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Senior Care: What is Alzheimer’s?

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So what exactly is Alzheimer’s

Alzheimer’s disease is a progressive neurological disease that, over time, results in the brain’s inability to function correctly. Alzheimer’s disease causes lapses in memory, communication, judgment and overall functioning.

alzheimers-article picAlzheimer’s was first identified by Alois Alzheimer in 1906 in Germany and is the most common type of dementia, a general term for impaired brain functioning. Other dementias include frontotemporal dementia, Huntington’s disease, vascular, Lewy body dementia, Parkinson’s disease dementia, and Creutzfeldt-Jakob disease. Dementia can also develop from potentially reversible conditions such as normal pressure hydrocephalus or vitamin B12 deficiency, as well as severe infections such as late-stage AIDS.

There are two types of Alzheimer’s disease: early onset Alzheimer’s, defined by onset before age 60, and late onset, or typical, Alzheimer’s.

Symptoms and Effects of Alzheimer’s

Symptoms of Alzheimer’s include problems with memory, communication, comprehension, and judgment. The individual’s personality may begin to change somewhat as well.

As the disease progresses, the individual gradually loses the ability to function mentally, socially, and eventually physically. Often in the middle stages of Alzheimer’s, he or she may also display inappropriate behaviours and emotions, which can be challenging for loved ones to handle. In its final stages, the person is completely dependent upon caregivers for basic needs.

Who Gets Alzheimer’s Disease?

There are an estimated 5.4 million people in the United States with Alzheimer’s or a related dementia, although not all are diagnosed. Additionally, researchers estimate that as many as 500,000 of those 5.4 million people in the United States have early onset Alzheimer’s. Alzheimer’s is not part of normal aging; however, as people age, the likelihood of developing Alzheimer’s increases.

Thirteen percent of individuals over age 65 have Alzheimer’s or another form of dementia, while almost 50% of individuals over age 85 have Alzheimer’s or another kind of dementia. The demographic group with the highest percentage of Alzheimer’s is Caucasian females, likely since their life expectancy is the greatest.

Diagnosing Alzheimer’s

Diagnosing Alzheimer’s disease is done, by ruling out other diseases or causes, reviewing family history and conducting a mental exam to see how well the brain is working. Some physicians also conduct imaging tests, which can show changes in the brain’s size and structure that may lead to the conclusion of Alzheimer’s.

While general practice physicians often diagnose Alzheimer’s, you can also seek an evaluation from a psychologist, geriatrician, or neurologist. Alzheimer’s cannot conclusively be diagnosed until after death when an autopsy is conducted and brain changes can be identified; however, diagnosis through the above tools is the industry standard at this time and has proven very accurate.

Treatment of Alzheimer’s

Alzheimer’s has no cure at this time, but determining more effective treatment and prevention methods, as well as finding a cure for the disease, is a high priority for researchers. Current treatment for Alzheimer’s focuses on alleviating the symptoms of Alzheimer’s, both cognitive and behavioural, by using drug therapy and non-drug approaches.

Drug Therapy

  • Cognitive enhancers are medications that attempt to slow the progression of Alzheimer’s symptoms. While these medications do appear to improve thought processes for some people, the effectiveness overall varies greatly. These medications need to be monitored regularly for side effects and interaction with other medications.
  • Psychotropic medications can be prescribed, to target the behaviour and emotional symptoms of Alzheimer’s. Psychotropics are medications that address the psychological and emotional aspects of brain functioning. For example, if a person is experiencing distressing hallucinations, a psychotropic medication, such as an antipsychotic medication, can be prescribed and is often helpful in relieving the hallucinations. As with cognitive enhancers, psychotropics have the potential for significant side effects and interaction with other medications, so they should be used carefully and be coupled with non-drug approaches.

Non-Drug Approaches

Non-drug approaches focus on treating the behavioural and emotional symptoms of Alzheimer’s by changing the way we understand and interact with the person with Alzheimer’s. These approaches recognize that behaviour is often a way of communicating for those with Alzheimer’s, so the goal is to understand the meaning of the behaviour and why it is present.

Non-drug approaches should generally be attempted before using psychotropic medications since they do not have the potential for side effects or medication interactions.

The goal of these approaches is to develop more effective interventions by adjusting the caregiver’s approach or the environment to minimize the challenging behaviours.

Preventing Alzheimer’s

There are abundant theories about how to prevent Alzheimer’s, but currently there is no sure-fire way to do this. A heart-healthy diet, an active lifestyle with plenty of physical exercise and social interaction, and regular mental exercise are strategies that some feel are effective in preventing Alzheimer’s.

Coping With Alzheimer’s

If you think that you or someone you know may have Alzheimer’s, know that we are here for you, both to provide current information and also to facilitate the sharing of ideas and suggestions from others in your situation. Being proactive and prepared can ease some of the challenges of this disease for you and your family. Coping with Alzheimer’s is not easy, but it’s not something you need to do alone.

