|
Alzheimer's Disease
|
|
WHAT YOU SHOULD KNOW Alzheimer's (ALS-hi-mers) disease is a long-term, incurable brain disease in which brain cells die, causing memory, thinking, and behavior problems. The disease usually starts at about 65 to 70 years, but may begin earlier. In the later stages, the patient must have 24-hour care for feeding, personal hygiene, and bathroom needs. Alzheimer's usually lasts from 2 to 10 years, but some people have lived up to 20 years with this illness. Causes Scientists have not yet found the exact cause of the disease. However, we do know that several factors make it more likely. They include: - Advanced age
- A head injury
- A heart attack
- Gender (The disease strikes more women than men.)
Signs/Symptoms Alzheimer's disease has three major stages. The earliest symptoms are often mistaken for normal signs of aging. Stage 1: Recent memory loss is the most common early sign. People in the earliest stage of Alzheimer's may recall what happened years ago, but forget things that occurred yesterday. They may have trouble remembering the names of common objects and familiar people. Recurring events may seem to be happening for the first time. They may become confused about the month or season. They may forget parts of their daily routine, such as brushing their teeth or combing their hair. Often, they will pretend to remember rather than admit their forgetfulness. As the disease progresses, walking may become harder for them. It may become difficult to balance a checkbook or take care of the house. They may have trouble making decisions that once were easy, and may lose interest in pastimes they once enjoyed. Any change in established routine may cause depression, anger, or confusion. Stage 2: At this stage, people begin to have problems accomplishing the chores of daily living, such as choosing what clothes to wear, eating, washing, shaving, and doing simple jobs. Personal hygiene may no longer seem important. Victims may fail to recognize friends and relatives, and may become loud, violent, and hard to control. They may have trouble sleeping, and begin wandering off. Typically, they may seem especially anxious, restless, and agitated in the late afternoon---a phenomenon called sundowning. They may find it hard to recall words or talk in normal sentences. They may switch from topic to topic until they become hard to understand. Emotions become more volatile and hard to control. Victims may seem depressed or worried, or unusually happy for no good reason. When frustrated, they may lash out childishly. Everything may seem to take more energy, and they may become easily fatigued. They may begin leaving things in strange places and forgetting where they put them. Reasoning and problem-solving become difficult; choices and decisions become impossible. It seems harder to plan an activity and follow through with it. Towards the end of this stage, people may begin to suffer hallucinations, and lose control of bladder function. Stage 3: Towards the end of the illness, people lose all memory and speech. Muscular control declines, and incontinence sets in. Victims begin to exhibit extreme hostility, loss of control, aggression and destructiveness. Finally, they lose all ability to care for themselves. Care Although drugs such as Cognex and Aricept may slow the progress of the disease in some people, Alzheimer's cannot be stopped or reversed. Treatment involves trying to maintain a good quality of life for as long as possible. Exercise, good nutrition, and social activity all play their part. Medications can help to relieve anxiety, nervousness, sleep problems, and depression. WHAT YOU SHOULD DO - Talking: Call Alzheimer's victims by name, and speak slowly, clearly, and calmly. Use short words and sentences. Don't give too much information at once. The tone of your voice and the way you look when you talk are important. Stand where you can have eye contact and be seen. To get their attention, you may want to touch their arm or shoulder, hold their hand, or put your arm around their waist.
- If you have to repeat yourself, always use the same words. Don't ask many questions because the person may be disturbed at not knowing the answer. Questions with a Yes or No answer may be easiest. It may take a while, but wait for a response. Remember that a victim of Alzheimer's may say one thing and mean another. You may need to ask if you correctly heard what the person said.
- Give instructions one step at a time. It may be easier to write down simple directions. Limit the number of choices because decisions may be hard to make. Talk only about things that are real to the person. If he or she has a hard time talking, you may finish the rest of the sentence. Arguing is not helpful.
- Eating: Meals should be taken at the same time and in the same place each day. There will be less confusion if there are few food choices. Eating patterns may change in people with Alzheimer's: They may gorge and then force themselves to vomit, or may not eat at all. Sometimes offering small meals and snacks may cause earlier food habits to return.
- Serving one food at a time may help reduce confusion. Be sure food is soft and cut in small pieces. Remind people with Alzheimer's to open their mouth and chew the food. Drinking liquids may be a problem. Choose gelatin, pudding, soup, or ice cream and limit caffeinated soft drinks, coffee, and tea. Caffeine may increase excitability and activity. Give the person healthy finger foods if he or she won't sit and eat.
- In the final stages of the disease, weight loss and difficulty swallowing may complicate matters. Try different foods to see whether the patient can handle one better than another. Try to get the person to drink 6 to 8 large glasses of water each day to prevent dehydration.
- Safety: Make the victim's home safe to prevent injury. Go through the house and remove or lock up dangerous substances such as drain cleaners, paint, or medicines. You may need to take off the stove burner knobs.
- Smoking is dangerous because the person may forget to put out a cigarette. Hot water and electrical machines may cause injury. Loose rugs can lead to falls. Doors and windows should be tightly closed to prevent wandering or other injury.
- Activities: People with Alzheimer's will function best when they have a regular routine. Try to keep care and activities the same from day to day. Repeating familiar activities with frequent breaks may often work best. Choose simple pastimes that hold the person's interest, and work with him or her on a one-to-one basis. Save difficult chores for times when the person seems the most alert.
- Personal Care: Alzheimer's patients often dislike showering or bathing. Be sure the bath water is not hot enough to burn. They may dress without noticing the color or pattern of their clothes. Hair care or other personal care may not interest them.
- Toileting: It may help to try to put a person with early Alzheimer's on a schedule: urinating every 4 hours, for example. Note the person's bowel movement routine and try to maintain it.
- Over time, people with Alzheimer's may become unaware of the need to relieve themselves. But you may notice that they are picking at their clothes, touching their genital area, or acting restless. Because they may sometimes forget the location of the bathroom, put up bright signs showing the way. Take them to the bathroom often.
- Sleeping: Try to keep the Alzheimer's sufferer awake during the day. To encourage uninterrupted sleep, limit liquids in the evening. Warm milk at bedtime may be helpful.
- Wandering: You may need to install new locks on the outside of doors to keep the patient from going outside alone. An alarm system near doors can alert you when they're opened. A bracelet or necklace with the person's name and phone number on it will provide identification in case he gets lost.
- Pain or Discomfort: It's often hard to tell whether someone with Alzheimer's is in pain or discomfort. Breathing noisily, moving rigidly, or constantly making noises may indicate pain; while a sad or scared expression may be a sign of discomfort.
- Depression: This problem is common in the early stages of Alzheimer's. One tip-off is a preference for being alone. If the person seems depressed, consult your doctor. Medication can solve the problem.
- Exercise: Regular activity is good for both the mind and the body. It can help alleviate anxiety and depression and improve sleep. Exercise can also bring more oxygen and fuel to the brain cells. Walking is especially beneficial for people with Alzheimer's.
- Coping: Alzheimer's disease is a life-changing disease for both the victim and the family. It's difficult to accept the fact that a loved one has this disease, and the full realization can cause fear, anger, and depression. It helps to discuss the situation with your doctors, family, and friends. Joining an Alzheimer's support group can be beneficial, too.
For more information on Alzheimer's call or write: The Alzheimer's Association, 919 N. Michigan Ave., Suite 1000, Chicago, IL 60611-1676, 1-800-272-3900. Or call the Alzheimer's Disease Education and Referral Center, 1-800-438-4380.
|
Conditions and Treatments:
|
|
|
|
|
|
|
|
|
|
