What is alzheimer’s disease?

It’s more than just forgetting things.

About 4 million people in the U.S. have Alzheimer’s. It is an illness that makes it hard for people to remember, think, and use language. It can make them act strange or seem moody. After a while, people with Alzheimer’s have a hard time with things like using the phone, cooking or handling money.

Sadly, many people think the early symptoms of Alzheimer’s are signs of normal aging. So Alzheimer’s is often not diagnosed and treated early.

Who gets alzheimer’s?

The disease is more common in older adults. And it affects all races. About 1 in 10 people over the age of 65 have Alzheimer’s. As many as 5 in 10 people over the age of 85 have Alzheimer’s.

There is something you can do.

Through research, we are learning more about how the brain is affected in Alzheimer’s. We do not yet know how to prevent or cure it. But we do know how to treat its symptoms.

It’s best to start treatment early.

People with Alzheimer’s often do better if they start treatment early.

Symptoms of Alzheimer’s

The first symptoms of Alzheimer’s may be hard to tell from the normal signs of aging. Forgetting names. Forgetting phone numbers. Losing things more often. People may accept these as a normal part of aging. But don’t ignore them. When they affect daily life, they may be early symptoms of Alzheimer’s disease.

Symptoms can vary from person to person. Some common symptoms of Alzheimer’s are:

  • Memory loss
  • Problems doing familiar tasks
  • Problems with language
  • Trouble knowing the time, date, or place
  • Poor or decreased judgment
  • Problems with abstract thinking
  • Misplacing things often, such as keys
  • Changes in mood and behavior
  • Changes in personality
  • Loss of interest in starting projects or doing things

If someone close to you has memory loss, it may be Alzheimer’s. Forgetting some things can be a normal part of aging. But it could be an early sign of Alzheimer’s when it affects daily life. Only the doctor can tell if the symptoms are Alzheimer’s.

Alzheimer’s Information for Caregivers

Taking Care of Yourself

Keeping yourself healthy is important so that you can continue to help the person you care for. That means staying healthy in body and mind. It’s important to know that you do not have to do it all. Getting help when you need it can help relieve some of your stress. Also, take notice of what your body is telling you. Don’t take being tired, stressed or changes in your appetite too lightly. Here are some more tips for staying healthy.

  • Stick to a healthy diet
  • Exercise
  • See your doctor on a regular basis
  • Get checked for stress and depression
  • Rest whenever you can
  • Let others help you
  • Talk about your feelings with others
  • Know that you’re not alone

The Alzheimer’s Association states that more than 80 percent of caregivers say they have high levels of stress. And nearly half said they suffer from depression. It’s common for caregivers to ignore their own needs. But before you can take care of anyone else you have to take care of yourself.

Know the signs of stress, and ask for help as often as you need it. Here are some of the warning signs to look for:

  • Denial
  • Anger
  • Social withdrawal
  • Anxiety
  • Depression
  • Exhaustion
  • Sleeplessness
  • Irritability
  • Lack of concentration
  • Health problems

If you are a caregiver who is having stress symptoms fairly often, you should see a doctor.

  • Get in contact with helpful resources in your community.
  • Learn all you can about Alzheimer’s disease and caregiving techniques.
  • Get help from family, friends, and your community.
  • Take care of yourself. Exercise, eat healthy, and get plenty of sleep.
  • Know what you can do and what you can’t.
  • Give yourself credit for what you do.

Family and friends can play a big part in your caregiving if you let them. If they offer to help, let them. If they don’t offer, ask them to help. You can also find out about the local resources in your area that can help you give care. Services like Adult Day Care and Respite Care can help both you and the person you care for. Visit the Alzheimer’s Association at www.alz.org or call 1-800-272-3900.

Home Safety

There are a lot of simple steps you can take to make the home safer for someone with Alzheimer’s. Here are a few tips you can use.

