Alzheimer’s Care

  • What are the warning signs of Alzheimer's?

    Some memory loss is a normal part of the aging process. However, there are specific symptoms that clearly signal Alzheimer’s disease. These include the inability to complete daily tasks, changes in mood or temperament, losing items in familiar places, and getting lost in familiar areas.

    Alzheimer’s sufferers also may forget what day or time of year it is, spend less care and effort in personal hygiene, and show a resistance to social outings, possibly in anticipation of their emerging communication difficulties.

    If you recognize any of these signs in yourself or a loved one, it’s important to get a checkup with your doctor.

  • What is Alzheimer's Aggression?

    Alzheimer’s Aggression is a common phase during the middle stage of Alzheimer’s when the person is becoming more frustrated and angry.

    Alzheimer’s sufferers may develop delusions, become extremely irritated and aggressive towards spouses and caregivers, and then not remember any incidents afterwards.

    Sufferers do not mean to be aggressive with their loved ones; it is the disease causing the behavioral outburts.

  • How is a memory care facility different from assisted living?

    Alzheimer’s and memory care facilities are similar to assisted care facilities and nursing homes in that they provide a safe and secured environment for those loved ones.

    These facilities provide 24/7 support and care for those afflicted with memory difficulties. They have locked entrances and exits to make sure residents don’t wander off. They also provide such services as dailty care, medication, physical therapy, transportation, laundry, meals, social activities, and more.

What is Alzheimer’s?

It’s a neurological degeneration of the brain. It is a form of dementia that brings about severe struggles with memory.

Symptoms of Alzheimer’s will develop slowly which makes it difficult to diagnose for most suffers until it is quite well established. These symptoms will worsen and make daily living very challenging for the suffer and family members.

There are generally three stages:

Beginning or Mild Stage:

People will function fairly normally. They can still drive, work, and engage in social gatherings. They will experience difficulty with word retrieval, remembering new people, they will lose important documents or items and experience disruption in their organizing or planning abilities.

Middle or Moderate Stage:

Generally the longest lasting of the three stages the moderate or middle stage will present with the most disruptions to the sufferer. They will have a great deal of difficulty communicating their needs. They will not want to bath or change their clothing or know what types of clothing needs to be worn. Many suffer from aggressive behaviors. They will also exhibit confusion, delusions and habitual/repetitive behaviors. Many will lose control of their bodily functions.

Late or Severe Stage:

This stage is the most difficult stage. It is especially difficult for the family care givers. The Alzheimer’s victim will lose their ability to converse, move and be conscious of their surroundings. They literally slip away from life. They also become more susceptive to disease.

Warning Signs of Alzheimer’s

There are many normal signs of aging that have us all wondering about memory loss. We meet someone that we know in the grocery store yet we cannot remember their name at that moment. The name will come to us later that day. We attend a social event but later we have difficulty telling others details about the event. We misplace things occasionally. These are all normal signs of the aging process, however there are specific symptoms that clearly signal Alzheimer’s disease.

Signs to Look For:

  • The inability to problem solve or follow a plan.
  • The inability to complete daily tasks such as meal prep/eating, bill paying (they may forget what numbers are for and how to use them), and keeping appointments.
  • They may lose the ability to maintain a calendar, know what time of year it is or even what day it is. They may forget what numbers are for and how to use them.
  • They may get lost walking along a familiar street. If driving they may start out for a certain destination yet become disoriented and not be able to get back home.
  • Exhibits difficulty in concentration. Conversations can stop without being finished.
  • Communication issues such as word retrieval in speech and or writing. Alzheimer suffers also repeat statements/questions often without recognizing that they are doing it. They often forget recent information.
  • A resistance toward social gatherings/outings. This may be occurring because they sense their emerging communication difficulties and are withdrawing due to that. They may not remember how to participate in their favorite activities or play a game.
  • Being unable to find items that they might have placed in an unfamiliar place. Then not having the ability to retrace where they have been in order to locate the item.
  • Less care and effort in personal hygiene and grooming.
  • Significant change in temperament and mood. They may become confused, angry, aggressive, anxious, depressed or fearful for no apparent reason. This can happen at work, home or group settings.
  • Inadequate ability to reason when having to make decision or use judgment.