Please contact us today, to discuss any of the above mentioned challenges you may be facing and how our services can help you remain independent, protected, safe, and in you home / community.

You got questions, we have answers: (905) 785-2341 or email us at homecare@inourcareservices.com

 

Sources:

Alzheimer’s Association What is Alzheimer’s? Accessed July 12, 2011.

Alzheimer’s Association Basics of Alzheimer’s Disease. Accessed July 12, 2011.

PubMed Health US National Library of Health. What is Alzheimer’s Disease? Accessed July 12, 2011.

 

Senior Care: Alzheimer’s Symptoms

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Symptomsalzheimers

Alzheimer’s Symptoms

We all have those times when we think, “What was his name? I know I met him before. Was it Jim? Tim?” Or, “I know I have it somewhere. If I can just remember where I put it!”. If you’re like me, these moments happen frequently in the busy pace of life. However, there is a significant difference between being absent-minded or preoccupied and having a true progressive memory problem such as Alzheimer’s disease. Here are four warning signs that could indicate a more serious problem:

  • You lose your keys. When they’re found, you have no recollection of how they might have gotten there.
  • You always were a fantastic cook, but lately even making coffee seems more difficult. You wonder who has been messing around with your coffeemaker.
  • You’re great at covering for yourself. For example, when someone asks you a question to which you don’t know the answer, you turn the question around by saying with a chuckle, “I’m not sure. What do you think?”
  • You’ve had a hard time recently balancing your chequebook, even though that’s always been your job.

If these symptoms paint a picture of you or someone you love, seek an evaluation from a physician, geriatrician or psychologist.

Symptoms of Early, Middle and Late Stage Alzheimer’s Disease

While Alzheimer’s disease has been described as having seven stages, the symptoms of Alzheimer’s can also be collapsed into three broad stages: early, middle, and late. Remember that symptoms can overlap and may vary in each person with Alzheimer’s.

Early (Mild) Stage Symptoms:

In early-stage Alzheimer’s, individuals may still function quite well overall. Although they may be aware of the increasing difficulty with certain tasks, they are also often quite skilled at hiding this from others by deflecting questions, changing the topic, or relying on their family or loved ones to make decisions or answer questions. Some persons also begin to withdraw, perhaps due to their uncertainty over their ability to cope with decisions or social interaction. Notice that in this stage, long-term memory typically remains intact.

Middle (Moderate) Stage Symptoms:

  • Significant personality changes, such as being argumentative, impulsive, angry
  • Resistive to, or combative with, physical care, even (sometimes especially) when provided by a loved one
  • Short-term and long-term memory loss
  • Increased difficulty communicating with others
  • A “love-hate” relationship with their caregivers; for example, extremely dependent on but also very unkind toward a spouse or adult child
  • Potential for wandering away from home
  • Very poor judgment and decisions
  • Often the physical abilities still remain intact here, such as their ability to walk around
  • Sometimes incontinence becomes a concern

Moderate, or mid-stage, Alzheimer’s is often the most difficult stage. While some individuals remain “pleasantly confused” throughout the entire disease, many display inappropriate behaviours and emotions. They may be quite restless and become paranoid or have hallucinations, or refuse to let you help them with a bath or getting dressed. They may get up several times in the night, and rummage through the same drawers repeatedly. This middle stage of Alzheimer’s can be very taxing for the primary caregiver, and this is often when in-home help is hired or the person is placed in a facility such as an assisted living or a nursing home.

Late (Severe) Stage Symptoms:

  • Decreased ability to interact with others
  • Ability to recognize people diminishes
  • Physical decline, such as inability to walk or talk
  • Difficulty with eating, even with assistance
  • Apparent withdrawal from surroundings
  • Incontinence

In this final stage of Alzheimer’s, people are often are quite immobile, and spend much of their time in bed or a wheelchair. They are no longer able to respond much to others, although you may occasionally receive a smile or hear some attempts at language. The behaviour challenges of mid-stage Alzheimer’s are replaced with what looks like complete withdrawal; however, these individuals can still benefit from gentle conversation, holding their hand or giving them a hug, visual stimulation such as colours and pictures, and especially hearing music. Individuals with late-stage Alzheimer’s become more prone to illnesses as their body loses strength. Often, infections like pneumonia eventually cause their death.

Diagnosis and Treatment

If you see yourself or your loved one described in these symptoms, contact a physician, psychologist or neurologist to arrange for an evaluation. Diagnosing Alzheimer’s disease involves several tests to rule out other conditions and is an important first step in treatment and management of the disease.

 

Sources:

Alzheimer’s Association; Stages of Alzheimer’s. Accessed July 8, 2011. US National Institutes on Health. National Institute on Aging. Accessed July 10, 2011.

