Caregiver Skills for Severe Stage Alzheimer's

by Christine Kennard Health Professional

Alzheimer's disease can broadly be categorized in seven stages.
The severe stage of Alzheimer's suggests
that it is probably
around five
years since the disease was first
diagnosed. Bodily functions are now failing. The caregiver has, over the years, taken on more and more responsibility for the care and wellbeing of the person with Alzheimer's. In this sharepost I have put together some tips to help you be a more effective caregiver in the severe, stage 7, of Alzheimer's.

First Big Rule-Caregivers Must Look After Themselves

You need to get support and care for yourself, from friends, family, through your local chapter of the Alzheimer's Association and from websites like OurAlzheimer's. You also need outside agencies to help you
where possible. Respite care facilities in nursing homes for people with dementia are going to be increasingly important as are Day Care centers. It will give you time to re-energize as much as possible and can give you some "Me" time.

How to find Respite Help for the Caregiver

Questions About Nursing Homes Answered

Compare Nursing Homes in your Area

Memory in Severe Stage Alzheimer's

All memory in stage 7 Alzheimer's is severely compromised. The person
may still have lucid moments and you can still use these
times to interact - perhaps using photos. Do not remind them what they have forgotten. As a caregiver you have to understand that the devastating brain damage caused by Alzheimer's means they often do not recognize you and may call you by other names. It can
feel very distressing but it is also an overt sign of the extent of brain damage you are working with.

How to Maximize Communication Skills in Severe Stage Alzheimer's

In the severe stage of Alzheimer's the person has lost the ability to interact properly and verbal skills are radically changed. Expect conversational replies to be just single words or gestures. Caregivers have to find other means to understand what the message may be.

  • Words often have to be interpreted or are better understood with other forms of communication. These include things such as body language, through noises such as grunts, shouts grimaces, laughing, crying, or through their refusal to do things such as eat or move.

  • Touch becomes more important to both the caregiver and the care receiver. However, it can soothe as well as cause alarm if the person with Alzheimer's does not understand what is happening, for example taking them to the bathroom.

  • Face them when you talk. Talk slowly and in a gentle and soft way (or at the level they can hear). Lighten the situation with smiles, distraction-"look outside, what a beautiful tree/day etc", "Chocolate cake for lunch".

How to Help People with Severe Stage Alzheimer's Do Tasks

Most skills, such as
dressing and washing, are rarely initiated but if they are assist rarther than take over. Approach tasks by explaining briefly and simply what you are going to do. Talk in a calm, warm and friendly manner. Do not shout.

If the person with Alzheimer's becomes too distressed (angry, violent, cries) stop if you can, although that will not always be possible. They are not behaving in that way to annoy you, it is because they are confused, frustrated or frightened. They may also be communicating to you what they want.

How to Meet the Physical Needs in Severe Stage Alzheimer's

As caregiver you are in charge of hygiene, creating a safe environment, fluid intake and an adequate diet
and, as much as you are able, providing dignity and respect.

Wandering or agitation may result from needs not being met. Examples are; needing the bathroom, wanting to get exercise, being hungry, wanting to go to bed. Inappropriate behaviors such as attempting sexual intimacy are common problems in severe stage Alzheimer's. Try to redirect them to other activities or take them to another room. If the problem is not resolved seek the help or a doctor. Sudden increases in agitation, wandering or
violence can be the result of physical conditions such as infection, constipation and other illnesses that require treatment.

As their physical condition deteriorates their lack of mobility
may cause skin problems such as pressure sores. There are products such as flannel coated rubber pads and
incontinence aids that can prevent or ease these problems.

Incontinence Products and Medicare Cover

Managing incontinence

How to Provide Activities in Severe Stage Alzheimer's

Even in stage 7, severe Alzheimer's it is important to provide some activity. Taking them out in the fresh air is often really appreciated. You must make sure they are warm enough as
older people often need extra layers of clothing even when it is quite warm. If the person is bedridden the bed can be pushed outdoors and/or the placed near a window.

Stroking, rocking, singing and most importantly, smiling, should be involved in the activity. Effective communication is the key to all activities at all stages of Alzheimer's. Two-way communication is vital to wellbeing and self-worth. Communication is a fundamental human need that never goes away and should never be under-estimated in terms of its value to Alzheimer's patients.

Medications in Severe Stage Alzheimer's

It is always important to seek medical help for their physical, behavioral and psychological needs. Medical conditions may result in changes to behavior.

Alzheimer's Treatments and Medications
will provide you with more information.

More about Caregiving and Alzheimer's Disease

Coping with the Final Stages of Alzheimer's**

The Right Time for Mom to Die-Finding the Right Resources

Information About Alzheimer's Disease

Alzheimer's Foundation of America

Christine Kennard
Meet Our Writer
Christine Kennard

Christine Kennard wrote about Alzheimer's for HealthCentral. She has many years of experience in private and public sector nursing care homes for people with dementia. She has worked in a variety of hospital, public and private health settings and specialized in community nursing. Christine is qualified in group analytic psychotherapy, is registered in general and mental health nursing and has a Masters degree.