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How can you deal a patient with alzhiemers desease?

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Question ajoutée par mary grace Bonayon , Private Duty Caregiver , Home Care
Date de publication: 2015/03/28

Alzheimer’s disease is an illness of the brain. It causes large numbers of nerve cells in the brain to die. This affects a person’s ability to remember things and think clearly. People with Alzheimer’s become forgetful and easily confused and may have a hard time concentrating. They may have trouble taking care of themselves and doing basic things like making meals, bathing, and getting dressed.

Alzheimer’s varies from person to person. It can progress faster in some people than in others, and not everyone will have the same symptoms. In general, though, Alzheimer’s takes many years to develop, becoming increasingly severe over time. As the disease gets worse, people need more help. Eventually, they require total care.

Alzheimer's disease consists of three main stages: mild (sometimes called early-stage), moderate, and severe (sometimes called late-stage). Understanding these stages can help you care for your loved one and plan ahead.

You can help family and friends understand how to interact with the person who has Alzheimer’s.

  • Help them realize what the person can still do and how much he or she can still understand.
  • Give them suggestions about how to start talking with the person. For example, "Hello George, I'm John. We used to work together."
  • Help them avoid correcting the person with Alzheimer’s if he or she makes a mistake or forgets something.
  • Help them plan fun activities with the person, such as going to family reunions or visiting old friends.
  • There is no cure for Alzheimer's disease, so the chief goals of treatment are to:

  • maintain quality of life
  • maximize function in daily activities
  • enhance cognition, mood and behavior
  • foster a safe environment
  • promote social engagement, as appropriate

Frauline Angloan
par Frauline Angloan , caregiver , TURBO

TRY TO TALK SLOWLY AND CLEARLY.IF HE/SHE DON'T REMEMBER THINGS FROM THE PAST,TRY TO ASK ABOUT HERSELF AND ALL THE PEOPLE AROUND HER.WHEN IT COMES TO MEDICINE USE EXELON PATCH TO DECREASE HER ALZHIEMER..IT'S THE BEST PATCH FOR OLD PEOPLE SUFFERING FROM THAT KIND OF DISEASE.

Sumaira Yousaf
par Sumaira Yousaf , HR Officer , Al Emlaq Facilities Management

Alzheimer's disease is an illness of the brain. It causes large numbers of nerve cells in the brain to die. This affects a person's ability to remember things and think clearly. People with AD become forgetful and easily confused. They may have a hard time concentrating and behave in odd ways. These problems get worse as the illness gets worse, making your job as caregiver harder.

It's important to remember that the disease, not the person with AD, causes these changes. Also, each person with AD may not have all the problems we talk about in this book.

he following sections describe the three main challenges that you may face as you care for someone with AD:

  1. Changes in communication skills
  2. Changes in personality and behavior
  3. Changes in intimacy and sexuality 1. Challenge: changes in communication skills

    "Talking with Dad is hard. Often, I don't understand what he is trying to say or what he wants. We both get pretty frustrated sometimes."

    Communication is hard for people with AD because they have trouble remembering things. They may struggle to find words or forget what they want to say. You may feel impatient and wish they could just say what they want, but they can't. It may help you to know more about common communication problems caused by AD. Once you know more, you'll have a better sense of how to cope.

    Here are some communication problems caused by AD:

    • Trouble finding the right word when speaking
    • Problems understanding what words mean
    • Problems paying attention during long conversations
    • Loss of train-of-thought when talking
    • Trouble remembering the steps in common activities, such as cooking a meal, paying bills, getting dressed, or doing laundry
    • Problems blocking out background noises from the radio, TV, telephone calls, or conversations in the room
    • Frustration if communication isn't working
    • Being very sensitive to touch and to the tone and loudness of voices

      How to cope with changes in communication skills

      The first step is to understand that the disease causes changes in these skills. The second step is to try some tips that may make communication easier. For example, keep the following suggestions in mind as you go about day-to-day care.

      To connect with a person who has AD:

      • Make eye contact to get his or her attention, and call the person by name.
      • Be aware of your tone and how loud your voice is, how you look at the person, and your "body language." Body language is the message you send just by the way you hold your body. For example, if you stand with your arms folded very tightly, you may send a message that you are tense or angry.
      • Encourage a two-way conversation for as long as possible. This helps the person with AD feel better about himself or herself.
      • Use other methods besides speaking to help the person, such as gentle touching to guide him or her.
      • Try distracting someone with AD if communication creates problems. For example, offer a fun activity such as a snack or a walk around the neighborhood.

