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Caring for the AD Patient
AD progresses at a different rate with each person. It is important to focus on things that the person with AD can still do and enjoy.
You will recognize the following signs in many patients with AD:
• Increasing and persistent forgetfulness.
• Difficulty finding the right word.
• Loss of judgment.
• Difficulty performing familiar activities such as brushing teeth or bathing.
• Personality changes such as irritability, anxiety, pacing, and restlessness.
• Depression. Depression may show itself in some of the following ways:
–– Anxiety—this can be caused by noise, feeling rushed, and large groups
–– Weight loss
–– Sleep disturbance
•Pacing and agitation. Agitation often is a symptom of underlying illness or pain. Medication can also cause agitation, as can changes in the environment.
• Cursing or threatening language.
• Disorientation, delusions, or hallucinations. A person with hallucinations sees, hears, or feels things that are not there. A person with delusions believes strongly in something that is not true, such as believing that he has been captured by enemies.
• Difficulties with abstract thinking or complex tasks. Balancing a checkbook, recognizing and understanding numbers or reading may be impossible.
The following suggestions will help you care for a patient with AD:
Structure. Serenity and stability reduce behavior problems. When a person with AD becomes upset, the ability to think clearly declines even more. Follow a regular daily routine. Plan the schedule to match the person’s normal, preferred routine and find the best time of day to do things when the person is most capable. Be sure to keep familiar objects and pictures around.
Bathing. Some people with AD won’t mind bathing. For others, it is a confusing, frightening experience. Plan the bath close to the same time every day. Be patient and calm. Allow the patient to do as much of the bath as possible. Never leave the patient alone in the bath or shower. A shower or bath may not be necessary every day—try a sponge or partial bath some days.
Dressing. Allow extra time so the patient won’t feel rushed. Encourage the patient to do as much of the dressing as possible.
Eating. Some patients will need encouragement to eat, while others will eat all the time. A quiet, calm atmosphere may help the patient focus on the meal. Finger foods will help those who struggle with utensils.
Incontinence. Set a routine for taking the patient to the bathroom, such as every three hours during the day. Don’t wait for the patient to ask. Many people with AD experience incontinence as the disease progresses. Be understanding when accidents happen.
Communication. When talking, stand where the patient can see you. Use simple sentences and speak slowly. Focus attention with gentle touching if permitted.
Environment. Make the environment familiar and safe. Set the water heater no higher than 120°. Keep medicines and any potentially dangerous items out of reach.
Exercise. This helps patients improve their motor skills, functional abilities, energy, circulation, stamina, mood, sleep, and elimination. Avoid pushing the patient to exercise, but provide encouragement. Give simple instructions. Mild stretching exercises are good. Demonstrate how to tense and release muscle groups in sequence, keeping the order the same each time. Exercise or walk at the same time each day. A daily walk may reduce wandering.
Night ritual. Behavior is often worse at night. Create a ritual that is calming. Soothing music is helpful for some. Leave a night light on to reduce confusion and restlessness.