  • Add lighting in places between rooms, stairways, and bathrooms. Changes in levels of light can be confusing.
  • Place different colored rugs in front of doors or steps to help the person expect staircases and doorways.
  • Watch over the person when he or she is taking any medications.
  • Close off all items or areas that could be a danger. Use locks and child safety latches.
  • Clean out the refrigerator. Take out all food that may be spoiled.
  • Limit the use of equipment that could be a danger (Such as stoves/ovens, grills, toasters or knives).
  • Try to get appliances that have an automatic shut-off. This can help prevent burns or fires.
  • Keep a list of important phone numbers at hand. (Such as numbers for police, and fire, as well as the doctor, hospital and poison control.)
  • Check fire extinguishers and smoke alarms. Have fire drills often.
  • Consider signing up for the Safe Return Program at http://www.alz.org/Services/SafeReturn.asp. This is a nationwide program that helps those with Alzheimer’s get home safely if they wander off alone.

As the disease progresses, your loved one’s personality, abilities, and moods may change. As you help the person, be patient and always look for new ways to do things. Something that worked one day may not work the next.

Everyday Tasks

Getting Dressed.

Clothing is a good way for a person to express themselves. Looking good can make a person feel better. That’s why it’s important to think about what the person likes and what they don’t like.

  • Don’t rush the person. Be flexible. If the person wants to wear the same outfit over and over, try getting more than one of the outfit or get ones that are similar.
  • Make sure clothing is simple and comfortable. Shirts or sweaters with buttons in front are easier to wear than pullover tops. Also, larger clothes may be easier for the person to put on.
  • It’s common for someone with Alzheimer’s to wear layers of clothing. Try not to worry. If they are too hot, they will remove some of the items.
  • People with Alzheimer’s sometimes don’t like to change their clothes. In this case, dress them in clothes that can be worn during the day and to sleep at night.

Eating Meals

Eating problems are often seen in people with Alzheimer’s as the disease progresses. In the beginning, you may see changes in the person’s appetite. What they like to eat may change as well. Sometimes there will be weight loss, overeating or trouble with eating. To encourage people with Alzheimer’s to eat, some simple changes can be a big help. Snacks between meals can help increase weight. A change in mealtime routines, such as playing soft music, has also been shown to keep people at the dinner table longer.

To help, make changes in how food is served:

  • Take away pits, bones, peels, or wrappers. Food should be able to go straight from the plate to the mouth.
  • Reduce distractions such as the phone or television during mealtime.
  • Serve foods that can be eaten easily, or with their hands.
  • Add different textures and color to food. It will help keep your loved one interested in what they’re eating.

Driving

Alzheimer’s affects many of the functions that a person needs to drive safely. It is important for families to think about the issue of driving and talk about it with the doctor. If you notice any of the changes below, you should consider stopping your loved one from driving right away.

Being confused:

  • Getting lost
  • Forgetting to use turn signals
  • Confusing the brake pedal and the gas pedal
  • Being confused about directions or detours

Driving unsafely:

  • Hitting the curb while driving
  • Failing to yield
  • Problems with changing lanes or making turns
  • Driving at the wrong speeds

If you need to tell your loved one that (he/she) can no longer drive, it is important to be sensitive. Remember, Alzheimer’s disease affects the ability to reason. Don’t try too hard to convince the person. A simple statement may be best. If you can’t get the person to stop driving, here are some things you should consider:

  • Have your doctor call the State Department of Motor Vehicles to ask that (he/she) take a driver’s test.
  • Try other ways to get around such as buses, taxis, senior vans, family and friends.
  • Check with your local Alzheimer’s Association to learn about transportation options in your community.

Dental Care

Good dental care can be hard for people with Alzheimer’s. Brushing is sometimes hard because the person can’t understand or won’t accept help from others.

  • Keep instructions short. Like “hold your toothbrush,” “put paste on the brush,” “brush your top teeth,” and so on.
  • Show them how to do it. Hold a brush and show the person how to brush their teeth. Try to brush teeth or dentures after each meal and make sure they floss every day. Also remove and clean dentures every night. While the dentures are out, brush the person’s gums and roof of the mouth.
  • Caregivers are key in helping the person have good dental care. They are ones most likey to notice any problems. If you notice a problem, talk to the dentist right away. Tell the dentist that the person has Alzheimer’s, so they can create a special routine.

Bathing

Bathing is often the hardest personal care task that caregivers face. Because it is so private, the person with Alzheimer’s may feel embarrassed or threatened.

