Alzheimer's Disease: Tips for Caretakers

caregiver stress imageAn estimated 5.1 million Americans have Alzheimers disease. Approximately 10 million Americans are unpaid caregivers for a person with Alzheimers or another form of dementia. The health and emotional stability of people who care for Alzheimers patients directly affects the patients themselves, and thus should be an important part of the patients care plans. In addition, the National Alliance for Caregiving (NAC) and the AARP estimate that in 2005, the economic value of the care provided by the 10 million family members and friends of Alzheimers patients was almost $83 billion (based on their hours of care, which, for 1 in 4 of the caregivers surveyed, was 40 or more hours per week).

What Caregivers Can Expect in Alzheimers Patients as the Disease Progresses:

  • A decline in logical thinking and judgment
  • Inappropriate social behaviors
  • Confusion and disorientation
  • Wandering
  • Rummaging and hiding objects
  • Aggressiveness, anger, and frustration
  • Hallucinations
  • Paranoia
  • Night wakefulness
  • Refusal to eat

Tips to Lessen the Stresses of Caring for a Loved One With Alzheimers Disease:

Alzheimers Patient Who Tends to Wander

  • Recognize common precursors to wandering, such as restlessness and disorientation.
  • Reassure and reorient the person.
  • Reduce noise levels and distractions.
  • Involve the person in productive daily activities and exercise.
  • Have a written plan for yourself if the person does wander.
  • Keep a recent photograph of the person to give to police if the person does wander.
  • Inform the police and your neighbors of the persons tendency to wander.
  • Have the person wear bright, distinctive clothing.

Alzheimers Patient Who Rummages and Hides Things

  • Lock cabinets and specific rooms.
  • Store valuables and unsafe substances out of reach of the person.
  • Learn where the person tends to hide objects.

Alzheimers Patient Who Becomes Angry or Aggressive

  • Dont take the persons belligerence personally.
  • Dont confront the person about their behavior, it may be beyond their control.
  • Give the person (safe) space to let their anger play out.
  • Look for patterns in potential anger triggers.

Alzheimers Patient Who Hallucinates or Is Paranoid

  • Dont argue with the person about whether or not what they are talking about is real.
  • Increase lighting so there are less shadows.
  • Remove mirrors.

Alzheimers Patient Who Cannot Sleep at Night

  • Limit intake of caffeine.
  • Increase physical activity during the day.
  • Either limit naps, or encourage naps (depending on the persons normal daily routine).
  • Establish a nighttime routine, including calming elements such as a bath, soft music, and a warm drink (such as milk).
  • Keep a nightlight on all night.

Alzheimers Patient Who Refuses to Eat

  • Provide the person with a number of small meals throughout the day rather than a few large meals.
  • Make the persons favorite food.
  • Provide finger food.
  • Provide soft foods that dont require chewing.
  • Remove distractions during mealtimes.
  • Have a different caregiver help the person with eating.

Caregiver Burden

The daily routine of caring for a chronically ill person can put tremendous physical and emotional strain on caregivers, particularly for families who have assumed care responsibilities more recently. A number of studies have been conducted regarding interventions targeting Alzheimers caregivers, as research has shown that caretaker burden is a primary reason for placing Alzheimers patients in nursing homes.

Project Care was a 5-week long, randomized controlled trial that found that specifically targeted, group-based behavioral interventions reduced caregiver distress related to neuropsychiatric symptoms in the patient (such as irritability, anxiety, and depression). The Resources for Enhancing Alzheimers Caregiver Health (REACH initiatives conducted by the National Institutes of Health) have found that targeted interventions with multiple components may be more effective for caregivers than broader, psychoeducational interventions. The importance of easing the mental and physical burdens of those who care for Alzheimers patients cannot be underestimated, as the health of Alzheimers patients is closely related to the health of their caregivers. RESOURCES: Alzheimers Association http://www.alz.org HelpGuide http://www.helpguide.org References: Gaugler JE, Kane RL, Kane RA, Clay T, Newcomer RC. The effects of duration of caregiving on institutionalization. Gerontologist. 2005 Feb 1. 45(1):78-89. Gonyea JG, O'Connor MK, Boyle PA. Project CARE: a randomized controlled trial of a behavioral intervention group for Alzheimer's disease caregivers. Gerontologist. 2006 Dec 1.46(6):827-832.
Last reviewed November 2007 by Theodor B. Rais, MD Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
1 2 3 Next
Print Article