How to take care of Alzheimer patients at home?

Alzheimer vs. Dementia

Dementia refers to a decline in mental and cognitive abilities that impair one’s daily life. Alzheimer’s disease is the most common type (60-80%) of dementia. It is a progressive nervous system disorder in which the neurons (the cells of the brain cells) are gradually destroyed, and thus, a person’s behavior, thoughts, and emotions are affected. Once damaged, Neurons cannot be repaired, or damaged neurons cannot be replaced, as neurons do not divide. Thus, there is a progressive worsening of memory, ability to concentrate, among others. Care of patients with Alzheimer’s by family members, friends, and medical support staff can be challenging. Since there is no definitive treatment for dementia, palliative care remains the mainstay of therapy along with some drugs (rivastigmine, galantamine, and donepezil), which act by increasing some other neurotransmitters in the brain. Thus, caring for patients with Alzheimer’s makes a huge difference in their lives. Many of the caregivers feel overwhelmed over a while as they see the person deteriorating further in cognitive, behavioral, physical, and functional abilities. It may lead to neglect of one’s health in place of patient care and put one at an increased risk of stress, burnout, anxiety, loneliness, and depression. Several strategies help the caregiver cope with dementia care while making the caregiving journey meaningful and less challenging.

Alzheimer Stages: Understanding the disease

As mentioned above, Alzheimer’s is a progressive disease. There are 3 broad stages in the course of the disease: mild, moderate, and severe. The care required thus varies upon the stage in which the person is. Mild Alzheimer’s: Patients with mild or early-stage Alzheimer’s disease can still have independent functioning in their daily life. Difficulty in remembering recent events, concentrating, and problem-solving are some of the earliest signs of neurocognitive decline in Alzheimer’s disease. Moderate Alzheimer’s: It is associated with significant loss of memory, a state of confusion, and the following physical symptoms: Difficulty in recognizing family members, close friends, and relatives; impaired co-ordination while performing daily tasks; restlessness and insomnia; urinary and fecal incontinence; and some personality changes. Severe Alzheimer’s: It is the last stage of Alzheimer’s. People cannot carry out independent daily living activities such as dressing up, walking from one point to another, and having a meal. They lose their awareness of the environment and cannot converse, recognize close family members, and lose time, place, and personal orientation.

Common do’s and don’t

Creating a Routine: A daily routine with a plan of activities to help patients with Alzheimer’s to feel comfortable and adapt to their surroundings. Thus, maintaining a routine gives a sense of continuity to the patients and the caregiver as well. Any changes, such as the change of caregiver or change of setting, should gradually adjust to the new environment and at his own pace.

Planning Activities:

The person with Alzheimer’s must be kept engaged in some work to slow the cognitive decline. Activities help to reinforce the neuronal circuitry in the brain and thus, promote memory retention. These include:

• Listening to music and watching light-hearted movies/shows,
• regular exercising, such as walking, stretching exercises, playing board games,
• engaging in hobbies like gardening, cooking, stitching, etc.

When the person feels his best in energy or enthusiasm, they may feel fatigued and low on energy at others. Thus, scheduling your activities according to these periods will help you spend quality time with the person. Small cards mentioning the disease the person is suffering from can also be kept with the person, and he/she be instructed to show it if they feel uncomfortable. Alternatively, such cards can be given to other service providers at small businesses, such as cafes and restaurants, to give a prior intimation. The card’s content may have something written, such as ‘ My father suffers from Alzheimer’s disease. He might say or do some unexpected things. Thank you for your understanding and co-operation.’ Keeping lines of communication open: As mentioned, as Alzheimer’s progresses, the person’s ability to meaningfully communicate decreases. Thus, they may find it difficult to express themselves or form cogent/ coherent thoughts. Some communication body language which makes communication effect include:

• Maintaining eye contact while speaking.
• Addressing the patient by his name
• Assuming a welcoming and relaxed posture
• Trying to be calm and not frustrated while conversing.
• Avoiding a breakdown in front of the patient

It also gives the caregiver an outlet for his expressions and understanding the patient better. Monitoring nutrition: We are built by the nutrition we take. Patients with Alzheimer’s are more prone to lose weight since they frequently forget their last-taken meals, are no longer conscious of their mealtimes and have trouble chewing and swallowing. To overcome these challenges, incorporate the following changes by giving nutritious foods, serving meals at the same time daily, serving food on colorful plates, selecting foods that are easy to chew and swallow, and ensuring that their calorie requirements are met 4-5 small portions instead of 2 big portions. Also, multivitamin tablets and vitamin D and calcium tablets should be given to boost their immunity.