  • Do what you can ahead of time, such as making the room warmer and having bath towels nearby. Some people may not like to be undressed by someone else. In this case, wrap a towel around their shoulders to add more privacy.
  • Make the person feel in control. Involve and coach him or her through each step.
  • Create a safe and pleasing atmosphere. Place non-slip adhesives on the floor surface. Put grab bars in the bathtub to prevent falls. Test the water in advance to prevent burns. Set the water heater to 120 degrees to avoid burns.

Using the bathroom

Often, people with Alzheimer’s have trouble using the bathroom. They may have loss of bladder and/or bowel control. It can be caused by many things. Some of these can be medicines, stress, a physical condition, and the environment.

  • Make the bathroom easy to see. Post signs that read “toilet” to help someone find the bathroom. Keep the door open and a light on, especially at night.
  • Watch for signs the person you care for has to use the toilet. Track how often they go to the bathroom, and take them to the bathroom ahead of time.
  • Make sure clothes are easy to put on and take off, for using the bathroom.

Be supportive. Help the person with Alzheimer’s keep a sense of dignity. Reassure them. It will help them be less embarrassed.

Behavioral problems

Sometimes people with Alzheimer’s act strangely. This can be hard for a caregiver. These tips may help you cope. The person is not acting this way on purpose. If the person you care for experiences any of these, be sure to tell the doctor.

Sleeping Problem

Sleeping problems in those with Alzheimer’s and tired caregivers are very real problems. They are a reason why people with Alzheimer’s are placed in nursing homes. Many people with Alzheimer’s get anxious at night.

If the person you care for is awake or upset, approach them calmly. Find out if there is something they need. Gently remind them of the time. Try not to argue or ask them to explain. Tell them that everything is all right and everyone is safe.

It may help to plan more active days. Try not to let them nap in the afternoon. Plan activities, such as taking a walk throughout the day. Limit sweets and caffeine to the morning hours. Serve dinner early, and offer only a light meal before bedtime.

Try having the person sleep in a different bedroom, in a favorite chair, or wherever it’s most comfortable. Keep a light on. This will make them less likely to get upset if they wake in the dark or in a strange place.

Wandering

A person with Alzheimer’s may wander away when you don’t expect them to. The person may not wander just by foot. They could also go by car or by other forms of transportation. But there are things you can do.

Get them to move around and exercise during the day. This will help them to be less restless. Let them help with daily tasks like folding laundry or making dinner.

Consider, along with your loved one, whether you should tell the neighbors about your loved one’s condition. Keep their phone numbers at hand. Consider signing the person up for the Alzheimer’s Association’s Safe Return Program. It’s a program that helps people with Alzheimer’s get home safely.

You may find the person wandering. They may feel lost or abandoned. Let them know everything is ok.

Aggression & Combativeness

People with Alzheimer’s may become angry easily. They can even strike out or fight. This usually means that the person with Alzheimer’s is frustrated, scared or cannot say what they want to say.

Look for early signs of frustration during times such as bathing, dressing, or eating. Handle these times in a calm and reassuring way. Distract them. If the person is upset because he or she can’t button a shirt, get them going on another task.

Talk directly with the person. Try not to show anger or impatience in your voice or in how you move.

Don’t put yourself in harm’s way. You can often avoid harm if you simply step back. Stand away from the person. If the person is headed out of the house and onto the street, you may have to be more assertive.

Hallucination

A hallucination is a belief that something is happening when it is not. When a person with Alzheimer’s has a hallucination, he or she sees, hears, smells, tastes, or feels something that isn’t there.

If the person with Alzheimer’s has a hallucination, handle it in a calm and supportive way. Try not to argue with the person about what he or she sees.

Check for noises that might be upsetting. This could be a noise from a TV or a computer. Look for lights that cast shadows, or make strange shapes on the walls and ceiling.

Spending time with someone with Alzheimer’s

For a person with Alzheimer’s, activities are important. Taking part can make them feel loved and needed.

  • Make the activities part of the daily routine.
  • Focus on having fun.
  • Let them work at their own pace. Don’t worry about “getting things done.”
  • Make instructions simple.
  • Find out what time of day works best.
  • Keep the person involved. Be patient.

What activities are best?

Before choosing an activity, there are a few things to consider.

  • Think about the person.
  • What do they like to do? What skills do they have? Choose activities they have always enjoyed.
  • Think about the place.
  • Is the room a safe place for the activity? Try to reduce any noises or lights that may distract, frighten, or confuse the person. For example, having the TV on may make it hard for the person to think about what they are doing.
  • Think about the time of day.
  • People with Alzheimer’s like to have a set schedule. So it’s best to do certain activities at the same time every day. This makes the person more relaxed.

