Caregivers cope with Alzheimer’s & dementia
“For better or worse, in sickness and in health” are vows that ring true for those who find themselves in the situation of caring for a loved one suffering from Alzheimer’s disease or another form of dementia.
On Sept. 24, caregivers, some of whom have spouses diagnosed with a form of dementia and others with family members battling the disease, gathered in the Home Instead offices in Bethel Park to learn how to cope with being a caregiver.
For Cathy Glumac, client services supervisor, providing the best possible environment for an elderly person with dementia is her professional as well as personal life – her mother is in the early stages of dementia.
Of the 15 in the class, names were not used, but individual stories were told and questions were asked.
Alzheimer’s disease, or another form of dementia, is basically the death of brain cells. By age 65, one in eight people will have some type of dementia, and by age 85, one in two will be diagnosed with a form of the disease.
“The cause is not known,” Glumac said, adding there may be several factors that result in the disease such as family history, cardiovascular disease and head or brain trauma. Lifestyle can also be a factor. Staying socially active is important as is using the brain. In response to a question, Glumac told the group she was unaware of any studies involving the impact of environmental factors.
One of the first signs of dementia is the difficulty of finding words. There is also memory loss to the point that it disrupts daily living. There may be difficulty completing familiar tasks and challenges with planning and problem solving. There can be confusion with time and place, and trouble understanding visual images and spatial relationships.
The part of the brain that controls short-term memory is the first part to die, while long-term memory may remain until the person’s death.
While Alzheimer’s is well-known, Glumac said her mother suffers from vascular dementia, which is the result of impaired blood flow to the brain that can sometime mimic the symptoms of a stroke. During vascular dementia, the patient has extreme highs and lows.
During what is known as mixed dementia, the patient exhibits a combination of Alzheimer’s and vascular dementia. And, in Lewy Body, symptoms mimic Parkinson’s disease with tremors and stiffness. In frontotemporal dementia, Glumac said, the patient exhibits drastic personality changes and loses the ability to speak sooner.
Glumac said an Alzheimer’s patient shows a change in the shape of proteins in the brain and a build-up of plaque and tangles in the brain, although a definitive diagnosis is not available until an autopsy is performed. For some, the disease begins in the 40s and 50s, but does not exhibit symptoms until many years later. For others, there is early-onset of the disease.
Glumac emphasized each patient is different and must be approached in varying ways. No matter how difficult, the caregiver must take the blame.
“Say, ‘I forgot how to make this. Let’s do this together,’” Glumac said. If a female patient liked to cook but is unable to follow a recipe, measure the ingredients and allow her to mix everything together in a bowl. Woman are often occupied by folding laundry. For men with dementia, tasks are more difficult to find. One member of the group said her husband helped her to clean out a closet.
There are other behaviors to modify, such as one group participant’s comment that her husband was a non-drinker but now wanted to drink a lot of alcohol. She hides the liquor. Glumac suggested she substitute grape juice for wine or water down the alcohol.
Excessive sleeping may be a sign of depression and should be discussed with the patient’s physician.
Other factors may mimic dementia symptoms and may be the result of medication or a lack of certain vitamins like B12 and D, Glumac said.
Medications to help stop the progression are available, but the type of dementia is needed before a physician writes a prescription. And medications, Glumac told the group, can slow the progression of the disease, but cannot cure the patient. And, all are expensive and have serious side effects.
As the disease progresses, the symptoms can change until the late stage, where the patient often cannot recognize oneself. Glumac told of one patient who would complain there was a stranger in her room but it was her reflection in the mirror.
Some patients have delusions, others wander, while still others exhibit aggression and agitation. Each behavior must be addressed in a different way.
Frustration is a common complaint among caregivers when loved ones become repetitious, express sexually inappropriate behaviors or make false accusations.
Redirecting the patient’s attention may help. For other patients, there may be physical changes like failing to eat or drink that can result in dehydration. Still others begin to crave sweets as those taste buds are the longest remaining.
She suggested capturing the patient’s memories in a Life’s Journey journal that can be used to divert the attention to the long-term memory. Singing and looking at old photographs is a good way to reduce the behaviors. Reassure the patient he or she is safe.
“Try three things, three different ways,” Glumac said.
As for the caregiver, Glumac recommends sleep, exercise and nutrition, and to stay connected to friends and for support. She also recommends relaxation techniques such as breathing exercises, yoga, stretching and meditation.
“You need time for you,” Glumac told the group.