Alzheimer's Disease

What is Alzheimer's?

A progressive brain disease that slowly destroys memory and thinking skills, and eventually even the ability to carry out simple tasks.

10 Warning Signs of Alzheimer's

1. Memory loss that disrupts daily life
2. Challenges in planning or problem solving
3. Difficulty completing familiar tasks at home, at work, or at leisure
4. Confusion with time or place
5. Trouble understanding visual images and relationships
6. New problems with words in speaking or writing
7. Misplacing things and losing the ability to retrace steps
8. Decreased or poor judgment
9. Withdrawal from work or social activities
10. Changes in mood and personality

Improving Quality of Life

Well planned activities can improve the quality of life of those with dementia.

Activity tips

• Focus on enjoyment, not achievement
• Encourage involvement in daily life
• Relate to past work life
• Look for favorites
• Change activities as needed
• Consider the time of day
• Adjust activities to stages of the disease

Create a safe, comfortable and supportive environment for activities.

Creating a comforting space

• Make activities safe
• Change your surroundings to encourage activities
• Minimize distractions that can frighten or confuse the person

A planned day allows you to spend less time and energy trying to figure out what to do from moment to moment.

Creating a daily plan

• What activities worked best and which didn't? Why?
• Were there times when there was too much going on or too little to do?
• Were spontaneous activities enjoyable and easily completed?
• Was the person bored or distracted?
• Is it time to introduce a new activity?

Identifying Triggers

Identifying what has triggered agitation can often help in choosing the best response to the behavior.

Potential triggers

• Change in Caregiver
• Change in living arrangements
• Travel
• Hospitalization
• Presence of house guests
• Bathing
• Being asked to change clothing

Aggression

Can be caused by many factors such as physical discomfort, environmental factors, & poor communication.

Physical Discomfort

• Is the person tired because of inadequate rest or sleep?
• Are medications causing side effects?
• Is the person unable to let you know he or she is experiencing pain?

Environmental Factors

• Is the person overstimulated by loud noises, an overactive environment, or physical clutter?
• Does the person feel lost?

Poor Communications

• Are you asking too many questions or making too many statements at once?
• Are your instructions simple and easy to understand?
• Is the person picking up on your own stress and irritability?
• Are you being negative or critical?

Respond to aggression thoughtfully and with care.

Listen

• Listen to the frustration, find out what may be causing the agitation and try to understand.

Provide Reassurance

• Use calming phrases such as "you're safe here" and "I'm sorry that you're upset"

Modify the Environment

• Decrease noise and distractions or move to another place

Remain Calm

• Do not raise your voice, criticize, ignore, argue with or shame the person

Activities

• Involve the person in activities such as art, music, or another hobby to help them relax

Avoid Using Restraint or Force

• Unless the situation is serious, avoid physically holding or restraining the person. He or she may become more frustrated and cause personal harm.

Decrease Level of Danger

• Assess the level of danger - for yourself and the person with Alzheimer's. You can often avoid harm by simply stepping back and standing away from the person. If the person is headed out of the house and onto the street, be more assertive.

Hallucinations

A hallucination is a false perception of objects or events involving the senses.

• When individuals with Alzheimer's disease have a hallucination they see, hear, smell, taste, or feel something that isn't there.
• The person may see the face of a former friend in a curtain or may hear people talking.
• If the hallucinations happen continuously, consult a physician to determine if there is an underlying cause.
• Have the person's eyesight and hearing checked, and make sure the person wears his or her glasses and hearing aid on a regular basis.

Responding to Hallucinations

Offer Reassurance

• Respond in a calm, supportive manner.
• A gentle tap on the shoulder may turn the person's attention toward you.
• Look for the feelings behind the hallucinations. You might want to say, "it sounds as if you're worried" or "I know this is frightening for you."
• Avoid arguing with the person about what he or she sees. Use distractions.
• Suggest that you take a walk or sit in another room. Frightening hallucinations often subside in well-lit areas where other people are present.
• Try to turn the person's attention to music, conversation, or activities you enjoy together.

Modify the Environment

• Check for noises that might be misinterpreted, such as noise from a television or an air conditioner.
• Look for lighting that casts shadows, reflections or distortion on the surfaces of floors, walls, and furniture.
• Cover mirrors with a cloth or remove them if the person thinks that he or she is looking at a stranger.

Sundowners

Studies indicate that as many as 20% of persons with Alzheimer's will, at some point, experience periods of increased confusion, anxiety, agitation, and disorientation beginning at dusk and continuing throughout the night.

Potential Causes

• End-of-day exhaustion (mental and physical)
• Upset in the "internal body clock", causing a biological mix-up between day and night
• Reduced lighting and increased shadows
• Disorientation due to the inability to separate dreams from reality when sleeping
• Less need for sleep, which is common among older adults