Coping With Daily Challenges - For The Caregiver: Alzheimers

Techniques for living with someone with Alzheimer's disease

Communication

• Use simple phrasing and short sentences, but be careful to avoid talking to the person as if he or she is a child.

• To get the person's attention, begin by using his or her name.

• Be patient. Give someone with Alzheimer's time to complete a sentence or thought, and try not to interrupt.

Bathing

• Follow the person's old routines as much as possible.

• Prepare everything in advance.

• Lay out towels, soap, shampoo, and clothes. Have the water ready and at the right temperature before bringing him or her into the bathroom.

• Avoid discussing whether a bath is needed. If the person refuses to get into the tub or shower, be flexible and suggest an alternative. If all else fails, try again later.

• Be calm, gentle, and reassuring. If the person seems disturbed at this invasion of privacy, cover portions of his or her body with a towel.

• Encourage him or her to do as much as possible without hands-on help. Talk through each step.

• Check the skin for rashes and sores. Use powder, cornstarch, or body lotion on dry skin.

• Safety tips: Use rubber tub mats, tub seats, grab bars, nonslip bathmats, etc. Do not use bath oil or products that make the tub slippery. Put razors and electrical appliances out of reach. Take the lock off bathroom doors.

Dental care

• Prepare the toothbrush and demonstrate how to brush.

• If the person will not brush and refuses assistance, try a foam applicator or a cloth moistened with mouthwash.

Dressing and grooming

• Consider the person's past grooming habits, but keep grooming simple to avoid frustration.

• Avoid forcing the person to choose what to wear. Remove clothes that are out of season or seldom worn.

• Try to establish a routine in which you help the person dress at the same time each day.

• Select simple clothing the person can manage easily without assistance. Avoid buttons, hooks, snaps, and ties.

• Lay out clothing in the order that it should be put on.

• Safety tips: Avoid shoes with slippery soles, pants or dresses that are too long or full, and long or full sleeves that may catch on doorknobs or furniture.

Mealtimes

• Playing with food may be a signal that the person has too many choices. Put one utensil on the table and one food on the plate at a time.

• Reduce sensory confusion at meals: Make sure the area is well lit. Use a plate color that contrasts with the food. Remove condiments from the table.

• Eliminate distractions. Make sure the person is comfortably seated and doesn't need to use the bathroom.

• Cut food into small pieces. If he or she chokes easily, switch to soft foods. Curved spoons, divided plates, and straws can make self-feeding more manageable.

• Serve foods containing fiber to help prevent constipation.

• Safety tips: Don't serve food or drink that is too hot. Remind the person to eat slowly and chew each bite thoroughly. If eating nonfood items becomes a problem, keep things like dog biscuits and flower bulbs out of sight.

Toileting

• Put a colorful sign or reflective tape on the bathroom door to make it easy to find.

• Buy slacks and pants with elastic waists, which are easier to manage than snaps and buttons.

• Keep a diary of when the person urinates and has bowel movements, and remind him or her to use the bathroom at these intervals. Restlessness or agitation may indicate bladder or rectal fullness.

• Help the person get into a comfortable position on the toilet.

• If the person has trouble urinating, have him or her blow bubbles through a straw in a glass of water.

• Restrict fluids two hours before bedtime. A portable commode or urinal bottle at the bedside may be helpful.

• Use incontinence aids such as disposable briefs, pads to protect furniture, and condom catheters for men.

• Try to be calm and understanding when accidents occur.

Sleeping

• Discourage long naps during the day.

• An afternoon walk or other exercise may promote a better night's sleep.

• The sleeping area should be quiet and dim, but not completely dark. Keep a night-light on in the bedroom (and in the bathroom).

• Be sure the person avoids caffeine after about 1 p.m.

• Safety tips: Place locks near the bottom of doors leading outside. Lock all outside windows, and place a gate on stairs.

Activity

• Observe how much activity the person can tolerate. Some may still enjoy a meal out or a social gathering, but others may become overstimulated or anxious.

• Look for signs that the person is becoming frustrated. If so, turn the person's attention to another activity or offer help.

• Provide opportunities for exercise, outdoor walks, and rides in the car—activities that people with Alzheimer's tend to enjoy.

• Focus on variations of activities the person enjoyed before becoming ill. If he or she liked cooking, for instance, he or she may be able to wash vegetables.

• Eat well, get enough rest and exercise, and pursue activities that bring you pleasure. If it's too hard to find the time, consider getting extra help with some household chores.

Fast fact

Approximately 70% of people with Alzheimer's disease live at home, rather than at a long-term care facility.

Safety measures

An environment that's safe for the average family nearly always contains hidden hazards for someone who is mentally impaired. As you try to anticipate safety hazards, look at the world through the eyes of a cognitively impaired person. Conduct a thorough inspection of all areas in and around the house, looking for potentially harmful things that the person with Alzheimer's might misuse or misinterpret.

• Correct hazards that could cause tripping and falling: cluttered areas, extension cords, throw rugs, slippery floors, and uneven surfaces.

• Lower the temperature on water heaters and insulate any exposed hot-water pipes. Block off radiators with furniture or a gate.

• Keep cleaning supplies, insecticides, gasoline, paint, solvents, and medicines out of reach or stored in cabinets with childproof latches. Get rid of poisonous houseplants, and put small items (pins, buttons, etc.) out of reach.

• Hide the stove knobs so the person can't turn on the burners. If you have an electric stove, install a switch that inactivates the burners, or switch off the stove at the fuse box or circuit breaker. If you have a gas stove, ask the local gas company for suggestions on how to disable it.

• Make certain that all stairs have sturdy handrails. Install a gate at the top of the stairs.

• Install handrails and grab bars in the bathroom. Use a skid-resistant mat inside the tub or shower.

• Lock away all firearms, power tools, and machinery.