Table of Contents
- Keep environmental distractions and noise (television, radio) at a minimum if possible. (Even normal noises, such as people talking outside a room, may seem threatening and trigger agitation or aggression.)
- Speak clearly in a gentle tone of voice using simple words and short sentences. Allow enough time for a response.
- Offer diversions, such as a snack or car ride, if the patient starts shouting or exhibiting other disruptive behavior.
- Maintain as natural an attitude as possible. Patients with Alzheimer's disease can be highly sensitive to the caregiver's underlying emotions and react negatively to patronization or signals of anger and frustration.
- Showing movies or videos of family members and events from the patient's past may be comforting.
Although much attention is given to the negative emotions of patients with Alzheimer's disease, some patients become extremely gentle, retaining an ability to laugh at themselves or appreciate simple visual jokes even after their verbal abilities have disappeared. Some patients may seem to be in a drug-like or "mystical" state, focusing on the present experience as their past and future slip away. Encouraging and even enjoying such states may bring some comfort to a caregiver.
There is no single Alzheimer's personality, just as there is no single human personality. All patients must be treated as the individuals they continue to be, even after their social self has vanished.
Bathing and Dressing. For the caregiver, grooming the patient challenging. For one thing, many patients resist bathing or taking a shower. Some patients find bathing confusing or frightening. Some spouses find that showering with their afflicted mate can solve the problem for a while. Establishing a daily and familiar routine can be helpful.
Often patients with Alzheimer's disease lose their sense of color and design and will put on odd or mismatched clothing. It is important to maintain a sense of humor and perspective and to learn which battles are worth fighting and which ones are best abandoned. Caregivers can pick a selection of outfits and allow the patient to select a favorite. Try to choose clothes that are easy to put on and take off.
Driving. As soon as Alzheimer's is diagnosed, the patient should be prevented from driving.
Wandering. A potentially dangerous trait is the patient's tendency to wander. At the point the patient develops this tendency, many caregivers feel it is time to seek out nursing homes or other protective institutions for their loved ones. For those who remain at home, the following precautions are recommended:
- Locks should be installed outside the door, which the caregiver can open, but the patient cannot.
- Alarms may be installed at exits.
- A daily exercise program should be implemented, which may help tire the patient.
- The caregiver should contact organizations, such as Alzheimer's Association or Medic Alert, for identification supplies and procedures that help locate patients who wander away from home and become lost.
Speech Problems. Speech therapy combined with Alzheimer's disease medications may be helpful for maintaining verbal skills in patients with mild symptoms.
Sexuality. In many cases, the patient becomes uninhibited sexually. At the same time, the patient's physical deterioration and receding capacity to recognize the spouse as a known and loved individual can make sexual activity unattractive for the caregiving spouse. Other patients may lose interest in sex. If sexual issues are a problem, they should be discussed openly with the doctor. Ways should be found to maintain non-sexual physical affection that can bring comfort to both the patient and the spouse.
Review Date: 06/22/2010
Reviewed By: Harvey Simon, MD, Associate Professor of Medicine, Harvard Medical
School; Physician, Massachusetts General Hospital. Also reviewed by
David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org)
