Refer to Chapter 19 in your text.
Alzheimer's disease is a progressive fatal illness that causes areas of the brain to shrink. The resulting symptoms start with memory loss and other cognitive deficits, advancing to major personality changes and eventual loss of control over bodily functions.
While some of us experience mild memory losses with aging, people with Alzheimer's have a more noticeable and rapid decline in memory and other cognitive skills. Learn the signs and symptoms to help you decide if its time to seek help for yourself or a loved one showing symptoms of Alzheimer's.
When Alzheimer's disease begins to destroy brain cells, no outward symptoms are evident. After a while, small memory lapses appear and grow more serious. The afflicted individual may forget the names of familiar people or places, the words to express what they want to say, or the location of everyday objects.
As the memory lapses of early Alzheimer's become more serious, other cognitive deficits and behavior problems develop:
While these are the major symptoms of Alzheimer's, not all patients have all these symptoms. However, it is good to be aware of the most typical warning signs, as it is important to recognize problems early, and get help for them. Are people with Alzheimer's aware of their signs and symptoms?
People with Alzheimer's show a range of responses to their own behavior and condition:
By the middle stage of Alzheimer's, most victims no longer are aware that they don't remember things or aren't communicating coherently. This is fortunate for them. In a safe environment with good care and social contact, most Alzheimer's patients seem relatively free of suffering. For their friends and relatives it's a different story: the long steady decline of their loved one is painful to watch. The demands of Alzheimer's care also take a toll, over the many years before inevitable death. Depression is more common among the caregivers of Alzheimer's patients than it is among the patients themselves.
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The Main Stages of Alzheimer's Disease | ||
| Early-stage Alzheimer's (Mild) | Mid-stage Alzheimer's (Moderate) | Late-stage Alzheimer's (Severe) |
| Memory loss or other cognitive deficits are noticeable, yet the person can compensate for them and continue to function independently. | Mental abilities decline, the personality changes, and physical problems develop so that the person becomes more and more dependent on caregivers. | Complete deterioration of the personality and loss of control over bodily functions requires total dependence on others for even the most basic activities of daily living. |
People vary in the length of time spent in each stage, and in which stage the signs and symptoms appear. Because the stages overlap, it is difficult to definitively place a person in a particular stage. However, the progression is always toward a worsening of symptoms. The stages identify groups of symptoms that reflect more and more brain decay and increasing dependence on caregivers. The end result of Alzheimer's is death, whether caused by the inability of the brain to keep the body going, or by another disease or injury along the way.
No matter what stage the individual is in at the time of diagnosis, apathy is a major problem from the beginning to the very end. More than forty per cent of people in early-stage Alzheimer's show a lack of interest, initiative, and emotional involvement. In the last stage of Alzheimer's, more than ninety per cent of people are apathetic.
The focus of early-stage Alzheimer's is cognitive decline. The Alzheimer's sufferer, as well as family, friends, co-workers, and medical practitioners start to notice the changes. Memory and concentration problems are evident and measurable by cognitive tests. Communication issues surface. Changes in personality and a few idiosyncratic behaviors begin to appear. As a result, the person's performance suffers both at home and at work. The apathy and lack of engagement that is characteristic of all three stages begins here.
Early signs and symptoms could include any of the following.
When Alzheimer's has been diagnosed early, the loss of abilities is often mild, and with a little help, the individual can continue living independently much as they did before. In this early stage, some people experience minor physical compensations, such as falling asleep easily, or immunity to colds, but these positive aspects of Alzheimer's are short-lived. In fact, by the time this condition is diagnosed, some of the problems described above may have already progressed to the point where the individual is already in the middle stage of the disease, needing considerable caregiver support.
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New Insights into Alzheimer's ResearchLearning how Alzheimer's disease begins is key to developing new therapeutics to slow or even prevent the disease. Researchers now believe that a failure in insulin processing in the brain may contribute to the development of Alzheimer's disease. Read Memory Special Report Johns Hopkins Health Alerts. |
The focus of mid-stage Alzheimer's is a decline in functioning of many body systems at once and steadily increasing dependence on caregivers. In mid-stage Alzheimer's disease, the cognitive problems of early Alzheimer's get worse and new ones develop. Memory and cognition problems become severe; communication becomes warped; and the personality is transformed.
The person has a marked change in appearance and hygiene as they become less and less able to take care of themselves. Physical problems increase, including problems with voluntary control of the body, and health declines. Wandering, aggressiveness, hallucinations, and paranoia appear.
This stage is the longest. Those sufferers who are able to recognize their own decline are especially at risk for becoming suicidal during this stage.
The range of problems that may occur include the following.
The focus of late-stage Alzheimer's is the complete deterioration of the personality. Cognitive symptoms worsen, and physical symptoms become profound. The loss of brain cells in all parts of the brain leads to lack of functioning in all systems of the body. The wild behaviors of earlier stages disappear, replaced by a dulling of the mind and body.
As the end of life approaches, the Alzheimer's patient may require around-the-clock care. It will be necessary for loved ones to decide whether that care can occur at home or in a facility. The guidance of a physician or a hospice team will be needed.
Please click into these links to find help and guidance to the caregiver and the Activity and SSD. This is excellent information. Please read and research these links.
Read a nurse's perspective on Alzheimers Disease: Click Here
Bathing
Just think how you would feel to have a caregiver you didn't know or recognize wheel you to the shower, take all your clothes off, push you under the water of the shower and start washing all your body parts. Wouldn't you feel embarrassed or vulnerable ? Think how the residents with Alzheimer's or dementia who have loss of memory, or unable to tell you who they are or where they are will feel. For them, taking them to the shower can be tramatic. Water is frightening to these people. They may scream, cry, or lash out at the caregiver. There is evidence that caregivers can alleviate agitation by tailoring bathing techniques to the person's particular needs and attending to their comfort. This has been described as "person-centered" bathing. Caregivers are encouraged to pinpoint what situations trigger combative resident behavior and to develop creative solutions. For example, if patients seem angry or embarassed about being undressed, it is suggested that caregivers allow them to wear a light gown, even in the shower, and use great care to prevent unnecessary exposure. For some residents, sponge baths or towel baths that take place in their room, or other techniques, such as no-rinse soap, may be as effective as traditional methods and far less upsetting to residents than full-body baths or showers.
We need to be tuned into the needs of the resident and find alternatives that are less upsetting at bath time.
