Alzheimer's: Dealing with daily challenges

From MayoClinic.com
Special to CNN.com

People with Alzheimer's disease often need help handling routine daily activities, such as bathing, dressing, eating and using the bathroom. If your loved one needs this type of care, balance the loss of privacy and independence with gentleness and tact. Consider these tips to make everyday activities easier.




Bathing

Bathing may be a challenge for a person who has Alzheimer's disease. Not understanding the process may leave your loved one angry or afraid.

* Find the right routine. Some people prefer showers, while others prefer tub baths. Time of day is often important as well. Experiment with morning, afternoon and evening bathing.
* Make it comfortable. Make sure the bathroom is warm, and keep towels or bath blankets handy.
* Keep it private. If your loved one is self-conscious about being naked, provide a towel for cover when he or she gets in and out of the shower or tub.
* Help your loved one feel in control. Explain each step of the bathing process to help your loved one understand what's happening.
* Be flexible. If daily bathing is traumatic, alternate tub baths or showers with sponge baths.

Dressing

The physical and mental impairment of Alzheimer's can make dressing a frustrating experience. But helping your loved one maintain his or her appearance can promote positive self-esteem.

* Limit choices. Offer no more than two clothing options each morning. Clear closets of rarely worn clothes that may complicate the decision.
* Provide direction. Lay out pieces of clothing in the order they should be put on. Or hand out clothing one piece at a time as you provide short, simple dressing instructions.
* Be patient. Rushing the dressing process may cause anxiety.
* Consider your loved one's tastes and dislikes. Don't argue if your loved one doesn't want to wear a particular garment or wants to wear the same outfit repeatedly. You may even want to buy duplicates of a few favorite outfits.

Eating

A person with Alzheimer's may not remember when he or she last ate — or why it's important to eat.

* Eat at regular times. Don't rely on your loved one to ask for food. As Alzheimer's progresses, your loved one may not respond to hunger and thirst.
* Vary the menu. Offer limited but healthy food choices with varied textures, colors and spices .
* Choose foods that contrast with the color of the plate. Alzheimer's disease may compromise your loved one's visual and spatial abilities — sometimes making it tough to distinguish food from the plate.
* Serve things one at a time. Putting only one item on the plate at a time can help keep meals pleasant and simple.
* Be careful when serving hot food. Your loved one may not recognize that a food is too hot to eat.
* Limit distractions. Turn off the television or radio and the ringer on the telephone to help your loved one focus on the task at hand.
* Eat together. Make meals an enjoyable social event so that your loved one looks forward to the experience. Offer encouragement and praise during the meal.

Toileting

As Alzheimer's progresses, problems with incontinence often surface. Help your loved one maintain a sense of dignity despite the loss of control.

* Make the bathroom easy to find. A sign on the door that says "Toilet" may be helpful. You can even use a picture of a toilet.
* Be alert for signs. Restlessness or tugging on clothing may signal the need to use the bathroom.
* Establish a schedule. Schedule bathroom breaks every two hours, before and after meals and before bedtime.
* Make clothing easy to open or remove. Replace zippers and buttons with Velcro. Choose pants with an elastic waist.
* Take accidents in stride. Praise toileting success — and offer reassurance when accidents happen.

Patience is key

As you help your loved one meet daily challenges, be patient and compassionate. If a certain approach stops working, don't be discouraged. Simply try something new. As Alzheimer's progresses, every bit of understanding, flexibility and creativity you can muster will make life easier for both you and your loved one.

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November 18, 2005

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Alzheimer's: Balancing needs of caregiver and loved one

From MayoClinic.com
Special to CNN.com

As an Alzheimer's caregiver, you may feel as if you're riding a roller coaster — never sure of what the next curve may bring. It's incredibly stressful; yet it can also be rewarding.

Rocked by this dizzying mix of emotions, you walk a tightrope, balancing your own needs against those of your loved one. Learning to recognize and defuse stress can make it easier to keep your balance. Focusing on the rewards from your efforts also helps.



The rewards of caregiving

"Two of the main things I hear people talk about are feelings of satisfaction in making good on a commitment and in paying back loved ones," says Glenn Smith, Ph.D., a neuropsychologist at Mayo Clinic,Rochester, Minn.

Another reward Dr. Smith notes is a sense of accomplishment. "People often express that they realize they are stronger than they ever thought they could be," he says.

The benefits of caring for someone with Alzheimer's disease won't always be obvious to you. That's normal.

"It's important that people don't try to deny the grief that they may feel," says Dr. Smith. "To work through that grief is part of the growth a person can experience."

According to Dr. Smith, some of the ways in which you can address your grief — and still reap rewards — include:

* Accept your grief and understand it as a normal process.
* Set realistic goals and recognize that at some point you may not be able to continue to provide total care.
* Take stock of what you have accomplished and the goals you have met.

Are you a 'hidden patient'?

Caring for someone with Alzheimer's can be all-consuming. The stress of caregiving makes you more likely to become ill or depressed. This is especially true if you're older or if you don't get enough help. Even in situations when friends and family are able to help, many caregivers insist on doing everything themselves. Doctors often think of such caregivers as hidden patients.

Common signs of caregiver stress include:

* Depressed mood
* Frequent crying
* Decrease in energy
* Sleeping too little or too much
* Unintended weight gain or loss
* Increased irritability and anger

Taking care of yourself

If you're like a lot of people, you probably take better care of your car than you do yourself. Eating healthy foods, getting enough sleep and staying in touch with friends are just routine maintenance for the average person.

When you're stressed, you need to take even better care of yourself. Schedule times when you can take regular breaks. Maybe a friend can spend time with your loved one, reading a book aloud or watching a movie together, while you get out of the house. Or you might place your loved one in elder care two or three days a week.

Where can you find help?

The National Eldercare Locator can link you to local organizations that provide services to seniors. This site is especially useful for family members who may live some distance from the person with Alzheimer's. All you need is a ZIP code to find the services for that region.

A service of the Administration on Aging, the Eldercare Locator can be accessed via the Internet or by phone. The toll-free number, (800) 677-1116, has operators available Monday through Friday, from 9 a.m. to 8 p.m. Eastern time.

Area Agency on Aging (AAA) offices can be found through the Eldercare Locator or in the phone book, under "Aging" or "Social Services."

In addition to senior centers, subsidized housing and adult day care services, AAAs also offer a wealth of in-home services, including:

* Meals-On-Wheels
* Homemakers, who help with such tasks as grocery shopping and housekeeping
* Chore Services, which include minor home repairs and yardwork
* Personal Care Services, which assist with bathing and feeding
* Respite Care, to provide a short break for caregivers

The Alzheimer's Association offers a wide variety of programs, educational materials and support services. Most communities have a regional chapter of the organization, which sponsors local support group meetings.

The Alzheimer's Association also provides:

* A 24-hour, toll-free Contact Center (800) 272-3900 that links callers to information about the disease, treatments, care strategies and community programs.
* The nation's largest Alzheimer's library, containing more than 5,000 books, journals, audiocassettes, videotapes and CD-ROMs. After browsing the online catalog, you can arrange for interlibrary loans through your local library.
* The Safe Return program, which helps families locate loved ones who have wandered off. More than 100,000 individuals with Alzheimer's have been registered in the program nationwide.

A heartbreaking journey

Watching a loved one travel through the stages of Alzheimer's is heartbreaking. Caring for them during this time is one of the hardest jobs imaginable. It requires an abundance of physical and emotional energy. Accepting help and taking care of yourself are crucial to success.

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