Alzheimer’s disease is the most common type of dementia that can have a big impact on people’s daily routines and activities. It is a progressive disease that slowly advances in three stages- early, middle and late. Symptoms vary from person to person as the disease affects people in different ways, and the symptoms worsens over time depending on the rate at which the disease progresses. Individuals diagnosed with this condition are said to survive not very long, but the truth is an individual can live as long as 20 years with proper care and support and medical supervision.
Early-Stage Alzheimer’s
In this stage, a person is able to function independently without anyone’s support, and can actively take part in regular tasks, such as can drive, work and be a part of social activities. At the same time, the individual might feel like having memory lapses, such as forgetting familiar words or places or the location of everyday objects. Symptoms are not apparent at this stage, but one may be at the receiving end of common difficulties like
Losing or misplacing a valuable object,
Not being able to come up with the right word or name,
Having difficulty carrying out tasks in social or work settings,
Forgetting material that one just went through,
Experiencing increased trouble with planning and organizing.
These symptoms might come in the notice of family members, who should immediately seek medical attention as a doctor would be able to identify symptoms using certain diagnostic tools. A diagnosis of early stage Alzheimer’s disease can be very daunting not only for those with the disease, but also everyone who loves and cares about them.
As a caregiver, you may find yourself in a new and unfamiliar role, which can take a toll (gradually) on both your physical as well as emotional health. There might be a lot of questions bothering you, such as what can be expected as the disease progresses, and whether you will be able to support the person living with dementia. With an early diagnosis, the person living with the condition can make use of available treatments and you both can benefit from local resources and support services.
A big challenge faced by caregivers is not knowing where to draw the line, in terms of how much assistance to give or when to give it because the person with early-stage dementia is primarily independent with dressing, walking, bathing and may still drive, volunteer or work. You can start off by ensuring your loved one’s safety first (find out if there’s an immediate safety risk for the person to perform a particular task alone), it is important to not let stress take the better of you for your mind to remain active to be able to prioritize tasks or actions that do not cause unnecessary stress for the person with dementia, instead of what will happen in the future focus on his/her current needs (always assume the person is capable of completing a task, don’t intervene), talk it out- ask your loved one if they need anything or the frustrations they may be experiencing, and accordingly make a plan, find activities that you both can do together and keep the conversation flowing about expectations for how you will provide support.
As a caregiver, you may experience a few emotions, such as denial, fear, stress/anxiety, anger/frustration, grief/depression- which you need to deal with carefully. It’s better that you talk about these emotions together, which can help you work past the difficult feelings and spend more time happy with each other.
Tips to help your loved one in early stage stay healthy for as long as possible:
Encourage physical activities,
Prepare meals that maintain a balanced diet,
Create a daily schedule that encourages quality sleep and socialization with others,
Identify situations which may be too stressful for your beloved, and
Work together to find what can calm him down and relax.
It is equally important that you maintain your own health, some tips are:
Find out ways you can get support now,
Build a support network,
Connect with other caregivers,
Ask for and accept help,
Do not take offense in anything,
Rest when needed,
Stay healthy through diet, exercise and regular health checkups, and
Stay engaged
Equip yourself with information and resources which will empower you to overcome any difficulty with ease. For example, accept the diagnosis, learn more about Alzheimer’s disease, learn about treatments, and plan for the future.
Middle-Stage Alzheimer’s
This is usually the longest stage and lasts many years. Symptoms may include (varies from person to person):
Not being able to recall events or personal history,
Experiencing confusion about the place one is at and the day one is in,
Difficulty controlling their bladder and bowels,
Experiencing changes in sleep patterns, such as sleeping during the day and becoming restless at night,
Increased instances of wandering and becoming lost,
Feeling moody or withdrawn, particularly in socially and mentally challenging situations,
Noticeable changes in personality or behavior, including suspiciousness and delusions.
In this stage, the person living with Alzheimer’s can still take part in daily activities with assistance. With increase in the need for more intensive care (as the disease progresses), it is a good idea to consider respite care or an assisted living facility or home care (in consultation with the top senior care of Charlotte, NC providers).
You need to have a lot of patience when caring for someone in the middle stages of Alzheimer’s. Your responsibility will increase as the person’s abilities change and functioning independently becomes more difficult.
You might encounter changes in behavior, which can be quite distressing for caregivers and family members (learn more about the common behaviors during this stage and ways you can handle the person). Gradual loss in ability to communicate, including trouble finding the right word, repeating questions, losing the train of thought, reverting to a native language and relying on non-verbal communication; problems with eating, dressing and grooming; and driving are all middle-stage concerns. Also, do not leave the person alone as it can pose a risk, take necessary precautions to prevent wandering.
