As a young girl, I thought the words “Alzheimer’s” and “dementia” had to do with old age. I have begun to suspect that my mother is beginning the early stage of some form of dementia, so I did some research and realized that I, now at mid-life, should be paying attention to this disease as well. As with other illnesses, our lifestyle plays a vital role prior to onset. Typically the healthier we are overall, the longer we can keep symptoms at bay.
First let’s define dementia. Dementia is an umbrella term for the symptom of a progressive decline in the cognitive function of the brain. These multiple brain impairments are caused by damage or changes in the brain. While Alzheimer’s disease (AD) is not the only type or cause of dementia, it is the most common. Dementia can be the result of other conditions as well. Elderly loved ones are most vulnerable to developing AD - and age is the most common risk factor of Alzheimer's. Most patients with AD are over the age of 65 with women living an average of 4.6 years after diagnosis and men living 4.1 years. Alzheimer’s disease is not to be confused with normal aging and it is not inevitable. But, it is an irreversible disorder that leads to the loss of physical and mental capacity. Simply put, Alzheimer’s is an unknown cause of brain disease that leads to dementia.
A recent CNN article stated that more than 5 million Americans are living with Alzheimer’s today and another person is developing the disease every 69 seconds. By 2050, the number of people living with AD is expected to triple.
Warning Signs of Alzheimer's Disease
First of all, if you suspect you or someone you love is displaying symptoms, seek a thorough evaluation by a medical professional. The Alzheimer’s Association has a 10 Warning Signs and Checklist that may be helpful to you:
- Memory Loss that disrupts daily life. One of the most common signs of AD is forgetting recently learned information. Other signs may be forgetting important dates, names, events, or asking the same question over and over again.
- Challenges in planning or solving problems. Some may experience changes in ability to develop and follow a plan or work with numbers.
- Difficulty completing familiar tasks at home, at work or at leisure. People with AD often find it hard to complete daily tasks. Sometimes having trouble driving to a familiar location, managing a budget or remembering the rules of a favorite game.
- Confusion with time or place. People with Alzheimer’s can lose track of dates, seasons and the passage of time. They may have trouble understanding something if it is not happening immediately. Sometimes they may forget where they are or how they got there.
- Trouble understanding visual images and spatial relationships. For some, having vision problems is a sign of AD. They may have difficulty reading, judging distance and determining color or contrast. In terms of perception, they may pass a mirror and think someone else is in the room.
- New problems with words in speaking or writing. People with Alzheimer’s may have trouble following or joining a conversation. They may stop in the middle of a conversation and have no idea how to continue or they may repeat themselves. They may struggle with vocabulary, having trouble finding the right word or call things by the wrong name.
- Misplacing things and losing the ability to retrace steps. A person with AD may put things in unusual places. They may lose things and be unable to go back over their steps to find them again or they may accuse others of stealing.
- Decreased or poor judgment. People with Alzheimer’s may experience changes in judgment or decision making. Example would be if they use poor judgment when dealing with money, giving large amounts to telemarketers. They may pay less attention to grooming or keeping themselves clean.
- Withdrawal from work or social activities. A person with Alzheimer’s may start to remove themselves from hobbies, social activities, work projects or sports. They may have trouble keeping up with a favorite sports team or remembering how to complete a favorite hobby. They may also avoid being social because of the changes they have experienced.
- Changes in mood or personality. The mood and personalities of people with Alzheimer’s can change. They can become confused, suspicious, depressed, fearful or anxious. They may be easily upset at home, work, with friends or in places where they are out of their comfort zone.
How Will a Doctor Diagnose Alzheimer's Disease?
Remember some memory changes may be age related, but memory problems that interfere with daily life are a more serious matter. Since there is not one test to diagnose Alzheimer’s disease, your doctor may ask for a variety of tests to come up with a diagnosis. In addition to a physical exam he may ask for blood and urine tests. He may ask a series of questions that will assess cognitive and neurological functions. He may also check short-term memory, the ability to follow instructions, and problem solving skills with a test known as the Mini-Mental State Exam (MMSE) and the “mini-cog”. Reflexes, speech, coordination and balance of the person are also examined. Imaging tests may be required to help rule out other causes for the symptoms, like a stroke or tumor. A diagnosis may not be easy because Alzheimer’s warning signs may be confused with old age. Dementia can be caused by other things besides Alzheimer’s Disease, so some of these tests rule out other causes. If it is Alzheimer’s, early diagnosis is key because with treatment it will help the person live a better life, even though the disease is still progressing.
Treatment of Alzheimer's
Although there is no cure for Alzheimer’s, there are treatments available to alleviate or slow down the symptoms. Managing the symptoms of AD may require medication that is directed at the malfunctioning chemical messenger in the brain. These medicines have been shown to be successful in improving symptoms. Treatments aimed at reversing the disease have been largely unsuccessful. However, recent studies look promising and researchers are developing a better understanding of how the disease works. With early diagnosis you can participate in the course of treatment that will allow a longer period of independence and will allow you to make known your wishes for a long-term care plan.
Caring for Someone with Alzheimer's Disease
As an Alzheimer’s caregiver, your approach will depend on the progression of the disease. You will need to prepare emotionally and be ready to make material changes. You may not be able to control the behavior of the person you are caring for but you can control the environment, which is very important. Their sense of reality is very real to them so by maintaining a calm and safe environment you may be able to have some control of the behavior. Unfamiliar surroundings and loud noises are two triggers for difficult behavior and that may be some of the environment you are able to control. To prepare emotionally you will need to do research and understand as much of this disease as you can. Problem behavior is often a way in which an AD patient tries to communicate, so understanding these things can help you to face the difficult task of being an AD caregiver. Learn the triggers for problem behaviors and adapt the environment. Use the Internet or find local organizations that offer information and support. An AD patient will not benefit from you trying to correct them or engaging in an argument, therefore one of your goals should be to create a supportive and loving environment. You really need to know what to expect so that you can prepare emotionally and make any necessary changes for the short term and long-term duration of this disease.
- Good general health is important through physical exercise, proper nutrition, and socialization.
- A routine should be established; include familiar daily activities that provide meaning and a sense of purpose for the person with Alzheimer’s. For activities choose the time of the day when the person is most alert. Keeping things simple.
- Allow the person with Alzheimer's to complete as many things as possible independently.
- Keep danger at bay; remove obstacles that could endanger them. An example would be to hide the car keys, lighters, etc. What may appear safe to you may not be for a person with AD.
- Take care of yourself; allow yourself enough rest and relaxation. Recognize when the person’s behavior is more than you can handle.
- Minimize change to your routines and surroundings.
- Reword your request or statement if the person seems confused or anxious.
- Keep communicating in a loving and calming manner. Little reminders of the events for the day will help keep them calm.
- Remember that lost skills will not be regained.
by Deah Bowes