If it becomes necessary to place your family member in a nursing home, counseling or coaching services may help you and your family deal with feelings of guilt, grief, anger, depression, and anxiety,. Support can be obtained through family and group counseling, support groups, and individual therapy. If needed, your physician can help you evaluate your options, though planning for long-term care should be discussed well before in becomes necessary.
Patient Directed Treatments: An individual with Alzheimer’s disease may exhibit difficult behaviors such as severe mood swings, verbal or physical aggression, combativeness, repetition of words, and wanderings. Efforts to maintain or improve the patient’s behavior can help improve the quality of life for the patient, your family, and you.
The following techniques are designed to manage the functional and behavioral deterioration of a patient with Alzheimer’s disease. These strategies have worked for many families, often delaying institutionalization. Talk with your physician about strategies that may help you.
Pharmacological Treatments: Several medications are currently on the market that help to delay the severity of cognitive impairment as well as treat the behavioral symptoms of Alzheimer’s disease. Talk to your family member’s physician to discuss drug therapy, and consult the American Association for Geriatric Psychiatry for more information.
Independence Promoting Strategies: Interventions designed to improve patients’ functioning also have been shown to improve Alzheimer’s disease symptoms. Such strategies help the patient retain mental and physical abilities and help with daily activities of hygiene, dressing, grooming, and eating. The techniques use incentives, verbal and physical prompting, and physical guidance. For example, having an Alzheimer’s patient choose the specific activity to engage in for the day promotes independence.
Strength/Mobility Enhancement: The well-known benefits of exercise apply to the person with dementia as well. Simple stretches, scheduled walking, or peddling a stationary bicycle all can help prolong mobility, decrease agitation, and improve sleep in the mild to moderately diseased patient.
Sleep Management: Sleep problems associated with Alzheimer’s disease can be a major source of caregiver stress and fatigue. Studies have shown that a period of brihgt light may decrease an individual’s agitation and improve sleep patterns. Other strategies for enhancing nighttime sleep include maintaining a darkened environment at night, providing an early evening warm bath, and limiting daytime napping.
White Noise: White noise, a continuous, monotonous, soft background noise, has been shown to modestly decrease verbal agitation in some patients. In addition to white noise generators, recordings of ocean waves, flowing streams, or other nature sounds may be soothing for the patient. Music therapy may also help by stirring memories and emotions.
Lighting: Dimming lights at mealtime may decrease mealtime agitation and increase food consumption.
Visual Cueing: Visual cueing, such as posting a picture of a bed on the door of the patient’s bedroom, can help a person with dementia find his or her way around a home as memory begins to fade. Pictures may provide more effective cues for direction than words.
Tomorrow I will post an additional eight items that are useful in helping families with loved ones needing long-term care.
Elayne Forgie has been a professional geriatric care manager for over 20 years and was a founding Board Member of the Florida Geriatric Care Managers Association. She is the President/CEO of ElderCare at Home, Inc. and The Alzheimer's Care Resource Center. Information on this website or contained in this article is not intended to replace the medical advice of your doctor or health care provider.
