Caring for Seniors with Alzheimer's Disease

The most helpful approach to Alzheimer's disease, no matter what stage people are in, is to focus on their remaining strengths and interests, encouraging them to continue to do what they can if it gives them pleasure. Here are some examples:

• A daughter gave her mother photos to look through and sort, so they could then put them in albums together.
• A son asked his visiting mother to help in the garden.
• A woman asked her mother to chop vegetables for a salad.
• The daughter of a former grocer brought him to the supermarket with her to help her pick out produce. Her father had lost a lot of his abilities, but this knowledge of how to select the best fruits and vegetables returned to him naturally.
• A son handed his father, a retired professional musician, his trumpet and he played it beautifully, even though he couldn't dress or feed himself.

It can be helpful for people in the early to mid stages of the disease to begin the regular practice of relaxation techniques. Regular practice can help reduce anxiety and delay some of the memory loss. In addition, many doctors recommend taking anti-anxiety medication, which can help patients cope.

Adult daycare in the early stages can be very helpful, both for the caregiver and patient. These programs usually provide activities designed to stimulate the mind and possibly delay progression of the disease. They also offer respite to the caregiver, enabling the patient and caregiver to take a break from each other.

Here are some suggestions that may help:

• Explain that the activities may help delay progression of the disease.
• Call it a seniors club, rather than a day care. Avoid making it seem child-like.
• Tell your parent that it will give you a break from each other, and enable him or her to be with other people and have interesting things to do.
• Suggest that he or she try it out for a few hours a day or a week. If your parent likes it, you can increase the hours. If your parent doesn't like it, find out why and see if some changes can be made at the center. If not, perhaps you can try another center that won't have the particular issues that your parent objects to.

In general, don't call attention to any lapses of memory or inaccurate statements. Instead, act as if everything your parent does is normal.

• Don't argue with your parent. Instead, try to soothe and distract.
• Don't tell your parent that he or she is repeating something. Telling will just be upsetting and the repetition isn't something that can be stopped. Just keep responding to your parent's point in a pleasant way, then try to redirect the conversation.
• Avoid being patronizing or critical. Don't let your parent see your frustration or disappointment. These all injure self-esteem.
• Avoid correcting, explaining or reasoning with your parent. For example, if your parent asks to see his or her mother, don't say that she died long ago. Just say something like you wish you could see her too, and then move on to another topic, or ask what she was like.

Consider writing things down:

• Take notes and leave a written record of what you discuss when you visit so that your parent can look back and remember.
• Loved ones and friends can send notes, rather than call. Your parent can keep looking back on the notes to feel good.

• Avoid startling your parent. Don't come up behind him or her. Always approach from the front and introduce yourself if your parent might not remember who you are.
• Speak to your parent while facing him or her, and be sure to make eye contact while speaking.
• Don't quickly fill in a silence. Allow your parent plenty of time to respond to your comments.
• Try short sentences, easy words, and making just one point a time.
• Use facial expressions to reinforce your message.
• Avoid using words such as "him," "her" or "it." Instead say the name of the person, and that person's relationship to the parent, such as your daughter Suzy, or your best friend Annie, or refer to the specific object, such as your green sweater.
• While talking, turn off the radio or TV, which can be too distracting.
• Avoid crowds, as the noise and motion can disturb and overwhelm a person with Alzheimer's.

• Play bingo.
• Play a simple card game.
• Read aloud -- either from a magazine your parent likes, or a chapter of a book. If he or she wants to discuss something as you read, stop to do so. It will be good for your parent.
• Look at a photo album together of your parent at a younger stage. Often, memory of those early years is better than of the later ones, and your parent may enjoy reminiscing.
• If your parent is still living in a home, rather than in an institution, cook a simple dish together, doing it one step at a time, with all the ingredients already measured out. Stop if your parent gets too tired or overwhelmed, and continue the next day. Then, you can eat the meal together with others, and your parent can feel proud of having prepared it.
• If your parent is still living in a home, rather than an institution, he or she can do household chores, which can help him or her to feel useful. Some suggestions include:
  • Raking leaves
  • Washing dishes
  • Putting dishes in or taking them out of the dishwasher
  • Doing laundry
  • Folding clean laundry
  • Weeding the garden
  • Watering the plants
  • Sweeping
  • Vacuuming
  • Dusting
  • Cleaning the sink

• Try to keep the mood upbeat.
• Maintain a friendly, positive tone. Avoid anger or irritation, which can upset the patient.
• Try to talk about topics of interest to your parent, such as lunch or sports or the weather, as he or she may often do better on those subjects. Avoid more abstract topics, such as politics.
• Avoid open-ended questions, which can be overwhelming. Instead ask yes or no questions.
• If you find yourself getting frustrated by your parent's repetition of a question, calmly redirect the conversation to a different topic.
• If you believe your parent might be depressed -- a common reaction in Alzheimer's patients who are aware of their diminishing abilities and often feel anxious about them -- have your parent evaluated and, if needed, treated for the depression and/or anxiety.
• If you are depressed, an understandable reaction to seeing a parent who has become impaired, seek treatment for your depression. Caregivers often find themselves overwhelmed and need to learn to carve out some time for themselves, as difficult as it may seem.
• Support groups for people with Alzheimer's, their family and friends, meet both in person and on line, and could be helpful. For support groups sponsored by the Alzheimer's Association, go to Alzheimer's Association. For online forums, go to living_with_Alzheimers.
  
  

Here are some things you can do:

• Try to discern the cause of the agitation and remove it.
• Try stroking your parent's arm to soothe him or her.
• Let your parent know you are listening to his or her concerns and taking them seriously.
• Try taking your parent to a quiet room and playing a soothing CD.
• Try to distract your parent, rather than responding to rants or rages.
• If you feel that your parent could be a danger to him- or herself or to anyone else, call 911.
• If this agitation is something new, or a progression of milder symptoms, be sure to let your parent's doctor know.

This can happen at the end stage of Alzheimer's and is very upsetting for everyone. You can try making milkshakes and putting them in a plastic container with a cover and let your parent sip as much as he or she can from a straw.

Care.com is a website that lists people throughout the United States who provide care to seniors, includes photos and descriptions of their backgrounds, and does free background checks for members. You can search by zip code. For specific listings, go to: Care.com.