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Alzheimer's Disease: Tips for Caretakers by Jacquelyn Rudis

caregiver stress image There are millions of Americans who have Alzheimer’s disease. And with this, there are the millions who are unpaid caregivers for a person with Alzheimer’s or another form of dementia. The health and emotional stability of people who care for Alzheimer’s patients directly affects the patients themselves, and thus should be an important part of the patients’ care plans.

What Caregivers Can Expect as the Disease Progresses

A decline in logical thinking and judgment
Inappropriate social behaviors
Confusion and disorientation
Wandering
Rummaging and hiding objects
Aggressiveness, anger, and frustration
Hallucinations
Paranoia
Night wakefulness
Refusal to eat

What Caregivers Can Do to Decrease Stress

Patient Who Tends to Wander

Recognize common precursors to wandering, such as restlessness and disorientation.
Reassure and reorient the person.
Reduce noise levels and confusion.
Involve the person in productive daily activities and exercise.
Have a written plan for yourself if the person does wander.
Keep a recent photograph of the person to give to police if the person does wander.
Inform the police and your neighbors of the person’s tendency to wander.
Have the person wear bright, distinctive clothing.

Patient Who Rummages and Hides Things

Lock cabinets and specific rooms.
Store valuables and unsafe substances out of reach of the person.
Learn where the person tends to hide objects.

Patient Who Becomes Angry or Aggressive

Identify the immediate cause, if possible.
Do not take the person’s belligerence personally.
Reassure the person.
Do not confront the person about their behavior, it may be beyond his control.
Avoid using restraint. This may further frustrate the person.
If needed, step back and stand away from the person. Give the person a safe space to let their anger play out.
Try a relaxing activity, such as having the person listen to soothing music.
Look for patterns in potential anger triggers.

Patient Who Hallucinates or Is Paranoid

Don’t argue with the person about whether or not what they are talking about is real.
Increase lighting so there are less shadows.
Remove mirrors.
Stay calm. If safe to do so, provide reassuring words and a comforting touch.

Patient Who Cannot Sleep at Night

Limit intake of caffeine.
Increase physical activity during the day.
Limit naps.
Establish a nighttime routine, including calming elements, such as a bath and a warm drink (eg, milk).
Keep a nightlight on.

Patient Who Refuses to Eat

Provide the person with a number of small meals throughout the day rather than a few large meals.
Make the person’s favorite food.
Provide finger food.
Provide soft foods that don’t require chewing.
Remove distractions during mealtimes.
Have a different caregiver help the person with eating.

What Can Be Done to Reduce Caregiver Burden

The daily routine of caring for a chronically ill person can put tremendous physical and emotional strain on caregivers, particularly for families who have assumed care responsibilities more recently. Here are some tips on coping with the stress that may come with caring for someone with Alzheimer's:

Know that there is help available. You are not alone. Adult day care, in-home assistance, visiting nurses, and Meals-on-Wheels are some services that may be helpful.
It is okay to ask for help from family and friends. Also consider joining support groups or an online community.
Take care of yourself. Be mindful of what you eat, get plenty of exercise, and get enough rest.
Squeeze in some personal time. Stroll around the mall, have lunch with friends, or just take a nice walk.
Manage your stress level.
Do not be hard on yourself or the situation. Accept changes that may come with meeting the needs of someone with Alzheimer's. Sometimes care beyond what you can provide is needed. This includes in-home caregiver services and residential care.
Get your legal and financial planning in order. Talk with an attorney about legal, financial, and care issues.

The importance of easing the mental and physical burdens of those who care for Alzheimer’s patients cannot be underestimated, as the health of Alzheimer’s patients is closely related to the health of their caregivers. But your health is important too. So be sure to take care of yourself as you care for others.

RESOURCES:

Alzheimer’s Association http://www.alz.org
Help Guide http://www.helpguide.org

CANADIAN RESOURCES:

Alzheimer Society http://www.alzheimer.ca/
Health Canada http://www.hc-sc.gc.ca/index-eng.php/

References:

2009 Alzheimer’s disease facts and figures. Alzheimer’s Association website. Available at: http://www.alz.org/national/documents/report_alzfactsfigures2009.pdf. Published 2009. Accessed April 10, 2009.
Caring for Alzheimer’s. Alzheimer’s Association website. Available at: http://www.alz.org/living_with_alzheimers_caring_for_alzheimers.asp. Accessed April 11, 2011.
Gaugler JE, Kane RL, Kane RA, Clay T, Newcomer RC. The effects of duration of caregiving on institutionalization. Gerontologist. 2005;45:78-89.
Gonyea JG, O'Connor MK, Boyle PA. Project CARE: a randomized controlled trial of a behavioral intervention group for Alzheimer's disease caregivers. Gerontologist. 2006;46:827-832.

Last reviewed April 2011 by Brian Randall, MD

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