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Alzheimer Disease

WHAT YOU SHOULD KNOW:

Alzheimer Disease (Discharge Care) Care Guide

Alzheimer disease (AD) is an irreversible brain disorder that results in the gradual loss of memory. In AD, parts of the brain die and cannot make normal levels of brain chemicals. This causes problems with how you think, behave, and remember things. The disease usually starts at about age 65 to 70 years but can start earlier. AD usually lasts from 2 to 10 years, but some people may live 20 years or more with the disease. The exact cause of AD is not known.

AFTER YOU LEAVE:

Medicines:

  • Cholinesterase inhibitors: Cholinesterase inhibitors are a group of medicines that help increase the amount of normal chemicals in your brain. They may help you think better and may make it easier to do every day activities.

  • NMDA receptor antagonist: This medicine may help slow the death of brain cells.

  • Antidepressants: This medicine may be given if you to feel depressed or anxious.

  • Antianxiety medicine: This type of medicine may help you feel less nervous and restless. It may also help you sleep better.

  • Incontinence medicine: You may need this type of medicine to help you with bladder and bowel control.

  • Anticonvulsants: This medicine may be used if you are easily angered or restless.

  • Antipsychotics: This medicine may be used to control delusions (false beliefs), hallucinations (seeing or hearing things that are not there), or violent behaviors

  • Take your medicine as directed. Call your primary healthcare provider if you think your medicine is not helping or if you have side effects. Tell him if you are allergic to any medicine. Keep a list of the medicines, vitamins, and herbs you take. Include the amounts, and when and why you take them. Bring the list or the pill bottles to follow-up visits. Carry your medicine list with you in case of an emergency.

Follow up with your primary healthcare provider as directed:

Write down your questions so you remember to ask them during your visits.

Care for someone who has Alzheimer disease:

  • Activities: People with AD do best with daily routines. Try to keep activities the same from day to day. Take breaks often. Save difficult activities for when the person seems the most alert. Choose activities that the person is interested in doing. Help the person get started and try to break difficult activities into small steps.

  • Depression: Depression is common in early AD. Medication, counseling, and exercise may help.

  • Eating: Mealtime should be at the same time and in the same place each day. It is best to limit food choices. Eating patterns may change in people with AD. It may help to have the person eat small meals and snacks. Ask caregivers about giving vitamins if you do not think the person is eating enough.

    • Serving 1 food at a time may help decrease confusion. Select foods that are soft to chew and cut the food into small pieces. Remind the person to chew the food. Give the person healthy finger foods if he or she will not sit down to eat. Try different foods to learn what the person can handle. Too much caffeine may cause the person to be more active. Limit soft drinks, chocolate, coffee, and tea to decrease caffeine intake.

    • Try to have the person drink 6 to 8 cups (8-ounce) of water each day. This will keep the person from getting dehydrated. Some people with AD have trouble swallowing and drinking liquids. Gelatin, pudding, soup, and ice cream are good choices for people who have trouble drinking enough liquids.

  • Exercise: Regular exercise may help decrease depression and anxiety and improve sleep. Walking is a good exercise for people with AD. Check local senior centers for information about group exercise activities.

  • Recognizing pain or discomfort: It may be hard to know if a person with AD is having pain or discomfort. Noisy breathing or rigid body movements may be a sign of pain. A sad or scared look may also mean the person is having discomfort. The person may also constantly make certain noises when he or she is in pain.

  • Personal care: It may be hard to get someone with AD to shower or bathe. Make sure to check the water temperature so they do not burn themselves. It may help to choose and lay out clothes each night for them to wear the next day. Make sure to brush the person's teeth or dentures daily. Do not forget to take the person to the dentist for check-ups.

  • Safety:

    • Go through the house and remove things that could cause accidents. Make sure household cleaners and medicines are out of reach. You may need to remove the stove burner knobs and hide matches and lighters to prevent injury. Remove loose rugs to prevent falls. Keep doors and windows tightly closed to prevent wandering or other injuries. If the person smokes, make sure cigarettes are always put out.

    • Avoid falls by making sure that the house has good lighting. Add extra light if needed, especially in doorways, bathrooms, and stairways. Use night lights. Have their vision checked.

    • Keep a list of emergency numbers (police, fire, ambulance, and poison control) where you can find it easily.

  • Sleeping: Keep the person with AD active and awake during the day. Limit how much liquid the person drinks in the evening. This may help him or her sleep through the night. Make sure that the person goes to bed at the same time every night.

  • Talking:

    • Call the person by name and speak slowly, clearly, and calmly. Try to decrease noise in the background. Use short words and sentences. Do not give too much information at once. Stand where you can have eye contact with the person. To get the person's attention, you may want to touch their arm, elbow, or shoulder or hold their hand.

    • Use the same words if you have to repeat yourself. Do not ask too many questions. It may take a while, but wait for the person to respond. Questions that need a yes or no answer may be easiest for them to answer.

    • Give directions one step at a time. It may be easier to write down simple directions. Limit the number of choices because it may be hard for the person to make decisions. Do not argue with the person.

    • Ask caregivers if hearing aids could help the person with AD.

  • Toileting:

    • In early AD, it may help to try to have the person on a bathroom schedule. This may mean reminding the person to urinate every 4 hours. Be aware of the person's bowel movement routine and keep it the same.

    • With time, the person may not be able to tell you when they need to the bathroom. You may notice that he seems restless, tugs at his clothes, or touches his genitals when he has to go to the bathroom. Sometimes the person may forget where the bathroom is located. Post bright signs to tell the person where to find the bathroom.

  • Wandering: New door locks may be needed to keep the person from going outside alone. An alarm system near doors may tell you if the person wanders out. Have the person wear a necklace or bracelet with their name and phone number on it in case they wander away from you and are found by someone else.

Care for the family caregiver:

  • Alzheimer disease also affects the family and friends who care for that person. As the disease gets worse, family and friends may feel frustrated and resentful no matter how much they love the person. AD may cause financial problems, which adds more stress to those caring for the person. Be sure to visit your caregiver if you feel overwhelmed.

  • People with AD may be cared for at home instead of at a nursing home, especially in the early and middle stages of the illness. It is important for the family caregiver to be trained so that they can understand what is happening and learn ways to help. There are support services available that help the person with AD stay at home longer. Ask your caregivers about training to learn how to care for someone with AD. Ask for more information about programs to help care for someone with AD:

    • Adult day care: This is a program where the person with AD goes for a part of every day to a center with other adults that have AD.

    • Respite care: This is a temporary service where patients may stay in a nursing home for a limited number of days. This service is especially helpful if the family caregiver needs to go away for a few days. It can also be used when the family caregiver needs a break from caregiving.

For more information:

  • Alzheimer's Association
    225 N.Michigan Ave, FL 17
    Chicago , IL 60601-7633
    Phone: 1- 800 - 272-3900
    Web Address: http://www.alz.org
  • Alzheimer's Disease Education and Referral Center
    P.O. Box 8250
    Silver Spring , MD 20907
    P.O. Box 8250
    Silver Spring , MD 20907
    Phone: 1- 800 - 4384380
    Web Address: http://www.alzheimers.org

Contact your primary healthcare provider if:

  • The person you are caring for:

    • Has a fever

    • Has a rash or his skin is itchy and swollen

    • Appears depressed and has difficulty coping with his symptoms

  • You have questions or concerns about his condition or the care he is receiving.

© 2013 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

Learn more about Alzheimer Disease (Discharge Care)

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