Caring for Alzheimer's patients

Tragic disease robs memory, ability to reason

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— It's the fourth leading cause of death in individuals older than 60 years old, although it may afflict persons as young as 40 years of age. The tragedy of Alzheimer's disease is its relentless destruction of memory and the ability to reason.

Alzheimer's disease is believed to be a degenerative disorder. The nerve fibers surrounding the hippocampus (the brain's memory center) become damaged, and information is no longer carried properly to or from the brain. New memories cannot be made and previous memories cannot be formed.

The cause of Alzheimer's disease is still not known. Some suggested causes include a genetic predisposition, environmental toxins or infectious agents.

There is no single test for Alzheimer's disease. Treatable conditions must be excluded before diagnosis of the disease is made. Alzheimer's disease has a significant impact on emotions and behavior. Conditions that can also produce these symptoms include depression, adverse drug reactions, metabolic changes, nutritional deficiencies, stroke, head injuries and thyroid problems.

There are a number of behaviors that may indicate a person could be in the beginning stages of the disease. As Joan Lucas, social services coordinator of the Doak Walker Care Center, said, "If you have any doubts or concerns, the best thing to do is to check in with your health-care provider. Although Alzheimer's is dementia, not all dementia is Alzheimer's."

Some of the warning signs include: difficulty with familiar activities of daily living; slipping job performance; language difficulties; confusion of place and time; lack of judgment; problems in abstract thinking; misplacing objects; mood fluctuations; changes in personality; and lack of initiative.

Lucas further explains, "The onset of Alzheimer's can be rapid or gradual. Oftentimes, family members don't recognize the warning signs until the individual is no longer able to safely care for himself or herself."

Alzheimer's disease affects not only those who have it but also their families and friends. Profound changes in a loved one can be very disturbing. Caregivers of Alzheimer's patients have a difficult job.

Mealtime can be especially frustrating, but there are ways to decrease the frustrations and increase the food intake of a person who has Alzheimer's disease.

It is best to establish a routine by serving meals in the same place and close to the same time every day. Turn off the television or radio to create a quiet, calm atmosphere. Try to avoid phone conversations during mealtimes, and limit the number of people in the room.

Keep the table setting simple. Avoid brightly patterned dishes or placemats that can be visually confusing. Avoid presenting too many food items at one time.

Some stimulation is a good idea. Describe the foods being served and explain what meal is being eaten and the time of day. Use the most appropriate utensil. Spoons are often handled better than forks. Bowls may be easier to eat from than plates. Children's spill-free cups with two handles can be helpful. Eat your meal at the same time. The presence of a caregiver at mealtime can be reassuring. A person with Alzheimer's disease may imitate eating behaviors. You can reinforce verbal cues such as "pick up your fork" by simultaneously providing the action.

There currently is no cure for Alzheimer's disease. However, good planning and medical and social support can lessen the burdens on the person with Alzheimer's disease and the family. Physical exercise, social activity, proper nutrition and health maintenance are important to the well-being of anyone afflicted with the disease as well as for caregivers.

Katherine Zambrana is a senior at Colorado State University and an intern with the Yampa Valley Medical Center Wellness Program.

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