      "Every few months I sense that another piece of me is missing. My life… my self… are falling apart. I can only think half-thoughts now. Someday I may wake up and not think at all."— From "The Loss of Self"

      To encourage the person with AD to communicate with you:

      • Show a warm, loving, matter-of-fact manner.
      • Hold the person's hand while you talk.
      • Be open to the person's concerns, even if they are hard to understand.
      • Let him or her make some decisions and stay involved.
      • Be patient with angry outbursts. Remember, it's the illness "talking."
      • If you become frustrated, take a "timeout" for yourself.

      To speak effectively with a person who has AD:

      • Offer simple, step-by-step instructions.
      • Repeat instructions and allow more time for a response. Try not to interrupt.
      • Don't talk about the person as if he or she isn't there.
      • Don't talk to the person using "baby talk" or a "baby voice."

      Here are some examples of what you can say:

      • "Let's try this way," instead of pointing out mistakes
      • "Please do this," instead of "Don't do this"
      • "Thanks for helping," even if the results aren't perfect

      You also can:

      • Ask questions that require a yes or no answer. For example, you could say, "Are you tired?" instead of "How do you feel?"
      • Limit the number of choices. For example, you could say, "Would you like a hamburger or chicken for dinner?" instead of "What would you like for dinner?"
      • Use different words if he or she doesn't understand what you say the first time. For example, if you ask the person whether he or she is hungry and you don't get a response, you could say, "Dinner is ready now. Let's eat."
      • Try not to say, "Don't you remember?" or "I told you."

      Helping a Person Who Is Aware of Memory Loss

      AD is being diagnosed at earlier stages. This means that many people are aware of how the disease is affecting their memory. Here are tips on how to help someone who knows that he or she has memory problems:

      • Take time to listen. The person may want to talk about the changes he or she is noticing.
      • Be as sensitive as you can. Don't just correct the person every time he or she forgets something or says something odd. Try to understand that it's a struggle for the person to communicate.
      • Be patient when someone with AD has trouble finding the right words or putting feelings into words.
      • Help the person find words to express thoughts and feelings. For example, Mrs. D cried after forgetting her garden club meeting. She finally said, "I wish they stopped." Her daughter said, "You wish your friends had stopped by for you." Mrs. D nodded and repeated some of the words. Then Mrs. D said, "I want to go." Her daughter said, "You want to go to the garden club meeting." Again, Mrs. D nodded and repeated the words.
      • Be careful not to put words in the person's mouth or "fill in the blanks" too quickly.
      • As people lose the ability to talk clearly, they may rely on other ways to communicate their thoughts and feelings. For example, their facial expressions may show sadness, anger, or frustration. Grasping at their undergarments may tell you they need to use the bathroom. 2. Challenge: changes in personality and behavior

        Here are some common personality changes you may see:

        • Getting upset, worried, and angry more easily
        • Acting depressed or not interested in things
        • Hiding things or believing other people are hiding things
        • Imagining things that aren't there
        • Wandering away from home
        • Pacing a lot of the time
        • Showing unusual sexual behavior
        • Hitting you or other people
        • Misunderstanding what he or she sees or hears

        Also, you may notice that the person stops caring about how he or she looks, stops bathing, and wants to wear the same clothes every day.

        Other factors that may affect how people with AD behave

        Changes in Behavior

        You may see changes in behavior that the disease didn't cause. For example, certain medicines, severe pain, poor eyesight or hearing, and fatigue can cause behavior changes. If you don’t know what is causing the problem, call the doctor.

        In addition to changes in the brain, the following things may affect how people with AD behave.

        How they feel:

        • Sadness, fear, or a feeling of being overwhelmed
        • Stress caused by something or someone
        • Confusion after a change in routine, including travel
        • Anxiety about going to a certain place

          How to cope with personality and behavior changes

          "I finally figured out that it's me who has to change. I can't expect my husband to change because of the disease."

          Here are some ways to cope with changes in personality and behavior:

          • Keep things simple. Ask or say one thing at a time.
          • Have a daily routine, so the person knows when certain things will happen.
          • Reassure the person that he or she is safe and you are there to help.
          • Focus on his or her feelings rather than words. For example, say, "You seem worried."
          • Don't argue or try to reason with the person.
          • Try not to show your anger or frustration. Step back. Take deep breaths, and count to 10. If safe, leave the room for a few minutes.
          • Use humor when you can.
          • Give people who pace a lot a safe place to walk. Provide comfortable, sturdy shoes. Give them light snacks to eat as they walk, so they don't lose too much weight, and make sure they have enough to drink.

          Use distractions:

          • Try using music, singing, or dancing to distract the person. One caregiver found that giving her husband chewing gum stopped his cursing.
          • Ask for help. For instance, say, "Let's set the table" or "I really need help folding the clothes."

          Other ideas:

          See Medicines to treat behavior problems related to AD for more information about these problems and some medicines that may help.

          How to cope with sleep problems

          "I'm exhausted. I can't sleep because I have to watch out for my wife. She wanders around the house, takes out all kinds of stuff from the kitchen. I don't know what she's going to do."