If you recognize these signs in yourself or a loved one, it is important to get a checkup with your family doctor. They then might refer you to a Neurologist for specific testing to determine memory loss/Alzheimer’s.

Your Doctor will look at:

  • Memory loss and the weakening of your cognitive skills.
  • Daily functioning issues/problems you may be experiencing.
  • Behavioral or personality changes you are exhibiting.
  • There may also be specific memory test that may be administered and brain-imaging tests that will show the progression of the disease if present.

These examinations will rule out other physiological conditions that may be affecting memory.

The earlier the diagnosis of Alzheimer’s the earlier treatment can begin to lessen symptoms in order to maintain independence longer. There are also clinical trials for Alzheimer suffers to participate in if they so choose.

Alzheimer’s Aggression

Unfortunately, Alzheimer’s aggression is an all too common phase of this terrible disease. Generally, it occurs during the middle stage of Alzheimer’s when the person is forgetting more becoming frustrated and angry.

It is the number one reason caregivers put their loved ones into assisted living facilities/nursing homes. Alzheimer’s suffers may develop delusions, become extremely irritated and aggressive toward their spouses/caregivers. Once the incident is over the loved one who is suffering from Alzheimer’s won’t remember the aggressive incident at all.

There are behavioral strategies and new medication options that can help with the aggressive tendency’s.

One of the major challenges we face as caregivers is figuring out where the aggression is coming from. Is the Alzheimer’s patient scared/frustrated with themselves, hungry/thirsty? Is there something in their surroundings that is making them uncomfortable? In simple terms, we need to do our best to figure out what the triggers are that cause their aggressive outbursts.

In dealing with these behaviors we need to keep in mind that our loved ones do not mean to be aggressive with us. We cannot take their behaviors personally, which can be extremely difficult to do, yet we must. The Alzheimer suffer is not to blame it is the disease that is causing their behavioral outburst.

Reacting/Responding to aggressive behaviors

  • Do not take the aggressive behaviors/outburst personally. Recognize that these outbursts/behaviors are part of the disease not the person.
  • Avoid confrontation whenever possible(Always). Don’t argue with them about who or what they are remembering or who they may want to talk to (living or dead). They are in their world not yours. They can’t It’s not that they wouldn’t love to remember and be present with us they can’t. Go with it. Get them to talk about whatever they want to talk about. It makes them feel connected and safe.
  • Modify their surroundings to work out challenges and barriers to their well-being, security and serenity.
  • Respond to the person not the aggressive behavior or statement. Recognize the emotion that is being conveyed not the anger in which it is being delivered.
  • Validate their responses. Let them know that it is OK to feel frustrated, anxious or sad.
  • Comforting touches can help relieve the frustration or fear.
  • Keep a sense of humor. Not necessarily outwardly as that may be misunderstood but internally for your own sanity.
  • Place labels on rooms, items in rooms. Tape unnecessary remotes to block out what isn’t needed.
  • Plan ahead if you anticipate that a situation or event may trigger an outburst. Plan for an alternative to the hustle and bustle. Routines are best.
  • Don’t ask to many questions at one time. Give limited, step by step directions.
  • Their reality is not our reality. Instead of arguing about it go alone with it, listen to them.
  • Focus on the place they are most secure – the past. It is often less confusing for them and something they remember better.
  • Understand that the logical or expected resolution to a situation will not factor into the Alzheimer’s brain. You need to adjust your way of thinking without losing your temper.
  • Distraction from the situation may work. Give them physical space if they begin to become physically aggressive. Ask for support.
  • There is never punishment for these behaviors! Never! 

Understanding the reasons that our loved one’s respond aggressively to us can assist us in finding possible solutions to their behaviors. As caregivers, we need to observe our loved ones to see if we can pick out possible triggers for their aggressive behaviors.

Explanations/reasons for aggressive behaviors.

  • Communication with others or the result of not being able to communicate their needs with others.
  • Boredom and needing more stimulation in their environment.
  • Over stimulated and needing a more peaceful environment.
  • Physical distress/pain, possible infections such as sinus, cut/wound or urinary tract infections.
  • Environmental Factors. Are our loved ones feeling too hot or too cold?
  • Are our loved ones tired? Are they hungry? Do they need a meal or snack?
  • Are the medications that they take creating a toxic reaction which escalates the aggression? 
  • Possibly undiagnosed vision or hearing issues making communication even more strained for our loved ones.

