Presentation on theme: "Alzheimer’s Disease: Supporting the Person Supporting their Caregivers"— Presentation transcript:
1Alzheimer’s Disease: Supporting the Person Supporting their Caregivers Shelly Zylstra
2A Few FactsOnce considered a rare disorder, Alzheimer’s disease is now seen as a major public health problem that is seriously affecting millions of older Americans and their families.In 2050, +70 million people will be over the age of 65; 20 million over the age of 85.An estimated 14 million Americans will have Alzheimer’s disease if a cure is not found.Alzheimer’s disease will be the leading cause of death among adults by the middle of this century.
3What Is It?Alzheimer’s disease is an irreversible, progressive brain disease that slowly destroys memory and thinking skills.Not Normal Aging!Alzheimer’s disease destroys brain cells and causes abnormal structural changes in the brain
4Dementia is Not Normal Aging 20 year old brain year old brain
5The Brain Adult weight: about 3 pounds Adult size: a medium cauliflowerDifferent parts of the brain do different things
6Cerebral HemispheresWhere sensory information received from the outside world is processed; this part of the brain controls voluntary movement and regulates conscious thought and mental activity:accounts for 85% of brain’s weight
7Cerebellum In charge of balance and coordination: takes up about 10% of brainconsists of two hemispheresReceives information from eyes, ears, and muscles and joints about body’s movements and position
8Brain Stem Connects the spinal cord with the brain Relays and receives messages to and from muscles, skin, and other organsControls automatic functions such as heart rate, blood pressure, and breathing
9Different Parts-Different Roles Hearing Words Speaking Words Seeing Words Thinking about WordsEven though the activities are similar, a different part of the brain is involvedWalking-KickingTalking-SwearingChewing-Swallowing
14Stages of Alzheimer’s disease FunctionEarly StageMemoryRoutine loss of recent memoryOrientationSeeks familiar and avoids unfamiliarLanguageMild aphasia (word finding difficulty)MotorSome difficulty writing and using objectsMoodApathy & depressionADL’sNeeds reminders with some ADL’s
15Stages of Alzheimer’s disease FunctionMiddle StageMemoryChronic, recent memory lossOrientationMay get lost at times, even in homeLanguageModerate aphasia (word finding difficulty)MotorRepetitive actions; apraxia (unable to start an action)MoodSome mood and behavior disturbancesADL’sNeeds reminders and help with most ADL’s
16Stages of Alzheimer’s disease FunctionLate StageMemoryMixes up past and presentOrientationMisidentifies familiar placesLanguageExpressive and receptive aphasia; often does not understandMotorBradykinesia (very slow walking); fall riskMoodIncreased mood and behavior disturbancesADL’sNeeds reminders and help with all ADL’s
17Stages of Alzheimer’s disease FunctionTerminal StageMemoryNo link to past or presentOrientationOblivious to surroundingsLanguageMute or a few incoherent wordsMotorLittle voluntary movement; dysphasia, myoclonus, seizuresMoodCompletely passiveADL’sTotal Care
18Alzheimer’s Symptoms Very gradual onset Picture may differ from person to personGradual withdrawal from active engagement with lifeNarrowing social activities and interestsLessening of mental alertness and adaptabilityLowering of tolerance to new ideas and changes in routineThoughts and activities may be selfish or childlike
19Alzheimer’s Symptoms Progressive memory loss Difficulty remembering familiar thingsDifficulty performing familiar tasksProblems finding the right wordsMisplacing things/ MessinessConfusion and agitationPoor judgment and poor decision making skillsChanges in personality – mood swingsLoss of initiative
20Might Even Involve the Law! Wandering/LostAuto AccidentsIndecent ExposureHomicide/Suicide/Domestic ViolenceSuspicion of DUI/IntoxicationAbuse/NeglectTrespassingShoplifting
21BehaviorsAlzheimer’s disease often causes a person to exhibit unusual and unpredictable behaviors.This can easily lead to frustration and tension in the person with Alzheimer’s as well as the person responsible for them.
23Agitation, Anger, Depression Agitated behavior can be disruptive to the elders daily life.Anxiety may not be put into words but instead manifest physical symptoms such as a racing heart, nausea, or pain.Agitation may increase the risk of harm to the affected individual and to others.
