Alzheimer's Disease: Responding to Sundowning
5/11/2008 ·
Coping with my mother's forgetfulness was easy in the early stages of her dementia. Things changed after she started to hallucinate. I was taking my mother back to her apartment in an assisted living community when she described one of her hallucinations.
"Last night four people came into my apartment and asked to live with me," she began. "I told them it was my apartment and they couldn't stay. I could see them clearly and then they slowly disappeared. It took me a while to realize they weren't real."
I didn't want to upset my mother. What should I say? "It's a good thing you figured that out," I replied. Mom agreed with me.
Her hallucinations marked the start of sundowning - late afternoon and evening confusion in people with memory disease. Unfortunately, sundowning isn't one behavior, it's many: hallucinations, confusing dreams and reality, irrational ideas, agitation, wandering, and shadowing (following closely). The Alzheimer's Association of Los Angeles says sundowning people "may become demanding, suspicious, upset or disoriented, see or hear things that are not there and believe things that aren't true."
My mother had all of these behaviors. She thought people were robbing her while she slept. She confused my childhood neighbors with her childhood neighbors. She started shadowing me, following me so closely I could feel her breath on my neck, and asking the same questions again and again. What are the causes of sundowning?
Physical and mental exhaustion are two causes, according to the national Alzheimer's Association. Fading afternoon light and poor indoor lighting also contribute to sundowning. Daytime naps are another cause. (If you sleep half the day you're awake at night.) And Mayo Clinic's website says sundowning "may be related to the flurry of activity during shift changes." Caregivers may take steps to prevent sundowning behaviors.
REVIEW MEDICATIONS. Prescribing medication for people with memory disease can be tricky. Some medications may contribute to sundowning, so the person's physician should review all medications, prescribed and over-the-counter. Staff members should be informed of any harmful drug interactions. The patient's physician may prescribe a sleep aid to prevent sundowning.
DISCOURAGE NAPPING. Naps may be replaced with walks, pet therapy, and group activities. After my mother lost the ability to read she enjoyed listening to stories. One reader chose a mystery. "I can't tell you what the book is about," my mother said, "but it's very exciting."
ENCOURAGE EXERCISE. Nancy L. Mace and Peter V. Rabins, MD, authors of "The 36-Hour Day," think "sufficient exercise seems to help confused people sleep at night." If the person can't walk he or she may be able to stretch while seated. My mother participated in seated ball activities, but wasn't impressed by them. "They asked me to throw and catch a ball," she said. "I'm not a kid."
AVOID CAFFEINE. People with memory disease should avoid caffeine: coffee, tea, caffeinated colas, and chocolate. They also shouldn't drink alcohol. Marilyn Larkin, author of "When Someone You Love Has Alzheimer's," thinks even small amounts of alcohol "may contribute to the physical and mental deterioration of the person with Alzheimer's."
IMPROVE LIGHTING. Wandering people may be looking for the bathroom, so make sure all hallways are well lit. Night lights will also help the person find the bathroom and return safely. If you leave the bathroom light on make sure it doesn't shine in the person's eyes.
REDUCE BACKGROUND NOISE. Blaring television, loud radio, and crowd noise upset people with memory disease. Television and radio may be replaced with soothing CD music. Many nursing care facilities have a community volunteer who comes in to play the piano for residents.
BE REASSURING. If the person is worried about hallucinations tell them they are in a safe place. Displaying photos of loved ones is also reassuring. The person with memory disease may prefer to sleep in a favorite chair instead of his or her bed. Caregivers may also reassure the person by offering to get them an extra blanket or robe.
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Mental Exercises For Alzheimer's: Boost Your Brain And Maxim
5/11/2008 ·
Use it or lose it! Mental exercises for Alzheimer’s are not only a powerful preventative measure, they can tone and build the brain and memory of an Alzheimer’s sufferer the way physical exercise tones and builds the body.
Mental exercises can slow down, halt, or even help to reverse the early signs of Alzheimer’s disease (AD). Unfortunately, normal day to day living usually doesn’t give the neuron sharpening exercise you need.
The good news is that you’re never too old to start boosting your brainpower, and it can be fun.
The fact that mental exercises can bolster your brain has even been discovered by the press. The Daily Mail in England reports that volunteers aged 65 and over who did just ten hours of training their memory, problem solving and reaction times had mental abilities similar to people seven to fourteen years younger who hadn’t done such exercises.
Studies show that staying mentally active can slash the chance of getting Alzheimer’s by fifty percent. Even the schoolwork that you did when you were young has an effect. A study carried out in China showed that those with no schooling were five times more likely to get Alzheimer’s disease than those who graduated from high school. A Swedish study showed that those with schooling below grade eight were two and a half times more likely to get AD.
So just what sort of mental exercises tunes up the brain and gets it firing on all cylinders?
Luckily you don’t have to do the mental equivalent of sit-ups and push-ups. Mental exercises for Alzheimer’s can be fun and enjoyable. You can even play games to fire up the neurons. Here are some ideas to get you started.
- Playing cards is good mental exercise, and bridge is often touted as an exceptionally good card game to get you thinking.
