ALZHEIMER DISEASE (AD)
AD is a disease of the brain where the nerve cells are destroyed. Caring for someone with AD can be very challenging. The challenges you face vary from day to day. There are 3 stages of AD: the mild stage; the moderate stage and the late stage.
Alzheimer’s affects different people differently and one has to learn coping mechanisms to deal with the challenges you will face while caring for a person with AD.
During the first stage there are small changes in the person’s personality as well as a little memory loss. They do not remember the names of people. Solving mathematical problems may prove to be difficult and they are unable to balance a cheque book for instance. They experience difficulty in planning and organizing. Compiling a grocery list and finding the items on shelves in a store will be challenging for them.
During stage two, memory worsens and confusion occurs. People are unable to organise, plan and follow instructions. They experience problems getting dressed and become incontinent. They may have trouble recognizing family and friends. At this stage they begin to wander. They are unable to remember the date and year. More serious personality changes will be observed – they make threats, accuse people of stealing, kick, scream, bite or grab things.
In stage three the person with AD passes away. They require round the clock care with all their basic daily needs. They will need help sitting and walking. Sometimes they will be unable to talk. They will find it difficult to swallow and as a result refuse to eat. The carer must remember that it is the disease causing the personality changes and not the person with AD.
There are 3 main changes in a person suffering with AD:
- Communication skills change;
- Personality and behavioural changes; and
- Intimacy changes.
People with AD find it difficult to communicate because they cannot remember things. They struggle to find the correct words to express themselves. It is very easy to become impatient with these people. Some communication problems caused by AD are:
- Inability to find the correct words;
- Unable to understand the words;
- Attention span is limited;
- Their train-of-thought gets lost during a conversation;
- They do not remember the steps involved in cooking, paying bills or getting dressed;
- They battle to ignore background noises e.g. tv and phone calls;
- They become easily frustrated when struggling to communicate;
- They are very sensitive to touch and sound.
There are ways of coping with the changes in communication skills:
- Keep eye contact and use the person’s name;
- Be aware of your body language, the tone and loudness of your voice;
- Other than speaking, gently touch or guide the patient;
- Try to maintain a two-way conversation. It makes the patient feel better about themselves.
People with AD also suffer from hallucinations or delusions. These may sometimes be caused by medication. In the event of these occurring, a doctor should be consulted. Keep harmful objects out of reach.
People with AD may also become paranoid. It is their way of experiencing loss trying to deal with it. They accuse and blame other people because no other explanation makes sense to them.
People with AD do not cope very well with change. It is therefore important to keep a routine. Rummaging and hiding objects is also a result of AD. The following steps can be taken to keep the patient safe:
- Toxic or dangerous chemicals should be locked away;
- Spoiled foods to be removed from the fridge;
- Keep valuable items and papers safely locked away;
- Keep all trash cans hidden and covered, people with AD may rummage through it;
- Check through all trash cans before you empty them.
AD causes changes in their brain but the following factors may also affect the behaviour of the patient
1.How they feel:
- May feel overwhelmed, sad or fearful;
- Something or someone may cause them stress;
- A change in routine or having to travel may confuse them;
- They may be anxious about going somewhere e.g. a doctor’s appointment.
2. Problems with their health:
- May be ill or experience pain;
- New medication;
- A lack of sleep;
- Hunger, thirst, infections or constipation;
- Sight or hearing problems;
- The abuse of alcohol;
- Too much caffeine.
3. Problems in their surroundings:
- Being in an unfamiliar place;
- A high level of noise which may cause confusion or make them nervous;
- Signs that are misunderstood;
- Mirrors – they do not recognise themselves and think someone else is on the room with them.
In order to keep a person with AD safe in their home, a few precautions need to be taken. The following items may be added:
- Smoke and carbon monoxide detection alarms;
- A list of emergency numbers in an appropriate place;
- Stove to be fitted with safety knobs and a shut-off switch;
- Unused electrical sockets to be covered with childproof plugs;
- Install locks on all outside windows and doors.
The following should also be removed from the home:
- All medication;
- Cleaning products and dangerous chemicals e.g. turpentine;
- Poisonous plants;
- Remove all types of weapons e.g. knives, guns, scissors etc.
- Clear the garage of petrol cans etc.
Unclutter the house by removing excess furniture, old magazines and newspapers etc. Also ensure that the stairway has a sturdy handrail. Remove all small rugs. Fit the stairs with a gate. Ensure that the stairs are not slippery and buy the patient shoes or slippers with good traction. Label hot water taps and turn down the temperature of the geyser to prevent scalding. A person with AD should also not be allowed to drive.
All people with AD will eventually need help with daily routine tasks such as bathing, dressing, eating etc. It will be embarrassing for them. Planning is important so that they may retain their dignity. The patient’s self-esteem can also be boosted by allowing them to do household chores and helping to cook or bake. Playing music and dancing will bring back happy memories. Pets make people with AD feel more loved and often give them a new zest for life.
Caring for someone with AD can be challenging but a number of coping mechanisms will make it easier. Planning is essential and it is vital to remember that it is the disease itself that causes all the changes and not the person who has AD.
Each person with AD is unique and as a result will respond differently to the disease. With the correct help and information, many of the challenges of AD can be faced.