          Evenings are hard for many people with AD. Some may become restless or irritable around dinnertime. This restlessness is called "sundowning." It may even be hard to get the person to go to bed and stay there.

          Here are some tips that may help:

          • Help the person get exercise (PDF, 850K) each day, limit naps, and make sure the person gets enough rest at night. Being overly tired can increase late-afternoon and nighttime restlessness.
          • Plan activities that use more energy early in the day. For example, try bathing in the morning or having the largest family meal in the middle of the day.
          • Set a quiet, peaceful mood in the evening to help the person relax. Keep the lights low, try to reduce the noise levels, and play soothing music if he or she enjoys it.
          • Try to have the person go to bed at the same time each night. A bedtime routine, such as reading out loud, also may help.
          • Limit caffeine.
          • Use nightlights in the bedroom, hall, and bathroom.

          How to cope with hallucinations and delusions

          As the disease progresses, the person with AD may have hallucinations. During a hallucination, a person sees, hears, smells, tastes, or feels something that isn't there. For example, the person may see his or her dead mother in the room. He or she also may have delusions. Delusions are false beliefs that the person thinks are real. For example, the person may think his or her spouse is in love with someone else.

          Here are some things you can do:

          • Tell the doctor or AD specialist about the delusions or hallucinations.
          • Discuss with the doctor any illnesses the person has and medicines he or she is taking. Sometimes an illness or medicine may cause hallucinations or delusions.
          • Try not to argue about what the person with AD sees or hears. Comfort the person if he or she is afraid.
          • Distract the person. Sometimes moving to another room or going outside for a walk helps.
          • Turn off the TV when violent or upsetting programs are on. Someone with AD may think these events are really going on in the room.
          • Make sure the person is safe and can't reach anything that could be used to hurt anyone or himself or herself.

          How to cope with paranoia

          Check it out!

          Someone with AD may have a good reason for acting a certain way. He or she may not be paranoid. There are people who take advantage of weak and elderly people. Find out if someone is trying to abuse or steal from the person with AD.

          Paranoia is a type of delusion in which a person may believe—without a good reason—that others are mean, lying, unfair, or "out to get him or her." He or she may become suspicious, fearful, or jealous of people.

          In a person with AD, paranoia often is linked to memory loss. It can become worse as memory loss gets worse. For example, the person may become paranoid if he or she forgets:

          • Where he or she put something. The person may believe that someone is taking his or her things.
          • That you are the person's caregiver. Someone with AD might not trust you if he or she thinks you are a stranger.
          • People to whom he or she has been introduced. The person may believe that strangers will be harmful.
          • Directions you just gave. The person may think you are trying to trick him or her.

          Paranoia may be the person's way of expressing loss. The person may blame or accuse others because no other explanation seems to make sense.

          Here are some tips for dealing with paranoia:

          • Try not to react if the person blames you for something.
          • Don't argue with him or her.
          • Let the person know that he or she is safe.
          • Use gentle touching or hugging to show the person you care.
          • Explain to others that the person is acting this way because he or she has AD.
          • Search for missing things to distract the person; then talk about what you found. For example, talk about a photograph or keepsake.
          • Have extra sets of keys or eyeglasses in case they are lost. . Challenge: changes in intimacy and sexuality photo of rear view couple walking outside

            Intimacy is the special bond we share with a person we love and respect. It includes the way we talk and act toward one another. This bond can exist between spouses or partners, family members, and friends. AD often changes the intimacy between people.

            Sexuality is one type of intimacy. It is an important way that spouses or partners express their feelings physically for one another.

            AD can cause changes in intimacy and sexuality in both the person with AD and the caregiver. The person with AD may be stressed by the changes in his or her memory and behaviors. Fear, worry, depression, anger, and low self-esteem (how much the person likes himself or herself) are common. The person may become dependent and cling to you. He or she may not remember your life together and feelings toward one another. Sometimes the person may even fall in love with someone else.

            You, the caregiver, may pull away from the person in both an emotional and physical sense. You may feel be upset by the demands of caregiving. You also may feel frustrated by the person's constant forgetfulness, repeated questions, and other bothersome behaviors.

            Most caregivers learn how to cope with these challenges, but it takes time. Some learn to live with the illness and find new meaning in their relationships with people who have AD.

            How to cope with changes in intimacy

            Remember that most people with AD need to feel that someone loves and cares about them. They also need to spend time with other people as well as you. Your efforts to take care of these needs can help the person with AD to feel happy and safe.

            It's important to reassure the person that:

            • You love him or her
            • You will keep him or her safe
            • Others also care about him or her

            When intimacy changes, the following tips may help you cope with your own needs:

            • Talk with a doctor, social worker, or clergy member about these changes. It may feel awkward to talk about such personal issues, but it can help.
            • Talk about your concerns in a support group.
            • Think more about the positive parts of the relationship.
            • Get more information. Some books, articles, and DVDs/videos can help you understand how AD affects intimacy. 