Senior Care: Alzheimer’s & Dementia

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Alzheimers

Caring for people with Alzheimer’s and Dementia

While there’s nothing wrong with bingo as an activity, there are many reasons to think creatively when it comes to activities for those with Alzheimer’s disease and other kinds of dementia.

One of the keys is that the activity should be meaningful for the person. Often, meaning is tied to past occupation or hobbies, so what’s meaningful for one person might not be so for another. Whether you’re caring for a loved one in your own home or for a patient at a facility, consider the person’s interests, occupation and passions. If you work in a facility and don’t know the person’s history, ask their family members or observe their reaction to different activities. Then, choose a few activities they’ve responded well to and note the areas of interest. Here are a few types of people and corresponding activities to consider.

  • The Homemaker For those individuals who primarily took care of a home, you might offer a cloth to dust dressers or handrails, or to wash the table. They might enjoy folding a basket of washcloths and towels, or the task of setting the table. The object here is not to have the individual do large amounts of work, but rather to give the person something familiar and meaningful to do.
Just a note here. If you’re using this idea in a facility, you may want to ask the physician for an order that allows therapeutic work and receive permission from the family as well.
  • The Fix It Individual Was your loved one the fixer, the handyman, or the go-to guy? Maybe he’d like to sort through and match up nuts and bolts, or tighten screws into pieces of wood. Perhaps he’d like to connect smaller PVC pipes together. There are also activity boards with lots of “to do” things attached that you can purchase.
  • The Mechanic If his passion is cars, maybe he’d enjoy looking at pictures of old cars or tinkering with smaller engine parts. Some towns hold car events where older cars are displayed or driven down a road; if yours does, consider bringing him to that event. He also may be able to help you wash the car.
  • The Pencil Pusher For the person who sat at a desk and worked with papers, pens and pencils, she might love having a pile of papers to file, an adding machine or calculator to use, forms to complete or documents to read. Some people might like carrying a notebook and pen around to write down information.
  • The Musician If music is her thing, offer her opportunities to use this gift. People in the early to mid-stages of Alzheimer’s may be able to sing in a choir or play the piano. I know one woman with dementia who leads a sing-along almost daily because of her musical gifts. She’ll even take requests for which songs to play, and despite her poor memory, plays songs almost faultlessly.
If he enjoys listening to music rather than performing it, make recordings of his favorite songs and play them for him.
  • The Parent / Caregiver Have you ever noticed how people with dementia often brighten up and take note when babies and children are around? A child can often get a response when adults fail. Interactions with children and babies have been a normal part of many people’s lives. Sometimes when a person is living in a facility with other people of similar age or living at home and not getting out often, they no longer interact regularly with kids. Create opportunities for interaction with kids, whether that’s arranging for a visiting time, going on a walk together or bringing by your new baby to a facility near you.
Some older adults, particularly women, may also enjoy holding and caring for a baby doll. Often, the person connects with that baby doll and enjoys the sense of a familiar role in caregiving for the doll
  • The Animal Lover If your family member loves pets, consider having him walk the dog with you or brush the dog’s hair. If he’s not able to do these things, he might enjoy having a bird or two in a cage or a fish aquarium to watch. 
In the middle to late stages of Alzheimer’s, some people are comforted by holding a stuffed kitten or puppy. I’ve often observed them stroking the fur and holding it close.
  • The Gardener Is she an accomplished gardener? Provide her with a place to plant seeds, water them and watch them grow. She might also enjoy flower arranging or harvesting and preparing vegetables.
  • The Puzzler Although people with dementia typically have impaired memories, some of them are still quite capable of doing crossword puzzles, word searches and jumbles. Others might enjoy simple jigsaw puzzles as well. Have some different puzzle opportunities sitting out for your loved one to do.
  • The Engineer If he collected trains growing up, or is simply fascinated by them, consider setting up an electric train so he can help arrange the tracks or simply watch the activity. You can also gather a book collection or movies about trains.
  • The Sports Fan Provide the avid sports lover the chance to mini putt, do Wii bowling, play the beanbag tossing game or watch a little league baseball game. You can also arrange for several people to get together to watch the big game on television and eat some junk food, or, I mean healthy alternatives. Or, perhaps he’d get a kick out of sorting through and organizing baseball cards.
  • The Artist Art provides a creative outlet to make something, so it provides a purpose and a task. Gather some non-toxic clay, watercolor paints, washable markers, colored pens or pencils, and paper. You can use these materials in a directed way i.e. “Here’s some clay for you. Today let’s try to make a flower vase” or a non-directed way “There’s art supplies laid out on the table. Feel free to choose any color of paint to get started.” Clay and paint are great for tactile stimulation and they provide a way to occupy and strengthen the hands as well.
  • The Faithful Don’t neglect this important area. For many people, as they age, the importance of spiritual nurturing increases. Offer them books of faith in keeping with their tradition, times of prayer or meditation, or singing together.

Sources:

Alzheimer’s Society. Keeping active and staying involved. Accessed August 23, 2012.