Estimates of the number of Americans with Alzheimer’s disease often vary, but the U.S. National Institutes of Health puts the range between 2.5 million and 4.5 million. One thing is certain — the number of Alzheimer’s disease cases will rise significantly as the baby boomers swell the numbers of the over 65s. It is projected that 10 million baby boomers will develop Alzheimer's disease.
If one has to care for a patient with dementia or Alzheimer’s, it is important to know what things to expect. This can help the famliy caregiver plan for the future and cope with the sometimes overwhelming burdens of caring for the patient.
The family caregiver will observe and have to handle many aspects of behavioral and physical problems.
The Alzheimer’s patient with dementia gradually loses capacity to remember, understand, speak or write coherently (aphasia). The patient may become repetitious and engage in meaningless behavior. The family caregiver will need to learn verbal techniques, such as using short sentences, pleasant tone of voice, memory aids and simple messages, as well as effective nonverbal communications, including eye contact and touch.
Alzheimer’s patients tend to pace excessively, lose their way in once familiar surroundings (apraxia), and experience gait (walking) difficulties. Care should involve providing a secure home environment to prevent falls, such as having adequate lighting, removing loose rugs, and rearranging the furniture to allow better mobility.
There should be protected areas for pacing and walking around, mobility devices. The patient will need to engage in exercises that maintain posture and enhance muscle strength. The family caregiver should receive instructions on how–to techniques to assist patient's in moving, to be ambulatory as long as possible and to lower the chances of falling.
As the disease progresses, the Alzheimer’s patient will suffer bladder and bowel incontinence. Generally, these two conditions will happen separately. Bladder incontinence usually comes earlier, while bowel incontinence occurs toward the terminal stages.
Caregivers can help the Alzheimer’s patient prevent incontinence with tactics like timing bathroom breaks to coincide with observed patterns of incidence or using clothes that can be easily removed. There are also aids such as adult diapers and incontinence pads & liners that minimize skin breakdown, specially designed urinals, or even safety aids that help patients find the bathroom more quickly.
In addition, the caregiver needs to be sensitive to the patient’s embarrassment when incontinence occurs and frustration over the loss of control of these essential functions.
The level of assistance required will vary with individual patients. The caregiver’s goal is to allow independence of movement as much as the patient is capable, to encourage his or her efforts, and to help only to the extent needed. A patient may be able to perform an activity one day and be helpless the next.
The faculties of cognition and perception become compromised in Alzheimer’s patients. They may try to cover up these problems and their fear of failure, or avoid embarrassment by becoming withdrawn. The family caregiver can help by being reassuring and providing dependable support that helps the patient overcome anxieties and gain confidence. The caregiver can use memory aids to make up for fading memory and manipulate the home environment to reduce patient’s confusion.
The challenge of caring for Alzheimer’s patients can overwhelm the dedication and patience of the most competent caregiver. It is helpful for the family caregiver to join a support group to learn more and to share experiences with others in the same situation.