Alzheimer’s disease affects nearly 5 million Americans every year. Although the healthcare costs related to Alzheimer’s disease reached 172 billion dollars, most individuals with Alzheimer’s disease or other forms of dementia are cared for by nearly 11 million unpaid caregivers, valued at almost $144 billion.
Caring for a loved one with Alzheimer’s disease or dementia is stressful and can compromise the health and mental well-being of the caregiver. As a caregiver may give up a job to care for a loved one with Alzheimer’s disease loss of income and financial stress may also become a factor. Along with Alzheimer’s disease the loved one may experience other health issues such as cardiovascular disease, diabetes or cancer. The management of these health issues may also fall to the unpaid caregiver, adding more physical and emotional stress.
Knowledge and information about the course, progression and the suggested treatment and care of a loved one with Alzheimer’s disease can help to alleviate some of the fears and uncertainties that can accompany a diagnosis of Alzheimer’s disease. Understanding the stages of Alzheimer’s disease as well as being aware of the community resources available can aid an unpaid caregiver in formulating a plan of care for their loved one with Alzheimer’s disease, for both the short term and long term.
The Stages and Progression of Alzheimer’s Disease
Although the progression of Alzheimer’s disease can be unpredictable, seeming to slow or even stop for long periods of time, there are some clear stages that can be identified. In the early stage of Alzheimer’s symptoms may not be noticeable even by family members or close friends. These symptoms may include: reduced levels of attention, some periods of forgetfulness and lack of energy as well as incidents of confusion and symptoms of depression or fear and anxiety.
The second stage of Alzheimer’s disease is marked by noticeable memory loss and a greater reliance on a caregiver. A loved one with Alzheimer’s disease may forget the names of close friends and family and may lose the ability to maintain household responsibilities such as managing finances, shopping, cooking and driving. Family members may notice their loved one has begun to repeat themselves verbally, appear restless or agitated and experience more confusion, disorientation and memory lapse.
As Alzheimer’s disease progresses, a loved one may begin to exhibit mood swings, aggressive outburst, confusion about time and place. It is at this stage when a loved one’s behavior usually requires family members to seek the intervention of medical professionals. Most diagnoses of Alzheimer’s disease occur at this stage.
As a loved one with Alzheimer’s disease loses the ability to recognize family members, and to perform daily activities at any level they will be fully dependent on their caregivers. It is often at this stage that unpaid caregivers realize the need to admit their loved one into a long term care facility. At this stage a loved one with Alzheimer’s disease will have minimal awareness of his or her own actions and may have little communication and decision-making abilities.
Eventually an individual with Alzheimer’s disease will lose all ability to communicate or move about. They will also lose the ability to swallow food or liquids of any kind. At the end of life stage the caregiver will take measures to manage pain and to ease discomfort.
Treatment and Interventions for Alzheimer’s Disease
The earlier Alzheimer’s disease is identified the higher the likelihood of slowing the progression of the disease. Although there are no FDA approved drug treatments that will stop or reverse Alzheimer’s disease, studies have shown that medications that block the production of cholinesterase, the enzyme that breaks down acetylcholine in the brain, may delay the entrance into a long-term care facility by nearly two years. This same intervention has also been shown to reduce the behavioral symptoms associated with Alzheimer’s disease.
Other treatments and interventions that have been suggested for the treatment of Alzheimer’s disease are particular vitamins and Nonsteroidal anti-inflammatory drugs (NSAIDS). High doses of Vitamins E and C have been shown to lower and to slow the progression of Alzheimer’s disease. NSAIDS are used to target the inflammation associated with Alzheimer’s disease and are thought to be effective if used before the onset of the illness. Reported side effects of NSAIDS are fatigue, high blood pressure, dizziness and abdominal pain.
Caring for the Caregivers of Alzheimer’s Disease
Caring for an individual with Alzheimer’s disease is demanding and challenging and can become overwhelming for an unpaid caregiver, who is often elderly and may have health issues. Further, the unpaid caregiver is often a spouse or a loved one who must also deal with the emotional and psychological stressors that go along with the physical, mental and relational changes that are take place when a loved one develops Alzheimer’s disease.
The physical and mental health of unpaid caregivers of individuals with Alzheimer’s disease is important not just for the caregivers, but for the individuals being cared for. When a caregiver bears the full responsibility for the daily care of an individual with Alzheimer’s disease and when that individual displays symptoms of depression as well as problematic behavior, it lessens the time between diagnosis of Alzheimer’s disease and entrance into a long-term care facility.
It is essential that caregivers of individuals with Alzheimer’s disease receive all the resources available in order to assist them with proper nutrition and exercise programs, to provide memory aids for the individual with Alzheimer’s disease, to learn effective behavioral interventions, and to assist them in managing health care, medications and financial issues as well as accessing community services available for the individual with Alzheimer’s disease. Adult care services and respite care have been shown to decrease the level of stress and enhance the quality of life experienced by the caregiver of an individual with Alzheimer’s disease.
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Chapman, D. P., Williams, S. M., Strine, T. W., Anda, R. F. & Moore, M. J. (2006) Dementia and its implications for public health. Preventing Chronic Disease: Public Health, Research, and Policy, 3(2), 1-13. Retrieved on September 10, 2010 from http://www.cdc.gov/PCD/issues/2006/apr/pdf/05_0167.pdf
Dunne, A (2010) Nutrition and Dementia. Nursing and Residential Care, 12 (3), 112-116.