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Alzheimer Disease, Ambulatory Care
is an irreversible brain disorder that results in the gradual loss of memory. In Alzheimer disease (AD), parts of the brain die and cannot make normal levels of brain chemicals. The disease usually starts at about age 65 to 70 years but can start earlier.
Common symptoms include the following:
- Mild AD: Early AD symptoms may be minor and last from 1 to 3 years.
- Memory loss: Remembering what happened years ago, but unable to remember things from yesterday or forgetting the names of common things or people you know
- Confusion about what month or season it is
- Forgetting to brush your teeth or comb your hair
- Difficulty taking care of your home or finances or difficulty making decisions
- Loss of interest in your usual activities
- Feeling depressed, angry, or confused about the changes you notice
- Moderate AD:
- Problems choosing what clothes to wear, doing simple jobs, or caring for your self
- Unable to recognize people familiar to you
- Difficulty finding words to say what you mean, trouble talking in normal sentences, or speech that is difficult to understand
- Feeling anxious, restless, and agitated at night and seeming depressed or worried
- Difficulty controlling emotions and becoming loud, violent, and hard to control
- Becoming confused and wandering off or pacing
- Unable to plan and follow through with activities
- Thinking something is true even though it is not, seeing things that are not actually there, or inability to control when you urinate
- Severe AD:
- Complete loss of memory
- Complete loss of speech
- Loss of bladder and bowel control
- Finding it very difficult to walk
- Becoming angry and out of control or aggressive and destroying things
- Unable to care for yourself and needing someone to take care of you
Contact a 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.
Treatment for Alzheimer disease
may include medicines to help increase the amount of normal chemicals in your brain or slow the death of brain cells. You may also need medicines to help control your mood or help you feel less nervous or restless. Medicines to help with bladder and bowel control or to help you sleep better may be needed. Some people may be given medicines to control delusions (false beliefs), hallucinations, or violent behaviors. Counseling can teach you ways to cope with your disease.
Care for someone who has Alzheimer disease:
- Keep activities the same from day to day. People with AD do best with daily routines. 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.
- Keep mealtimes at the same time 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 healthcare providers about giving vitamins if you do not think the person is eating enough.
- Get regular 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.
- Learn to recognize 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.
- Provide personal care. Make sure to check the water temperature of the bath or shower 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 exams.
- Provide a safe environment. 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.
- 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.
- Use short words or sentences when speaking to the person with AD. Call the person by name and speak slowly, clearly, and calmly. Use short words and sentences. Use the same words if you have to repeat yourself. Do not ask too many questions. Do not argue with the person.
- Implement 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.
- Prevent 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.
Follow up with your healthcare provider as directed:
Ask someone to go with you to help you remember what your healthcare provider tells you. The person can take notes for you during the visit and go over the notes with you later. Write down your questions so you remember to ask them during your visits.
Care AgreementYou have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment. 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.
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