- Sudoku is a Japanese number game that takes concentration. The local newspaper will often have a game of Sudoku in it near the crossword puzzle, and books of games are easy to find in shops.
- Scrabble, crossword puzzles and jigsaws are all good for the grey matter.
- The solitaire games of FreeCell and Spider are good too, and you can play them on your computer.
- Keep learning! If you’re still working then continuing education not only helps keep Alzheimer’s at bay, it’s a good way to keep at the top in your job or profession.
- Learning new computer programs can be good mental exercise, and there lots to choose from. Go to your favorite computer store and check out the titles. You could learn a photo editing program and turn your snapshots into masterpieces, or get a genealogy program and research your family tree for example.
- Learn a challenging computer game. Once again there are lots to try out. You can become an entrepreneur running your own virtual reality railway, airline, zoo or much more. You can learn to fly with a flight simulator and fly almost anywhere in the world right in your own lounge room. You can battle anything from the ancient Romans to intergalactic warriors. There are lots of online games too, where you can compete against other players anywhere in the world any time of the night or day.
- Build your own website. Share your hobbies, interests or expertise with the rest of the world. You can even make money with this one. Click on over to my website and I’ll tell you the best place to get started, even for complete website building newbies.
- Do a course. Have you ever wanted to learn something but just haven’t done it yet? It could be photography, cooking or advanced calculus. Academic courses will really get your brain working. You’ll feel as though you’re cleaning all the rust off your brain, bit by bit getting it operating more freely until finally it’s running smoothly again.
- Here’s something to do less of. Don’t watch too much television unless it’s something mentally stimulating. Passively watching sitcoms and soapies dulls the brain you’re trying to sharpen.
Mental exercises can make a big difference to your life, whether you’re trying to prevent Alzheimer’s or already have it. You can gain years of life that could otherwise be lost. Get started now, and keep challenging your brain. It’s worth the effort. And remember that there are a lot more things you can do to fight this terrible disease. Of course, if you suspect you have Alzheimer's, see your doctor!
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Alzheimer's Disease: How to Care for Your Loved Ones
5/11/2008 ·
What is Alzheimer's disease?
Alzheimer's disease is a progressive, degenerative disease that destroys brain cells, eventually causing death. The disease is the most common cause of dementia which is the deterioration of a person's mental faculties. The cause of Alzheimer's is still not known.
What are the symptoms of Alzheimer's disease?
Alzheimer's disease gradually causes the loss of intellectual abilities such as memory, thinking, reasoning, judgment, orientation, and concentration, and it can cause drastic changes in personality, mood and behavior. In its early stages, it has symptoms similar to those of depression such as withdrawal, apathy, loss of concentration and interest, memory failure, anxiety, agitation, and delusions. Alzheimer's is a disease and not a normal part of aging.
How is the diagnosis of Alzheimer's disease made?
Alzheimer's disease is difficult to diagnose and is often misdiagnosed. It is made primarily from the symptoms reported by the affected person, by the family members and by a series of tests that evaluate a person's mental function. No brain scan or blood test can make the diagnosis, although the CT scan or MRI may show degeneration of brain tissue that is characteristic of the disease. An important step in diagnosing Alzheimer's disease is to rule out other possible causes of the symptoms which include depression, adverse effect from some medications, excessive consumption of alcohol, thyroid disorders, liver failure, kidney failure, a vitamin deficiency, bleeding inside the skull, and infections that can effect the brain.
What is the treatment for Alzheimer's disease?
There is no cure for Alzheimer's disease. Treatment primarily involves caring for him or her and dealing with the worsening symptoms. Most people in the early stages live at home and are cared for by the family members. Caring for an adult who has become completely dependent can be intensely stressful.
What should the family of an Alzheimer's person consider?
* Get a diagnosis early
* Take care of legal and financial planning
* Learn about the disease
* Learn how to protect your loved one
* Look for adult day-care programs, in home assistance, visiting nurses, and delivery of meals
* Don't neglect your own needs
* Talk to a support group to try to overcome the difficulty of grieving for a person who is still alive
* Know when to let go and place your loved one in an appropriate long-term facility
What home aids and medical equipment are available to help a Alzheimer's person?
* Beds & accessories
* Body positioners
* Braces & supports
* Compression wear
* Cushions
* Incontinence
* Lift out chairs
* Patient room
* Patient safety
* Pressure relief
* Ramps and lifts
* Rehabilitation
* Scooters
* Urologicals
* Walking aids
* Wellness
* Wheelchairs
* Travel & vacation equipment
What can be done at home to help a Alzheimer's patient? In the living quarters hand bars (especially at the tub and toilet), ramps and other aids should also be installed. Occupational and physical therapy should emphasize using the effected limbs and to help improve walking, mobility, eating, dressing, toilet functions, avoiding bed ulcers and improving other basic needs.
Early treatment, encouragement, and awareness about the patient's environment are important. The patient and his relatives and friends must understand the nature of the disabilities and the likelihood that progress will occur but will take time, patience, and perseverance.
