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Coping With Alzheimer's: Special Instructions for Caregivers
Alzheimer's Disease Frequently Asked Questions
1. Are there any medications that someone with Alzheimer's disease should
A person with Alzheimer's disease may be taking medicines to treat symptoms of the
disease, as wel as other health problems. However, when a person takes many
medications there is an increased risk of having an adverse reaction, including
confusion, agitation, sleepiness or sleeplessness, mood swings, memory problems,
While it may become necessary for a person to take medicine to treat the severe
symptoms of Alzheimer's disease -- such as hal ucinations or aggressive behavior --
some of these medications can worsen other symptoms of the disease. For example:
Some drugs such as tranquilizers can cause confusion, increased memory
impairment, and slowed reactions, which can lead to falls.
Certain medicines to treat depression, such as Elavil (amitriptyline), can cause
sedation and other side effects of particular concern to the elderly.
These drugs also can react with medicines used to treat Alzheimer's disease,
including Aricept, Exelon, Namenda, Cognex, and Reminyl. In April 2005,
Reminyl's label was changed to include information about the deaths of 13
elderly patients who were taking the drug during a study. The deaths were due
to various causes, including heart attack and stroke.
Some medicine used to treat hal ucinations can cause sedation, confusion, and
drops in blood pressure. They also can react with medicines used to treat
It is important to discuss the pros and cons of these treatment options with your doctor
before making a decision regarding medication. In addition, it is important to consider
the possible side effects of over-the-counter medications, including cough and cold
remedies, and sleep medicines. These drugs may also react with other medications
taken by the person with Alzheimer's disease. It is best to consult your doctor before
using any over-the-counter medication. 2. I'm thinking about taking a trip with my father, who has Alzheimer's
disease. Is there anything special I should do?
The most important things to do when traveling with someone with Alzheimer's disease
are to plan ahead and try to anticipate the person's needs, so you'l be ready for any
changes or problems. As you plan, be sure to consider the stage of the person's illness
and any behaviors that may be affected by traveling away from home. You may want to
try taking a short trip to see how your loved one reacts to traveling. Here are a few
Plan some activities for the person with Alzheimer's disease to do when
traveling. Simple things -- such as reading a magazine, playing with a deck of
cards, or listening to music -- can help keep your loved one calm when
Never leave a person with dementia alone in a car. When moving, be sure to
keep the seat belt buckled and the doors locked.
Bring an extra driver if your trip involves more than six hours of driving time.
If the person becomes agitated while traveling in a car, stop at the first
available place. Don't try to calm the person while driving.
Consider planning your vacation at a place that is familiar to the person with
Alzheimer's disease; for example, at a lake cabin that he or she has visited in
If your loved one is easily agitated, it may be wise to avoid places that are very
crowded. You may also want to avoid fast-paced sightseeing trips.
If your loved one has never been on a plane, it may be wise to consider driving,
Alert the airlines and hotel staff that you are traveling with a person who is
memory impaired and make sure the person is carrying or wearing some sort
Don't forget that your caregiving responsibilities continue even though you are
on vacation. It may help to bring someone along who can help you with these
3. I'm having trouble getting my loved one to eat. What can I do?
Good nutrition is important for people with Alzheimer's disease. In fact, poor nutrition
can worsen some symptoms of dementia. To get your loved one to eat, try some of the
following: General guidelines:
Talk to your loved one's doctor. Sometimes, poor appetite is due to depression,
Don't force feed. Try to encourage the person to eat, and try to find out why
Avoid serving non-nutritious beverages such as black coffee and tea.
Try to get your loved one to eat more protein and fat and less simple sugars.
Encourage your loved one to walk or participate in other types of light activity
Consider serving finger foods that are easy for the person to handle and eat.
Remember to treat the person as an adult, not a child. Don't punish the person
Serve beverages after a meal instead of before or during a meal so that your
loved one doesn't feel full before beginning to eat.
Plan meals to include your loved one's favorite foods.
Try getting your loved one to eat the high-calorie foods in the meal first.
Use your imagination to increase the variety of food you're serving. Prepare
meals that offer a variety of textures, colors, and temperatures.
Don't serve foods that provide little or no nutritional value, such as potato
chips, candy bars, colas, and other snack foods.
Choose high-protein and high-calorie snacks.
Make food preparation an easy task: choose foods that are easy to prepare and
Make eating a pleasurable experience, not a chore; for example, liven up your
meals by using colorful place settings and/or play background music during
Try not to let your loved one eat alone. If you are unable to eat with your loved
one, invite a guest to share their meal.
Use colorful garnishes such as parsley and red or yel ow peppers to make food
4. My mother has Alzheimer's disease, and I've noticed she is getting more
confused. How can I help her?
There are several things you can try to help a person who is confused:
Try to minimize any changes in the surroundings or to your loved one's daily
routine. If you have to make changes in routines, do so gradually.
Fol ow simple routines and avoid situations that require the person with
Help your loved one maintain his or her orientation by describing the events for
the day, reminding him or her of the date, day, time, place, etc., and repeating
the names of the people with whom he or she has contact.
Try placing large labels (with words or pictures) on drawers and shelves to
Simplify or re-word your statements or requests if the person doesn't seem to
Make certain that medications are being taken regularly and at the right times.