Boosting Self- Image in Alzheimer’s Disease  

Persons with Alzheimer’s should not lose touch with their selves. Thus, being comfortable with themselves is one of the first steps towards their self-confidence. Caregivers can promote that by encouraging them, supporting them, and helping them with their hygiene and grooming activities. Some activities include:

• Eating together at the same time.
• Helping them comb on their hair while making your hair
• Allowing them extra time for dressing up and makeup (if they use one)
• Buying accessories with velcro’s or zippers instead of buttons.

Ensuring their safety: Daily chores pose a challenge to people’s safety with Alzheimer’s due to their forgetfulness, making them fearful or feel unsafe. A simple transition from a concrete floor to a wooden staircase may confuse them, or they couldn’t make the difference between a glass pane separating two rooms. Some safety tips, if incorporated, reduce the chances of accidents besides making them comfortable.

• Blunting or padding sharp corners
• Giving them soft yet sturdy shoes
• Putting markers across the floor, in the form of fluorescent tapes, if they venture out at night.
• Sticking “hot” and “cold” signs near taps
• Ensuring timely medications through reminders or apps
• Preventing burn injuries by installing safety locks on stoves
• Keeping matches and lighters out of reach. If the person with dementia smokes, one must always supervise smoking and ensure that fire extinguisher are accessible in worst-case scenarios.
• Avoiding activities like driving in moderate disease as it poses a health risk to the patient and society, or ensuring that they have someone to help them out.

Adopting a furry friend: It has been scientifically shown that having pets reduces stress in children and older people. Pets like dogs and other animals can provide continuous love and companionship for someone who has Alzheimer’s. Besides, taking care of the pets gives a sense of purpose and helps the person have a sense of grooming responsibility. If the disease is advanced or difficult for the person o care for the pet, then help can always be asked for. Asking the neighbor or other family member to take the dog for a walk or ensuring that the cat is fed on time are just two ways to ensure that the pet stays together with the person suffering from Alzheimer’s. Searching for local charities and organizations that provide such care or community animal shelters helps as well. Bottom of Form Keeping oneself updated: One can always take free tutorials or classes covering a broad range of topics, ranging from the early signs and symptoms of Alzheimer’s, behavioral changes, which can be anticipated, psychological training, and maintaining finances. There are also stepwise guides, which include tips on helping someone groom, such as bathing, helping them with toiletries, eating, and much more.

Caring for self in Alzheimer

Taking care of a loved one with Alzheimer’s is both a humbling and noble experience, which may, at times, be overwhelming. It may affect the ability of the person to socialize and work out his commitments. Besides, it is important to take care of one’s physical and mental social wellbeing while caring for others at the same time. Also, one cannot take care of others if they are unfit or in a disturbed state of mind.

Some of the following tips may help in reducing the stress the burnout while at the same time promoting self-love and compassion.

Sharing one’s feelings: It is natural to avoid talking about a loved one’s illness to one’s friends or family. However, talking your heart-out about fears, apprehensions, and frustrations helps relieve the tension and provides an outlet. One may also join a support group or ask for a counselor’s support if feeling worse. Getting enough sleep: A sound sleep of 7-9 hours each night goes a long way in promoting freshness and enthusiasm every day one wakes up. Being active: A good 30 minutes of moderate-intensity exercise daily (150 minutes a week) promotes endorphins release (the feel happy substances). It promotes overall wellbeing and helps improve sleep as well. Being gentle to oneself: Often the caregivers are hard on themselves and blame themselves, whether for feeling miserable or the misplaced idea that they are not doing enough for their loved ones. It may lead to a vicious cycle of anger, frustration, and helplessness. But it is important to remain calm in the face of adversity. Well, one can’t change the circumstances, but one can surely change one’s response to one’s circumstances! Deciding upon professional help: Alzheimer’s patients may require professional help if they need full-time assistance with daily and personal activities such as bathing, moving, or feeding. Any injury which makes the patient bed-ridden or any cerebral accidents which make the person perpetually agitated or make him wander also warrants professional help. Eventually, it is up to the family members and the caregiver to decide upon the timing of asking for professional help.  

Conclusion:

In conclusion, the care of people with Alzheimer’s is both science and art. The caregivers may experience a gamut of positive and, at times, negative emotions. It is important to focus on the positive aspects while coping up with the negative stressors. Besides the ways mentioned above, caregivers should take the help of both family members and professional personnel to monitor the patient’s progress. Self-love and self-care for caregivers are essential. It goes a long way in preventing adverse health outcomes. Exercise, self-compassion, meditation, and controlling one’s emotional impulses are some of the ways by which they can help themselves.  

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