There are many products available for Alzheimer victims that could help to increase their quality of life and provide more independence, these products may be as valuable to the family or care-giver as to the patient or user. To learn more about products which can help Alzheimers, please visit MEDmarketplace.com's Diagnostic Related Products.
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Understanding The Stages Of Alzheimer's Disease.
5/11/2008 ·
A person’s mental and physical abilities deteriorate as he progresses through various stages of Alzheimer’s disease. However, the way the disease manifests can vary quite widely from one person to another.
Knowing about Alzheimer’s stages can help the caregivers plan for and cope with the disease better. The following is based on Dr. Reisberg’s study which divides the disease into seven stages.
Stage 1: This is when no symptom of the disease is manifest and full mental and physical functions are retained.
Stage 2: At this stage, there is some loss of memory and the person may forget names of friends and family at times. The person is full aware that his mental functions are declining. This is often mistaken to be the result of normal ageing processes rather than as the beginning of Alzheimer’s disease.
Stage 3: This is still an early stage of the disease, but the symptoms are more noticeable now. The sufferer may go into denial. There is an inability to concentrate on tasks and performance at work may deteriorate.
The person becomes more anxious. They get lost quite easily in unfamiliar territory. Misplacing objects is quite common at this stage. Their ability to remember recently acquired information deteriorates.
Stage 4: At this stage, the person can’t perform complex tasks on his own. Examples include filing tax returns or handling finances in general. As a way out, they may want to avoid such situations altogether.
The ability to concentrate deteriorates further and so does memory. They may not be able to remember some events in their lives. Mood swings are common.
Stage 5: Now the patients will need assistance in ordinary tasks like picking appropriate clothes to wear. They may be unable to remember parts of their lives, although they will still remember basic information about themselves, their family and some friends.
Their sense of time begins to deteriorate as well.
Stage 6: This is a moderate to severe stage of Alzheimer’s disease. Forgetfulness accelerates and they may not even remember the name of their spouse. Large chunks of their lives are forgotten.
They definitely need help to cope with routine activities like bathing, dressing, etc. Incontinence may set in at this stage. Their sleep patterns may be disturbed.
Their personality will likely undergo a complete change. They may become violent or exhibit obsessive behaviour.
Stage 7: This is severe Alzheimer’s disease. The ability to speak is limited to less than a dozen words. They may lose the ability to walk, sit up or even hold their head up. This is a stage where the brain is apparently incapable of directing the body.
These stages of Alzheimer’s disease may occur differently in various individuals. What is described above is a composite picture that can help to understand how a person’s faculties diminish with the progress of Alzheimer’s disease.
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The Neurological Causes of Alzheimer's Disease
5/11/2008 ·
The true causes of Alzheimer’s disease remain elusive. However, researchers have made progress in understanding the neurological roots of this debilitating condition.
The disease is named after Alois Alzheimer, who was the first to identify the peculiar plaques and tangles in the brain, which is characteristic of the illness. Till the final decades of the twentieth century, Alzheimer’s could be diagnosed accurately only by a post-mortem examination.
Nowadays, scientists are beginning to uncover precisely what is happening and why those characteristic tangles and plaques crop up in the brain.
Many of the symptoms of Alzheimer’s disease are caused by neurofibrillary tangles in the brain. Microscopic filaments clog the neurons. These filaments are made up of an abnormal kind of Tau protein.
In a normal brain, Tau protein bonds into microtubules and enables transmission of messages from one neuron to another. But in an Alzheimer brain, instead of bonding into message pathways, Tau protein bonds with itself. And the neuron messages go nowhere.
Since the neurons are clogged, signals from the environment are no longer transmitted the way they should be. That is why severe cognitive impairment is one of the symptoms of Alzheimer’s disease.
Scientists speculate that Tau protein malfunction which results in neurofibrillary tangles is caused by beta amyloid protein, but this is yet to be conclusively proved.
It is beta amyloid protein that causes plaques between neurons, which is the other main damage to the brain in Alzheimer’s disease.
The plaque deposits are sticky patches in the brain which contain beta amyloid protein. Plaque blocks communication pathways between neurons, which results in the memory problems and learning inabilities associated with Alzheimer’s disease.
The degree of cognitive impairment depends on the amount of plaque present. Plaque acts by interfering with the normal functioning of acetylcholine, which helps to transmit nerve messages.
Treatment for Alzheimer’s disease involves using acetylcholinesterase inhibitors, which works by blocking enzymes that consume the acetylcholine. This medication is effective during the early stages of the disease before too much plaque has already built up.
Some research seems to indicate that plaques cause tangles. One study took proteins from mice to eliminate the plaque-causing beta amyloid. They found that the proteins got rid of the tangles as well. Similar effects have been brought about by other medications as well.
Others believe that both plaques and tangles are the result of other processes. One possible culprit is swollen axons. Axons are critical for transmitting messages between neurons. When axons swell, they may block message transmission and perhaps lead to the plaques and tangles which bring on Alzheimer’s disease.
Scientists are working hard at uncovering the causes of Alzheimer’s disease, which may sooner or later lead to a comprehensive cure for this dreaded condition.
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