Alzheimers Disease A Carers Guide

Alzheimers Disease A Carers Guide



Alzheimer's Disease - a​ Carer's Guide
There are various definitions of​ Alzheimer ’s disease including:
- The slow onset of​ memory loss leading to​ a​ gradual progression to​ a​ loss of​ judgement and changes in​ behaviour and temperament.
- a​ living death
- The global impairment of​ higher functions, including memory, the capacity to​ solve problems of​ day to​ day living, the performance of​ learned percepto-motor skills (for example tasks like washing, dressing and eating), and the control of​ emotional reactions in​ the absence of​ gross clouding of​ consciousness.
Memory Loss
Memory loss occurs in​ all cases of​ Alzheimer’s disease .​
The most recent memories are the first to​ be affected, the things we’ve done in​ the last few hours or​ days .​
Later, as​ the disease progresses, the past memory also deteriorates.

The fact that memory loss is​ such an​ important feature of​ Alzheimer’s, the testing of​ a​ person’s memory is​ an​ easy and cheap method of​ diagnosing the condition .​
Questions asked should be extremely basic, for example:
- What day is​ it​ today?
- How old are you?
- Where are we now?
- What year is​ it?
- What month?
- Count backwards from 20 to​ 1.
These questions will test a​ person’s short term memory, and also orientation; disorientation being another problem experienced by Alzheimer's suffers.

Disorientation
Disorientation, or​ not knowing who or​ where you are, is​ closely connected to​ memory loss .​
Typically, an​ Alzheimer’s sufferer will forget birthdays, become unsure of​ what day it​ is, and even forgets their own name .​
You can understand why Alzheimer’s has been called ‘a living death’.
Because it​ is​ the short-term memory that goes first, suffers who go out alone have often returned to​ a​ house they lived in​ years ago, thinking they have come home.
Disorientation inside the home can become a​ problem too but not until the disease is​ in​ its later stages .​
It is​ important that nothing is​ moved or​ changed in​ the home to​ preserve continuity .​
If their environment and routine remains unchanged, an​ Alzheimer’s sufferer will remain more content and confident; change the environment however and their confusion and disorientation becomes readily apparent .​
This is​ why treatment at​ home rather than in​ hospital is​ preferred and transfer to​ hospital should be a​ last resort.
Personality Change
One of​ the cruellest aspects of​ Alzheimer’s disease is​ the change in​ personality many people experience .​
Often, the general behaviour and personality of​ Alzheimers suffers in​ the later stages will be in​ complete contrast to​ their usual behaviour they exhibited in​ earlier life.
Mood swings, from being ecstatically happy to​ extremely sad, verbal and sometimes physical aggression, and extreme anxiety and nervousness often affect the Alzheimers sufferer and, of​ course, the carer who can help best by offering continuous reassurance and patience.
Personal Hygiene
Personal hygiene often becomes a​ major issue with the sufferer forgetting to​ wash and bathe .​
Body odour, and stained and soiled clothing and hands can be a​ cause of​ great stress and result in​ a​ cruel loss of​ dignity.
Communication
During the early stages understanding simple speech remains unaffected, but finding the correct words can be a​ problem and the Alzheimers sufferer will often leave sentences unfinished .​
The taking of​ messages particularly over the telephone can be difficult and this is​ often one of​ the first signs of​ dementia.
As the disease worsens communication will become more difficult as​ comprehension skills decrease .​
Eventually their whole speech can become gibberish until eventually the Alzheimer sufferer will cease to​ talk altogether and will withdraw into his or​ her small world.
Sleep
Although the amount of​ sleep required by an​ Alzheimers sufferer is​ unlikely to​ change, their sleep cycle may do .​
So, instead of​ wanting to​ sleep at​ night and be awake during the day, this could become reversed .​
This isn’t a​ problem of​ itself except for the carer who will have his or​ her nights disrupted.
The carer is​ advised to​ keep the patient active and awake during the day as​ much as​ possible, even though it​ is​ tempting to​ seize an​ opportunity to​ do some chores and enjoy some peace and quiet should the sufferer fall asleep .​
a​ warm drink at​ bedtime may help, although any problems with incontinence should be considered .​
Ensure there are no other reasons for the restless nights, such as​ joint pain or​ night cramps .​
In the event the latter are a​ problem, administer mild painkillers .​
In the worst case scenario, many people use a​ night sitting service to​ ensure the sufferer is​ closely supervised while the carer gets a​ few nights of​ undisturbed sleep .​
Malnutrition
Eating and drinking can be a​ problem with Alzheimer suffers .​
More accurately the lack of​ food and drink and the resulting malnutrition is​ the problem.
A sufferer may develop an​ irrational fear of​ the food you are providing, or​ they may simply forget or​ refuse to​ eat .​
Two likely causes of​ the latter are ill-fitting dentures, especially if​ the sufferer has lost weight; and constipation .​
a​ well balanced diet with plenty of​ roughage and a​ high fluid intake will help prevent constipation.
General Advice For Carers
It is​ difficult to​ judge who has the worse time, the Alzheimers sufferer or​ the carer .​
In the early stages of​ the disease it​ is​ probably the sufferer, in​ the latter stages it​ is​ undoubtedly the carer.
Help minimise disorientation by not moving anything in​ the home .​
To do so will make their confusion worse.
Admit an​ Alzheimers suffer to​ hospital as​ a​ last resort .​
Once you do so disorientation and confusion will increase markedly.
Do not let a​ sufferer out alone, they may have difficulty finding the way back home.
Do all you can to​ help the sufferer maintain dignity .​
- a​ warm drink or​ a​ tot of​ their favourite alcoholic drink may aid sleep at​ night .​
- Try to​ keep the patient active and awake during the day.
- Keep a​ cold drink nearby to​ remind the sufferer to​ take fluids .​
- Keep disruption to​ routine to​ a​ minimum to​ prolong the Alzheimers sufferer’s independence as​ long as​ possible.
Closely supervise medication .​
It is​ very easy for the Alzheimers sufferer to​ forget they have taken their medication, and take it​ repeatedly .​
Alzheimer’s disease is​ progressive and incurable, although there are drugs that can slow the progression .​
It is​ one of​ the saddest diseases in​ that it​ is​ difficult to​ care for or​ regularly visit someone who no longer knows your name or​ recognises you.




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