Monday, 27 February 2012 | 5 comments
If you know someone or is living with someone with Alzheimer’s disease, maybe you would be interested in reading this article. Alzheimer’s disease affects millions of people worldwide. It is the leading cause of dementia in the elderly but is also attributed to the normal process of aging.
A person with Alzheimer’s disease is said to have some sort of degeneration in the brain. This degeneration causes deterioration in a person’s functioning in terms of memory, language, calculation, visual-spatial perception, judgment, abstraction, and behavior. The brains of the people affected by Alzheimer’s disease are said to have structural changes in the form of neurofibrillary tangles, plaques and deformities in the blood vessels. There are also structural changes in the nerve cells and there is the presence of fat deposits in the brain tissues. These changes all lead to deterioration of the functioning of the individual.
So, what causes Alzheimer’s disease? There are some theories which say that the cause is actually unknown but is hereditary. People with Alzheimer’s disease have a characteristic type of protein called AZ-50 in the brain during the early stage of the disease. It is said that AZ-50 may actually cause degeneration in the brain later on causing a reduction in the life expectancy rate of patients to 30-60%.
People may manifest signs and symptoms of Alzheimer’s disease on or after age 65. It is said that the prevalence of Alzheimer’s disease doubles for every 5 years when a person ages beyond 65 years old.
There are several stages of Alzheimer’s disease. Stage 1 is characterized by recent memory loss, increased irritability, impaired judgment, loss of interest in life, decline of problem-solving ability, and reduction in abstract thinking.
During Stage 2, a phase which lasts for about 2 to 4 years, there is a decline in the patient’s ability to manage personal and business affairs, an inability to remember shapes of objects, continued repetition of a meaningless word or phrase (perseveration), wandering or circular speech, wandering at night, restlessness, depression, anxiety, and intensification of cognitive and emotional changes of Stage 1.
Stage 3 is characterized by impaired ability to speak, inability to recognize familiar objects, inability to use objects properly, inattention, distractibility, involuntary emotional outbursts, urinary or fecal incontinence, lint-picking motion, and chewing movements. Progression through stages 2 and 3 varies from 2 to 12 years.
Stage 4, which lasts approximately 1 year, reveals a patient with a masklike facial expression, no communication, apathy, withdrawal, eventual immobility, assumed fetal position, no appetite, and emaciation or dramatic loss of weight. This is the final stage of Alzheimer’s disease.
If you have a loved one with Alzheimer’s disease, the best thing that you can do is to bring the patient to your physician, who will take a thorough medical history and physical exam. He or she may prescribe medicines for your loved one or may refer him or her for rehabilitation or other forms of treatment.
If you are living with a person with early-stage Alzheimer’s disease, here are some tips for you. First, you should keep requests for the patient simple. Next, avoid confrontation and requests that might lead to frustration. Remain calm and supportive if the patient becomes upset. Also, you should be able to maintain a consistent environment and provide frequent cues and reminders to reorient the patient. You should be able to adjust expectations for the patient as he or she declines in capacity.
You should be able to promote activities of daily living to the fullest, considering the person’s functional ability. You should be able to give the person variable assistance or simple directions to perform those activities. Anticipate and assess the person’s needs mainly through nonverbal communication because of the inability to communicate meaningfully through speech. Many times emotional outbursts or changes in behavior are a signal of the person’s toileting needs, discomfort, hunger, or infection.
To maximize orientation and memory, provide a calendar and clock for the person. Encourage the person to reminisce, since loss of short-term memory triggers anxiety in the patient.
Emotional outbursts usually occur when the person is fatigued, so it is best to plan for frequent rest periods throughout the day.
Maintain physical safety of the person by securing loose rugs, supervising electrical devices, and locking doors and windows. Lock up toxic substances and medications. Supervise cooking, bathing, and outdoor recreation. Be sure that the person wears appropriate identification in case he or she gets lost.
Terminate driving by removing the car keys or the car. Provide a safe area for wandering. Encourage and anticipate toileting at 2- to 3-hour intervals. Change incontinence pads as needed, but use them only as a last resort. Bowel and bladder programs can be beneficial in the early stage of the disease.
Provide structured activity during the day to prevent night wandering. If confusion and agitated wandering occur at night, provide toileting, fluids, orientation, nightlights, and familiar objects within a person’s view. Some persons with Alzheimer’s disease respond calmly when given the security of a stuffed animal or a familiar blanket.
Encourage other family members or friends to verbalize their emotional concerns, coping strategies, and other aspects of caregiver role strain. You should refer to local support groups, clergy, social workers, respite care, day care, and attorneys.