24Agitation Irritability, frustration, excessive anger Constant demands for attention & reassuranceRepetitive questions or demandsStubborn refusal to do things or go placesConstant pacing, searching, rummagingYelling, screaming, cursing, threatsHitting, biting, kicking
25Depression Extreme tearfulness Hand-wringing An excessive need for reassuranceOther signs of extreme unhappinessLoss of interest in things they used to loveExcessive sleepPersonality changes
26Aggression Verbal accusations and insults Aimless screaming Refusal to cooperate with simple requestsPhysical assaultsSelf-injury such as head banging or biting oneself
27Delusions When the person believes things that are not true. Common examples of delusions would be:Believing that one is in danger from others and that others have stolen items or money.A spouse is unfaithfulUnwelcome guests are in the houseA relative or friend is an imposter and not who they claim to be.
28HallucinationsThis is a false perception of objects or events involving the senses.The person may see, hear, smell, taste or feel something that is not there.If it doesn’t cause a problem it might be best to ignore it.If it becomes continuous then look for a possible underlying physical cause.
29Look for The “Why”Physical discomfort caused by an illness or medications.Over-stimulation from or overactive environmentInability to recognize familiar places, faces, or thingsDifficulty completing simple tasks or activities.Inability to communicate effectively.
30There is usually a Cause Physical factorsIs the person tired because of inadequate rest or sleep?Are medications causing side effects?Is the person unable to let you know he or she is experiencing pain?Environmental factorsIs the person over stimulated by loud noises, an overactive environment, or physical clutter?Does the person feel lost or abandoned?
31Sleeplessness and Sundowning About 20% experience periods of increased confusion, anxiety, agitation, and disorientation from dusk to dawn.End-of-day exhaustion (mental & physical)An upset in the “internal clock” causing a biological mix-up between night & dayReduced lighting and increased shadowsDisorientation due to the inability to separate dreams from reality when sleepingLess need for sleep, which is common among older adults
32Responding to Challenging Behaviors Stay calm and be understandingBe patient and flexibleDon’t argue or try to convince the personAcknowledge requests and respond to them.Try not to take behaviors personallyAccept the behavior as a reality of the disease and try to work through it.
33Try to Determine the Cause Often the trigger is some change in the person’s environment.Clutter, new person in the roomChange in routinePainHungerThirst/dehydrationFull bladder/UTIFatigue/pending illnessInfectionsSkin irritationConstipation
34Hints to Manage Behavior Don’tArgue or disagreeConfrontRaise your voiceTake offenseCorner, crowdTry to reasonDoSimplify the environment, tasks and routinesAllow adequate rest between stimulating eventsUse labels or clues to remind
35Do Don’t Back off Restrain, Use calm, positive statements ReassureSlow downOffer guided choices between two optionsLimit stimulation and offer simple exercisesDon’tRestrain,Shame, criticizeDemand or try to forceTalk down, ignoreExplain, teachRushShow alarmMake sudden movements
36CommunicationCommunication is critical and can be the basis for poor behaviorAre you asking too many questions or making too many statements at once?Are your instructions simple and easy to understand?Is the person picking up on your own stress and irritability?Are you being negative or critical?
37CommunicationRemember people with Alzheimer’s Disease often find it hard to remember the meaning of words that you are using or to think of the words they want to say.Identify yourself by name and call the person by name. Don’t ask, “Do you know who I am?”Approach the person slowly from the front and give them time to get used to your presence. Maintain eye contact.
38CommunicationTry to talk away from other distractions such as a loud TV or others trying to join the conversation.Speak slowly and distinctly. Use familiar words and short sentencesYou may feel angry but don’t show it. If you are about to “lose it” try counting to ten. REMEMBER that this person has a disease and is not deliberately trying to make things difficult for you.
39Keep things positive.Offer positive choices with no wrong answersIf the person seems frustrated and you don’t know what he or she wants, try to ask simple questions that can be answered with yes or no or one-word answers.Use gestures, visual cues, and verbal prompts to help.If conversation causes agitation drop the issue rather than try to clear it up.
40Use memory aids such as calendars & lists. Explore various solutions.Accept the behavior as a reality of the disease and try to work through it.Acknowledge requests and respond to them.Respond to the emotion and not the behavior.Offer corrections as a suggestion. Avoid explanations that sound like scolding. Try “I thought that was a spoon.”
41Caregiver Support Provide Information Provide Assistance Respite Care Adult Day CareCounseling or Support GroupsTrainingSupportive ServicesCaregiver ConsultantsLoan Closet
42Resources http://www.ahaf.org/alzdis/about/adabout.htm Or Call your local Alzheimer Association Chapter