            How to cope with changes in sexuality

            "We've shared the same bed for 38 years. But since he's had Alzheimer's, it doesn't feel right to have sex."

            The well spouse/partner or the person with AD may lose interest in having sex. This change can make you feel lonely or frustrated. Here are some possible reasons for changes in sexual interest.

            The well spouse/partner may feel that:

            • It's not okay to have sex with someone who has AD
            • The person with AD seems like a stranger
            • The person with AD seems to forget that the spouse/partner is there or how to make love

            A person with AD may have:

            • Side effects from medications that affect his or her sexual interest
            • Memory loss, changes in the brain, or depression that affects his or her interest in sex

            Hypersexuality

            Sometimes, people with AD are overly interested in sex. This is called "hypersexuality." The person may masturbate a lot and try to seduce others. These behaviors are symptoms of the disease and don't always mean that the person wants to have sex.

            To cope with hypersexuality, try giving the person more attention and reassurance. You might gently touch, hug, or use other kinds of affection to meet his or her emotional needs. Some people with this problem need medicine to control their behaviors. Talk to the doctor about what steps to take.

            Here are some suggestions for coping with changes in sexuality:

            • Explore new ways of spending time together.
            • Focus on other ways to show affection. Some caregivers find that snuggling or holding hands reduces their need for a sexual relationship.
            • Try other nonsexual forms of touching, such as giving a massage, hugging, and dancing.
            • Consider other ways to meet your sexual needs. Some caregivers report that they masturbate to meet their needs.

mohamed sabeen
par mohamed sabeen , QHSE Manager , Novus catering service

  • Trouble finding the right word when speaking
  • Problems understanding what words mean
  • Problems paying attention during long conversations
  • Loss of train-of-thought when talking
  • Trouble remembering the steps in common activities, such as cooking a meal, paying bills, getting dressed, or doing laundry
  • Problems blocking out background noises from the radio, TV, telephone calls, or conversations in the room
  • Frustration if communication isn't working
  • Being very sensitive to touch and to the tone and loudness of voices

How can I deal a person with alzhiemers...just be calm and recall to ur client about his/her condition..

Perlita Hupa
par Perlita Hupa , volunteer , Margosatubig General Hospital,Margosatubig Zamboanga Del Sur ,Philippines

Alzheimer disease is generative that is irreversible.A calm predictable environment help people with Alzheimer disease interpret their surrounding and activities.Environmental stimuli is limited and a regular routine is establish.A quiet,pleasant manner of speaking , clean and simple explanation.The use ofvmemory aids and clues help minimize confusion and disorientation and give the patient sense of security.

IAN KAIZER ACEREMO
par IAN KAIZER ACEREMO , Staff Nurse , Healthcare Specialists Incorporated

Alzheimer's Disease is a chronic progressive degenerative condition that is prevalent on the elderly population in which there is a decline in cognitive and mental function. I would say that the disease itself has no cure,but there are ways to manage this condition or slow the progression of the disease. Medications (e.g Tacrine HCL) used to improve the patient's memory, supportive nursing management and enhancement of functional skills are some of the examples on how to manage this health condition

Manilyn Banalo
par Manilyn Banalo , administrative assistant , Dussmann Gulf LLC

patient having alzhiemers desease is not an easy condition especially old. patient loss thier memories.as a caregiver i can help or deal with them by showing old pictures or activities that reminds them.introducing thier relatives and families that somehow part of patients life.i should always look aftr the patient for thier mind is nowhere to go they might do things that can harm themself especially picking sharp objects..in addition to it try to talk to the patient always and be with them anytime to assist them with thier needs.

Jaclynn Alvarado
par Jaclynn Alvarado , Assistant Procurement Officer , Philippine Amusement and Gaming Corporation

  • Help them realize what the person can still do and how much he or she can still understand.
  • Give them suggestions about how to start talking with the person

Salma Salmin
par Salma Salmin , Chief Clinical Pharmacist , Dr. Sulaiman Al Habib Medical Group

Ask to communicate with a care giver.

Nooreen sultana
par Nooreen sultana , Trainee Pharmacist , Sama Pharmacy

Alzhiemers Disease in simple words is forgetfulness which is caused due to loss of cholinergic neurons in the brian..which gets worsen by time. But it can be treated Pharmacologically and Non Pharmacologically.

I would advice the patients both about Pharmacological treatment such as Antipsychotic drugs and Choline esterase Inhibitors like Donepezil (Aricept) and other drugs like Memantine, antidepressants and Anticonvulsants.

Non Pharmacological treatment such as behavioural and Enviornmental interventions. and lifestyle changes would work.

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