Late-stage Alzheimer's
In the final stage of the disease, the symptoms are very severe to the extent that individuals lose complete ability to respond to their environment, to continue with a conversation, and, eventually, to control movement. Communicating becomes hard. Drastic changes in personality (due to decline in memory and cognitive skills) will necessitate extensive care.
Symptoms:
Need of around-the-clock assistance with daily personal care,
Communicating becomes difficult (communicating pain even),
No awareness of recent experiences as well as of their surroundings,
Increased susceptibility to infections, especially pneumonia,
Drastic changes in physical abilities, including walking, sitting and, eventually, swallowing.
This stage of Alzheimer’s may last from several weeks to a few years. With the progression of the disease, the needs of the person will change and might take a serious turn, including a person usually has difficulty eating and swallowing, is prone to infections, and needs assistance walking and eventually loses ability to walk.
Your role as a caregiver will be to make sure to preserve your loved one’s quality of life and dignity. This is the stage where the individual mainly experiences the world through his senses. The best way you can express your care and concern is through a gentle touch (brushing the person’s hair), sound (play calm music), sight (looking at old photographs together), and smell (preparing a favourite food).
Care needs that will need to be addressed include feeding, difficulty moving, comfort, toileting, preventing infections, and keeping the personal connection.
Food and Fluids
Monitoring eating is a critical caregiving task during late-stage Alzheimer's as a person in this stage of the disease may forget to eat or lose his or her appetite. You can encourage eating by adding sugar or preparing his favorite food. Your loved one’s doctor may recommend supplements between meals to add calories if he/she is facing weight loss issues.
Bowel and Bladder Function
Another common problem is difficulty with toileting, to the extent that the individual might need to be walked to the restroom and guided through the process. Not to mention, incontinence is also common in this phase of the disease. To keep up bowel and bladder function, limit liquids before bedtime, create a toileting schedule, use absorbent and protective products, and keep a close watch on bowel movements.
Pain and Illness
Not being able to communicate pain at this stage is quite a serious issue, as a caregiver you need to be absolutely vigilant. Figure out if your loved one is in pain or has an illness by looking for physical signs, including pale skin tone; flushed skin tone; dry, pale gums; mouth sores; vomiting; feverish skin; or swelling of any part of the body. Some of the nonverbal signs you should pay attention to are gestures, facial expressions (such as, wincing), spoken sounds that might indicate pain or discomfort. Also, watch out for anxiety, agitation, shouting and sleeping problems as these can all be signs of pain.
Infections and Pneumonia
The loss of ability to move is what can expose someone during late-stage Alzheimer’s to infections. Make sure their teeth and mouth are clean, treat cuts and scrapes right away (seek medical help for a deep cut), and immunize them to protect them against flu and pneumonia (reduce the risk by getting flu vaccines every year- both you and your loved one).
Health of Skin and Body
The inability to move around can cause the person to become bedridden or chair-bound, which can lead to skin breakdown (if left untreated, it can lead to infection, amputation or even death), pressure sores and "freezing" of joints. Here are some tips to maintain skin and body health:
Keep skin clean and dry,
Protect bony areas (by using pillows and by moisturizing elbows, heels, hips and other bony areas),
Prevent joint “freezing” with range-of-motion exercises in consultation with your doctor,
Change your loved one’s position at least every two hours to relieve pressure and improve blood circulation,
When it comes to lifting your loved one, strictly follow the instructions of your doctor or physical therapist and do not ever lift by pulling on the person's arms or shoulders.
Although there is no cure for Alzheimer’s disease, specialist care can provide people with dignity and a high quality of life. The best bet is to consider home care services that specialize in the placement of high-quality professional care providers, where the care provided will be tailored to your loved one’s current abilities and symptoms, and adapted with progression of the disease and change in skills. Going for home care will also enable your loved one to stay in familiar surroundings, helping them to feel safe and loved, even when faced with memory loss and reduced capacity.
Moreover, professional home carers are specialized in caring for Alzheimer’s, who can help by assisting with daily needs like bathing and eating, offer encouragement and engagement of daily activities, including social interaction, and most importantly, will help patients maintain familiar routines, thus helping your loved one live a dignified and independent live by helping to reduce their severity of symptoms such as anxiety, depression, withdrawal from social life, and self-imposed isolation.