Could It Be Alzheimer's?
It’s normal for people to become a bit forgetful as they
age. So how can you tell a harmless "senior moment" from Alzheimer's
disease? One in nine people 65 and older have this devastating form of
dementia. In its first stages, Alzheimer’s may not be obvious to friends and
family. But there are some early warning signs to watch for.
Warning Signs: Memory
and Speech
In early Alzheimer’s, long-term memories usually remain
intact while short-term memories become sketchy. Your loved one may forget
conversations you had. They may repeat questions that were already answered.
The disease also disrupts speech, so they might struggle to remember common
words.
Warning Signs:
Behavior
In addition to memory loss, Alzheimer’s can cause confusion
and behavior changes. Your loved one may get lost in familiar places. Mood
swings and lapses in judgment are also common, as is poor hygiene. People who
were once stylish may start wearing stained clothes and forget to wash their
hair.
Don't Ignore the Signs
It's hard to face the thought that a loved one could have
this disease, but it's better to see a doctor sooner rather than later. First,
the diagnosis might be something else. The symptoms could be caused by a highly
treatable problem, like a thyroid imbalance. And if it is Alzheimer’s,
treatments work best when they’re used early in the course of the disease.
How Is It Diagnosed?
There’s no simple test for Alzheimer’s, so the doctor will
rely on you to describe the changes in your loved one. A mental status test,
sometimes called a “mini-cog,” or other screening tests can measure their
mental skills and short-term memory. Neurological exams and brain scans may be
used to rule out other problems, like a stroke or tumor, and they can provide
other information about their brain.
What Happens to the
Brain?
Alzheimer’s causes nerve cell death and tissue loss
throughout the brain. As the disease gets worse, brain tissue shrinks and areas
that contain cerebrospinal fluid become larger. The damage harms memory,
speech, and comprehension.
What to Expect
Alzheimer’s takes a different path in every person.
Sometimes the symptoms get worse quickly and lead to severe memory loss and
confusion within a few years. For other people the changes are gradual. It
could take 20 years for the disease to run its course. Most people live 3 to 9
years after diagnosis.
How Will It Change
Daily Life?
Alzheimer’s affects concentration, so your loved one may not
be able to do ordinary tasks like cooking or paying the bills. A study suggests
trouble balancing the checkbook is often one of the first signs of the disease.
As symptoms worsen, they may not recognize familiar people or places. They may
get lost easily or use utensils improperly, like combing their hair with a
fork. Incontinence, balance problems, and loss of language are common in
advanced stages.
Should My Loved One
Stop Driving?
Poor coordination, memory loss, and confusion are a
dangerous combination behind the wheel. If you feel your loved one should stop
driving, tell them why. If they won’t listen, ask their doctor to step in. If
they still insist on driving, contact the Department of Motor Vehicles for an
assessment. Then make other plans for their transportation needs.
Can Exercise Help?
Physical activity can help your loved one keep some muscle
strength and coordination. It might also boost their mood and help them feel
less anxious. Check with their doctor to learn which types of exercise are
appropriate. Repetitive activities, like walking, gardening, or even folding
laundry may be the best at giving them a sense of calm.
How Is It Treated?
There’s no cure for Alzheimer’s and no way to slow the nerve
damage it causes in the brain. But there are medications that appear to help
maintain mental skills and slow the disease’s effects. If your loved one gets
treatment early on, they may be able to stay independent and do their daily
tasks for a longer period of time.
The Caregiver's Role
If you’re caring for someone with this disease, you’ll
probably wear many hats -- cook, chauffeur, and accountant to name a few. While
you may have to handle meal planning and finances, encourage your loved one to
do some things for themselves. It may help to label cabinets with their
contents and put up sticky notes with reminders of daily tasks. Be sure to buy
a weekly pill box for their medications.
Challenges in
Caregiving
In the early stages, people with Alzheimer’s often
understand what’s happening to them. They may be ashamed or get anxious. Watch
for signs of depression, which the doctor can manage with medication. Later on,
your loved one may become paranoid or aggressive and could even turn on you.
Remember that the disease is responsible for this change. Tell the doctor about
this kind of behavior promptly.
Sundown Syndrome
Experts don’t know why, but some people with Alzheimer’s get
upset when the sun goes down. This tends to last through the evening and
sometimes all night long. To ease tension, keep the house well-lit and close
the drapes before sunset. Try to distract your loved one with a favorite
activity or TV show. Switch them to decaf after breakfast.
When Your Loved One
Doesn't Know You
Many people with Alzheimer’s have trouble remembering names,
even of people closest to them. A temporary fix is to put up pictures of people
they’re likely to see often or know well with names printed underneath.
Eventually, your loved one may no longer recognize faces and may react as if
family members are strangers. This can be distressing, especially for the main
caregiver.
Warning Signs of
Caregiver Stress
Caring for someone with Alzheimer's can be physically and
mentally draining. Signs of caregiver stress include:
Anger, sadness, and mood swings
Headaches or back pain
Trouble concentrating
Trouble sleeping
Take Care of Yourself
To avoid caregiver burnout, make sure you take at least a
few minutes to do something you enjoy every day. Stay in touch with friends and
keep up with hobbies when you can. Find a friend or relative to be your support
person. You can also join an online or local caregiver support group through
the Alzheimer’s Association.
Essential Documents
While your loved one is still able to make important
decisions, talk to an attorney about drafting advance directives. These are
legal documents that spell out what they want in terms of medical treatments
and end-of-life care. They should name someone to make health care decisions
and manage finances on their behalf. This will help avoid confusion later on if
they're no longer able to state their wishes.
Home Health Care
Many people want to stay in their own homes as long as
possible. That’s not easy if they have trouble getting dressed or using the
bathroom on their own. A home health aide can help with personal hygiene and
other daily tasks. You can also check with your local Area Agency on Aging for
information on services that deliver meals or provide transportation to the
elderly.
Assisted-Living
Facilities
There may come a day when your loved one can no longer be
cared for at home. If they don’t need 24-hour nursing care, an assisted-living
facility may be good choice. They provide housing, meals, and activities, but
are much less expensive than nursing homes. Look for one with an Alzheimer’s
special care unit that can give 24-hour supervision and personal care to meet the
needs of people with dementia.
The Later Stages
People with advanced Alzheimer’s may lose their ability to
walk, talk, or respond to others. Eventually, the disease can hinder vital
functions, like the ability to swallow. This may be the time to switch to
hospice care, which provides pain relief and comfort for people with terminal
illnesses.
How to Help Children
Understand
Children may feel confused, afraid, or even resentful when a
family member has Alzheimer’s. Let the child know these feelings are normal and
answer their questions about the illness honestly. Help them celebrate happy
memories of your loved one. You could create a scrapbook with pictures from
happier times.
Can You Prevent It?
Is there anything you can do to lower your chances of getting
this disease? Research in this area is ongoing, but diet and exercise appear to
be important. Studies show people who eat a Mediterranean diet rich in
vegetables, fish, and nuts and get plenty of physical activity are the least
likely to get Alzheimer’s.
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