How to care for people with alzheimer’s?

Alzheimer’s care:  Tips for the caregiver

Dementia is a condition characterized by impairment in memory, thinking, behavior, and the ability to perform everyday activities. It affects mainly older people (65 years old), it is not a normal part of aging.  According to WHO, around 50 million people around the world have dementia, with nearly 60% living in low- and middle-income countries. Every year, there are nearly 10 million new cases and it is expected to reach 82 million in 2030 and 152 in 2050.  Much of this increase is attributable to the rising numbers of people with dementia living in low- and middle-income countries.

 Alzheimer’s disease is the most common type of dementia and may contribute to 60–70% of cases. In the early stages, memory loss, forget once-familiar faces, and struggle in recalling and memorizing recent events are seen. Later, the person could experience confusion, irritability, aggressiveness, mood changes, cognitive impairment, loss of memory, withdrawal, and emotional disorders. Problems like shortened attention span, difficulties with language, and an inability to think logically appears. People may also completely lose the ability to speak. Ultimately, conscious thought disappears.

The deterioration of cognitive and motor function in a patient with Alzheimer’s disease also causes deterioration in the quality of life and psychosocial functioning of the patients. Long-term illness, like Alzheimer’s, raises a lot of challenges for caregivers as well as for healthcare professionals involved in the delivery of care for patients. Caregiving often includes assistance with one or more activities of daily living, including bathing and dressing, etc.

Here are few tips to deal with Alzheimer’s.

1. Try to know their feelings and enter their world: They sometimes have delusions, if delusions are challenged, it can let them feel threatened and insecure. Always try to acknowledge their emotion and redirect their thinking. Focus on his or her feelings rather than words. Sometimes Alzheimer patient accuses someone for thefting a gold earrings. Caregiver must respond by saying “You must feel worried that your earrings are missing. Let’s go look for it.”
2. Avoid overstimulation: People with Alzheimer’s disease are sensitive to sound, especially several sounds at once. Turning off the television and lowering the volume of music while people are talking and eating is a way to avoid confusion.
3. Speak calmly: Don’t shout upon them, a warm tone of voice can comfort them.
4. Avoid using pronoun: The person may get confused about who is “he”/ “she”/ “they”. Use nouns, common, and simple words as possible. For example, instead of “have it,” say: “have your vegetable soup”.
5. Keep communication short, simple, and clear: Give one direction or ask one question at a time
6. Always use leading statements rather than asking open-ended questions. It helps them to be clear about the task. “Would you like to eat rice? is better than “What would you like to eat? A simple, inviting statement like “Let’s have rice” is even better. Healthy communication can improve a person’s ability to manage his health status with self-esteem, dignity, and a sense of belonging.
7. One can use closed-ended questions also: Questions that can be answered “yes” or “no. Ask, “Did you enjoy porridge at breakfast?” instead of “What did you eat in breakfast?”
8. Never carry a conversation with someone else as if the Alzheimer patient wasn’t there: It becomes quite tough for them to connect the conversation and understand it. They feel that they are treated as if they didn’t exist. Never talk in front of the person as if they weren’t present. Always include them in any conversation when they are physically present.
9. Haptic communication can be a good intervention technique: Haptic communication is communicating by touch. Touch is a way to speak without using words. It becomes important as the disease erodes language-oriented thought. Action like Patting or holding their hand, giving a hug, putting an arm around can be effective. Avoid talking on the phone.
10. Don’t use the statement as “Do you remember?” “Try to remember!” “Did you forget?” “How could you not know that? It may be humiliating for the Alzheimer person. Avoid remarks such as “I just told you that how can you forget?” Instead, just repeat it over and over.
11. Smile and make eye contact: Use nonverbal cues like maintaining eye contact and smile convey that you are glad to be with them and helps your loved one at ease and will facilitate understanding.
12. Say things that express positive emotions unambiguously: Use of strong emotional messages like “I enjoyed this so much,” “I always feel good after talking to you,” and “Visiting you is the best part of my day.” can help them.
13. Make the most out of the last word: Patients often lock on to the last word in a sentence because it is easy to remember. If you ask, “Would you like to wear the pink or the blue dress?” only the word “dress” may fix in the patient’s mind, and you won’t get an answer but if the caregiver can turn this tendency to their benefit. Always ask “Would you like to wear this pink dress or the one that’s blue? “And the person will say “blue.” The patient feels he/she has decided for himself/herself rather than being told what to wear. By making choice so easy can prevent them from being worried and anxious.
14. Help people to maintain existing social relationships and form new ones: This can be done by facilitating joint activities with friends and family, joining hobby groups, and encouraging conversation.