards and drawers
with words or pictures that describe their contents.
-
Have someone help you
organize closets and drawers to make it easier to find what you
need.
-
Post reminders to turn off
appliances and lock doors.
Living alone
Many individuals manage on
their own during the earliest stages of Alzheimer’s disease, with
support and assistance from others. The following suggestions may help
if you live by yourself.
-
Arrange for someone to help
you with housekeeping, meals, transportation, and other daily chores.
To get information about assistance available in your community, talk
to your local chapter of the Alzheimer’s Association or your
physician.
-
Make arrangements for direct
deposit of checks, such as your retirement pension or Social Security
benefits.
-
Make arrangements for help
in paying bills. You can give a trusted individual the legal authority
to handle money matters.
-
Plan for home-delivered
meals if they are available in your community.
-
Leave a set of house keys
with a neighbor you trust.
-
Make arrangements for
someone to regularly check your smoke alarm.
-
Have family, friends, or a
community service program call or visit daily.
-
Keep a list of questions
and concerns to discuss with them during your time
together.
-
Keep a list of things for
them to check out around the house, such as electrical appliances,
mail, and food items.
Making Job
Decisions
If you are still working when
you are diagnosed with Alzheimer's disease, you will need to make
decisions about eventual changes in work life. The following suggestions
may help you make decisions and discuss options with her
employer.
-
Talk to your employer about
your diagnosis. You may want to provide educational materials and
bring someone with you to help explain your situation.
-
Discuss with your employer
the possibility of switching to a position that better matches your
abilities and strengths or of reducing your work hours.
-
Continue to work as long as
you and your physician feel you are able.
-
Decide with your employer
who else will need to know about your diagnosis, such as co-workers
and clients with whom you work.
-
Tell co-workers that you may
become frustrated with yourself, or frustrating to them, when you have
trouble recalling information or finding the right
words.
-
Use reminders, memos, and a
calendar to help you perform your job effectively.
-
Research early-retirement
options.
-
Educate yourself and family
about employee benefits that may be available to you. Find out how to
make benefit claims.
-
When you stop working, find
an activity to take the place of your job. Consider volunteer work or
a new hobby.
Planning for the Future
After a diagnosis of
Alzheimer’s, you may worry about the impact the disease will have on you
and your family. Planning ahead is one way to deal with those fears. By
participating in decisions now, you can determine the kind of life you
want for the years ahead. In this section, you will find information and
tips to help you begin planning.
-
Choosing Health Care
Providers and Facilities
-
Financial Matters
You may
be worried about the cost of your future care and if you will have
enough money to cover these costs. Discussing your immediate and
future financial needs and goals will help protect you, the people who
depend on you financially, and the people who will care for you. Work
with a financial adviser and trusted family member or friend to
determine the following:
-
potential care expenses,
such as follow-up physician visits, prescription medications, care
services, and housing
-
current sources of income,
such as insurance, personal savings, investments, and employee or
retirement benefits
-
Legal Issues
It is important to obtain
legal advice and services from an attorney. You may want to hire an
attorney who practices elder law, a specialized area of law focusing
on issues that typically affect older adults. Bring a family member
with you when you see your attorney.
Free legal advice may be
available in your community. Contact your local Legal Aid Society,
Area Agency on Aging, or nonprofit legal assistance organizations.
Your local chapter of the Alzheimer's Association may be able to
provide referrals for legal advice and services.
Legal documents called
advance directives enable you to document your preferences regarding
treatment and care, including end-of-life wishes. Talk with your
family and your doctor about your preferences for end-of-life care. If
you do not decide on your care now, your family may have to later.
With advance directives, your family will know your
preferences.
Two common forms of advance
directives are a living will and a durable power of attorney for
health care.
-
A living will
states your choices for future medical care decisions, including the
use of artificial life support systems. You have the legal right to
limit or forgo medical or life-sustaining treatment, including the
use of mechanical ventilators, cardiopulmonary resuscitation,
antibiotics, feeding tubes, and artificial
hydration.
-
A durable power of
attorney for health care allows you to appoint an agent (usually
a trusted family member) to make all decisions regarding
health care. These decision may be about health care providers,
medical treatment, and end-of-life decisions. The term
durable means that this agent can act on your behalf after
you are unable to make decisions yourself.
Other legal
documents
Once you have filled out
these documents, make sure that you, your caregiver or a trusted
family member, your attorney, and your doctor all have a copy.
Recognizing
Alzheimer's
Everyone
forgets things now and then. Everyone gets moody. Everyone makes poor
decisions, but Alzheimer's behaviors are a little more
out-of-the-ordinary, and they get progressively
worse.
VISIT THE FOLLOWING SITES FOR MORE
INFO:
http://www.alz.co.uk/
http://www.alzheimer-europe.org/
http://www.alzheimer.org.nz/
IF YOU HAVE THE NEED FOR ADDITIONAL INFORMATION PLEASE
CONTACT
THE ADAP SECRETARIAT AT :
Rm 410, Medical
Arts Bldg. St. Luke's Medical Center
Quezon City, Metro
Manila
Tel. No.: (632)723-1039 email: adap@alzphilippines.com
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