Morning.

  • Eat breakfast together. Let the person help you make the meal.
  • Talk about the day’s news.
  • Talk about old photos.

Afternoon.

  • Make lunch together. Let the person help wash the dishes.
  • Read the mail.
  • Listen to music.
  • Do a crossword puzzle. Help each other with the answers.
  • Take a short walk.

Evening.

  • Make dinner together. Let the person help set the table.
  • Play cards or watch a movie.
  • Read books or magazines. Take breaks to discuss what you’re reading.

Talking to others about Alzheimer’s

Discuss with your loved one what to share with friends and family. You may need to tell friends and family about the diagnosis. Let them know that Alzheimer’s is a disease of the brain that affects memory and thinking over time. If talking about this is hard for you, print or e-mail pages from this site that explain the disease.

It’s important to talk to children and teenagers about the diagnosis. Young children need to know that they can’t “catch” the disease. Teenagers may be embarrassed by the person’s behavior. Let them know that the person with Alzheimer’s may forget their name sometimes. Remind them to be patient. It is no one’s fault. If kids or teens continue to have trouble, there are support groups just for them.

Make a list of people who can help you. And tell them about your situation. Neighbors are more likely to help if they know what to look for.

Important Websites & Books

The Alzheimer’s Association, www.alz.org
The National Council on Aging, www.ncoa.org
The National Family Caregivers Association www.nfcacares.org
Alzheimer’s Disease Education and Referral Center, www.alzheimers.org
The Eldercare Locator, http://www.eldercare.gov
The Safe Return Program, www.alz.org/Services/SafeReturn.asp

Helpful Books

The Best Friends Approach to Alzheimer’s Care
Baltimore, MD: Health Professional Press. Bell, Virginia and David Troxel. (1997)

Alzheimer’s Early Stages: First Steps in Caring and Treatment
Hunter House. Bennet, David; Kuhn, Daniel. (1999)

There’s Still a Person in There: The Complete Guide to Treating and Coping with Alzheimer’s
Putnam. Castleman, Michael; Naython’s, Matthew; & Gallagher-Thompson, Dolores. (1999)

Alzheimer’s: The Answers You Need
Forest Knolls, CA: Elder Books. Davies, Helen D. and Michael P. Jensen. (1998)

Losing My Mind: An Intimate Look At Life With Alzheimer’s
New York, NY: Free Press. DeBaggio, Thomas. (2002)

Keeping Busy: A Handbook of Activities for Persons with Dementia
Baltimore, MD: Johns Hopkins University Press. Dowling, James R. (1995)

Alzheimer’s: The Complete Guide for Families and Loved Ones
John Wiley & Sons. Gruetzner, Howard. (1997)

The 36-Hour Day: A Family Guide to Caring For Persons with Alzheimer’s Disease, Related Dementing Illness and Memory Loss in Later Life
Johns Hopkins University Press. Mace, Nancy L. & Rabins, Peter V. (1999)

Reversing Memory Loss: Proven Methods for Regaining, Strengthening, and Preserving Memory
Mariner. Mark, Vernon H. & Mark, Jeffrey P. (2000)

Mayo Clinic on Alzheimer’s Disease
Kensington Publishing Corporation. Petersen, Ronald C. (2002)

Coping With Caring: Daily Reflections For Alzheimer Caregivers
Forest Knolls, CA: Elder Books. Roche, Lyn. (1996)

The Forgetting: Alzheimer’s: Portrait of an Epidemic
Doubleday. Shenk, David. (2001)

The Memory Bible: An Innovative Strategy for Keeping Your Brain Young
Hyperion. Small, Gary. (2002)

Speaking Our Minds: Personal Reflections from Individuals with Alzheimer’s
W.H. Freeman & Co. Snyder, Lisa. (2000)

The Elder Law Handbook: A Legal and Financial Survival Guide for Caregivers and Seniors
G K Hall & Co. Strauss, Peter J. & Lederman, Nancy M. (1996)

The Complete Guide to Alzheimer’s – Proofing Your Home
Purdue University Press. Warner, Mark. (2000)