Provide a nutritious diet and encourage your loved one to exercise, if he or she
5. Is there anything I can do to help my mother preserve what memory she has
Losing cherished memories is one of the devastating consequences of Alzheimer's
disease. Some medications used to treat Alzheimer's disease may help slow down
memory loss and there are some techniques you can use to help enhance what memory
Use notes, lists, memos, etc., to help remind the person with Alzheimer's
Keep photos of family members and friends where the person can see them.
Label photos with names, if necessary. Reminisce with him or her about the
family, or activities he or she once enjoyed.
Use memory "tricks"; for example, thinking of the word HOMES to remember
the great lakes: Huron, Ontario, Michigan, Erie and Superior.
Use labels (with words or pictures) placed on drawers and shelves to identify
Limit your loved one's alcohol consumption and try to ensure he or she gets
Remind him or her of the date, day, time, place, etc., and repeat the names of
the people with whom he or she has contact.
Encourage your loved one to exercise his or her mind by reading, doing
puzzles, writing, etc., as well as to exercise his or her body as appropriate.
However, avoid challenging your loved one to the point of frustration.
6. Can ginkgo biloba cure Alzheimer's disease?
Ginkgo biloba -- an extract from the ginkgo tree -- has been touted by many as a
memory booster. Although a 1997 study in the U.S. suggested that ginkgo extract may
be of some value in treating the symptoms of Alzheimer's disease and other forms of
dementia, there is no evidence that ginkgo biloba wil cure or prevent Alzheimer's
disease. Other studies, however, imply that daily use of ginkgo biloba may cause side
effects, such as too much bleeding (especially when combined with daily use of aspirin).
The National Institutes of Health are currently researching the effectiveness of ginkgo
biloba in treating Alzheimer's disease, but to date, there is not enough information
available for doctors to recommend the broad use of ginkgo biloba for Alzheimer's
disease or other forms of dementia. 7. Is exercise recommended for someone with Alzheimer's disease?
Exercise offers many benefits for people with Alzheimer's disease. The major benefits
include improved strength, endurance, and heart fitness. Exercise can also increase
energy, and improve mood and sleep. Exercise also helps people with Alzheimer's
disease preserve motor skil s and improve balance, which in turn, can help prevent
serious injury from fal s. Further, exercise can help improve mental function.
The type and intensity of exercise appropriate for someone with Alzheimer's disease
depends on the person's degree of impairment. People in the early stages of the disease
may enjoy exercises such as walking, bowling, dancing, golf, and swimming, although
supervision may be necessary. Greater supervision may be required as the disease
progresses. Activities that could lead to injury should be avoided. It is important to talk to the person's doctor before beginning any exercise program.
There may be other factors -- such as bone disease, a heart condition, or balance
problems -- that could limit or restrict activity.
8. Do the symptoms of Alzheimer’s disease vary by the time of day?
Sundown syndrome -- also called sundowning or sunsetting -- is a behavior common in
people with Alzheimer's disease. It describes the confusion, anxiety, agitation, or
disorientation that often occur at dusk and into the evening hours. The episodes may
last a few hours or throughout the night.
While the exact cause of sundown syndrome is not known, experts believe there are
several contributing factors. These include physical and mental exhaustion (after a long
day), and a shift in the "internal body clock" caused by the change from daylight to
dark. Some people with Alzheimer's disease have trouble sleeping at night, which may
contribute to their disorientation. Medication that can cause agitation or confusion also
Sundown syndrome can be draining for the person with Alzheimer's disease and his or
her caregivers. Here are some suggestions for helping a loved one with sundown
• Schedule the day so that the more difficult tasks are done early in the
day, when the person is less likely to become agitated.
• Watch the person's diet and eating habits. Restrict sweets and drinks
with caffeine to the morning hours. Try serving the person a late
• To help the person relax, try decaffeinated herbal tea or warm milk. • Keep the house or room wel lit. Close the drapes before the sun goes
down so that the person doesn't watch it become dark outside.
• If the person falls asleep on the sofa or in a chair, let him or her stay
there. Don't wake the person to go to bed.
• Try distracting the person with activities he or she enjoys. Soothing
music or a favorite video may help, as well.
• Encourage the person to engage in some physical activity -- such as
walking, if able -- during the day. This may help him or her to sleep
9. When will the new Alzheimer's disease vaccine be available?
The Alzheimer's disease vaccine recently undergoing clinical testing produced an
unacceptably high rate of serious side effects and the study is currently on hold. As
such, no patients are currently undergoing this treatment. Alternative forms of vaccine
are currently being worked on. 10. Does the desire for sex diminish or totally disappear in people with early or
mid-stage Alzheimer's disease?
Sexuality has not been studied in Alzheimer's disease per se. However, many individuals
with Alzheimer's disease have mood disorders such as depression, which can cause
sexual problems. In addition, medications used to treat depression can also cause sexual
problems. Many persons with dementia also have decreased motivation that affects
much of their lives, such as their interest in their appearance, clothes, friends, etc., and
may affect their sexual function as wel .
If you are concerned about your partner's sexuality, try the fol owing recommendations:
• Have your loved one's doctor assess the presence of a mood disorder,
• Make sure your loved one's medical problems are managed properly.
For example, if they have pain from arthritis, make sure they are
• Have your loved one's doctor review each medication for its possible
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