Dehydration. Dehydration can become a problem. It is essential to encourage fluid intake equal to eight glasses of water daily. Coffee and tea are diuretics and will deplete fluid.
Eating Problems. Weight loss and the gradual inability to swallow are two major related problems in late-stage Alzheimer's and are associated with an increased risk of death. Weight gain, however, is linked to a lower risk of dying. The patient can be fed through a feeding syringe, or the caregiver can encourage chewing action by pushing gently on the bottom of the patient's chin and on the lips. The caregiver should offer the patient foods of different consistency and flavor. Because choking is a danger, the caregiver should learn to administer the Heimlich maneuver, which may be taught by the local Red Cross. In very late stages, some caregivers choose feeding tubes for the patient. They should be aware that feeding tubes have no measurable impact on survival.
Care for the Caregiver
About 80% of patients with Alzheimer's disease are cared for by family members, who often lack adequate support, finances, or training for this difficult job. Few diseases disrupt a patient and his or her family so completely or for so long a period of time as Alzheimer's. The patient's family endures two separate losses and grieves twice:
- First, they must grieve for the ongoing disappearance of the personality they recognize. Dealing with the patient throughout the course of the disease is like Alice's fall down the rabbit hole into Wonderland. No sooner has the caregiver grappled with one set of problems, when the patient's further deterioration creates new and more intractable ones.
- Finally, the caregiver must grieve the actual death of the person.
Often, caregivers themselves begin to show signs of mental disorder or ill health. The disease may even have negative effects on the immune systems of the patients' partners. Depression, empathy, exhaustion, guilt, and anger can play havoc with even a healthy individual faced with the care of a loved one suffering from Alzheimer's. The care-giving spouse is usually elderly and often frail. Children are likely to have grown up and may live far away.
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