Triggers 

  • Moving from a home environment to an assisted living facility or a new home.
  • Hygiene care can bring on aggressive behaviors.
  • Change in caregiver(s).
  • Not liking/caring for a caregiver.
  • An inability to do simple tasks for themselves.
  • Decisions being made for them without their input when possible can trigger anger.
  • An unrealistic belief that someone is trying to harm them.

Treatment

  • First step is a thorough physical examination by your family doctor. It is generally the progression of Alzheimer’s that is causing the aggressive outburst but a physical exam can rule out or confirm secondary conditions that may be influencing the aggression.
  • Medications – Antidepressants, Anxiolytics, Antipsychotics. Please understand that no drug has been found by the FDA to treat behavioral issues in dementia patients. That is why it is imperative to work with your family doctor should medication become necessary.
  • Behavior management techniques – The Alzheimer’s patient is dealing with an incredible level of stress, realized or not.

Our loved one’s stress can be managed by lessening environmental stress and modifying their routines and adjusting our approaches to those routines. Behaviors are triggered and can be lessened or eliminated by knowing the trigger(s) and avoiding it(them).

Make sure that the Alzheimer’s patients environment is stress-free. Our loved one’s physical environment needs to be easy and functional so as not to add unneeded confusion. Their physical mobility provides them with a level of comfort and independence.

We need to validate their emotions, their confusion and inability to remember simple things, without being argumentative or deeming toward them.

Behavioral response to aggressive behaviors need to take into consideration if those aggressive behaviors are harmful to the person with the dementia or to others. If the behaviors don’t directly affect our loved one or anyone else, then we do not need to respond to them. However, if these aggressive behaviors impact the well-being of our loved one or someone else than we will need to deal with it.

  • Relaxation periods or quiet environment periods.
  • Recognize what causes the upset. Is the aggression occurring at the same time of day, during similar events, with the same people?
  • Listening to their favorite music can help.
  • Physical exercise can help to reduce the feelings of stress and anxiety

Remember that this aggressive stage of Alzheimer’s will pass. The disease will continue but the aggressive stage will subside. As a caregiver, you need to take care of yourself during the duration of this disease. Seek out support from Alzheimer’s support groups friends and relatives.

Alzheimer/Memory Care Facilities

Similar to assisted care facilities and nursing homes Memory Care/Alzheimer facilities provide a safe and secured environment for their residents. These facilities provide 24/7 support and care for those afflicted with memory difficulties’ or ‘people afflicted with memory difficulties.

Memory care/Alzheimer facilities are secured facilities that have locked entrances and exits to make sure that a resident doesn’t wander off.

Often these facilities provide secured garden areas for the residents and their visitors to relax in. 

Alzheimer’s Services:

  • Daily Care
  • Meals
  • Personal Care
  • Laundry
  • Transportation
  • Medication
  • Social Activities
  • Physical Therapy

How to pay for Alzheimer or Memory Care

Alzheimer’s is the costliest disease in America. It annual cost is now more than that for heart disease and cancer. It is estimated that Alzheimer’s and other memory care needs is well over $250 billion dollars.

Medicare will not pay for in-home care and generally will only pay approximately for 100 days of assisted living care. The Alzheimer’s patient’s monies and assets will need to be depleted before Medicaid will kick in.

Care at home:

In-home cost for Alzheimer/memory care cost for the earlier stages of the disease will range, depending on where you live, between $15 to $30 plus an hour. Some families will provide the care themselves in the home for as long as they can until they need to get in-home assistance.

Assisted care:

Alzheimer’s care in assisted living facilities will range, depending on where you live, between $2,000 to $6,000 a month. Average being about $5,000 a month in most areas.

Nursing home care:

As with any type of nursing home care it is not more expensive to receive care in a nursing home with or without Alzheimer’s. The cost will range, depending on where you live, between $6,600 – $20,000plus a month.

Other options for pay can include, VA funds, private health insurance, Life insurance policies, reverse mortgages, and a variety of local, state and federal assistance programs. All of these vary by state.

There are Adult Day care programs that are available to in many area’s which provide hours of care away from home to those afflicted with Alzheimer’s. These programs provide the family care givers a much-needed respite.