The Complete Guide to Treating & Coping With Alzheimer's Disease by Tim Wormald - HTML preview

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Most treatments for Alzheimer’s disease aim at improving daily functioning of the patients and providing relief to their family members or caregivers.

Drugs: Pharmacological drugs can, to a certain extent, control changes in memory, perception, or thinking abilities. Although these drugs cannot stop the progress of Alzheimer’s disease, they can slow down its development.

Behavioral therapies: These therapies do not involve any drugs or medicines. These only aim to correct behavioral changes through specific communicational techniques, small changes in home décor to help Alzheimer’s patients, etc.

Family members and caregivers need to help implement these changes in Alzheimer’s patients over time. Although these therapies demand extreme patience, you can use certain simple drugs prescribed by doctors to assist in the adoption of these therapies and control extreme and erratic behavior like anxiety, depression, sleeplessness, aggression, etc.

Doctors aim at employing such behavioral therapies to control Alzheimer’s patients before using any drugs. This procedure proves to have a longer and better effect on such patients.

Education of family members and caregivers: Family members and caregivers of Alzheimer’s patients also need specific training to take care of such patients. Specific methods and systems Copyright © 2006 All rights reserved

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help them communicate with patients. Awareness of the disease, with its implications, simplifies managing Alzheimer’s patients. Such methods aim at improving behavioral and functional patterns, maintain overall health through proper diet, exercise, and body care.

Family members and caregivers of Alzheimer’s patients undergo severe stress and combat huge emotional, physical and financial challenges. Support and educational programs provide necessary skills and adequate support to them. It then becomes simpler to take proper care of Alzheimer’s patients and reduce their suffering.

Alzheimer’s disease is a slow and gradual disease with no cure. You cannot reverse its symptoms. The best treatment for Alzheimer’s disease is to delay its progress, lower the impact of symptoms and thereby reduce suffering and stress levels of Alzheimer’s patients, families, caregivers, and support groups.

Although hospitalization is necessary in the last stages of Alzheimer’s disease, you can manage such patients in the earlier stages efficiently in their home environment.

You could opt for small structural changes in your home to help safe, in-house movement of Alzheimer’s patients. Family education about different medical management techniques and support services can be very helpful. Such support programs and education improves the lives of Alzheimer’s patients, along with those of their family members and caregivers.

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17. Treating an Alzheimer's Patient

Alzheimer’s disease does not affect just the patient, it also causes enormous stress on family members or caregivers. While looking into available treatment options for Alzheimer’s disease, the care factor needs equal attention.

Treatment Options

The most important factor in the treatment of an Alzheimer’s patient is to detect its symptoms as being different from those of the normal aging process.

Depression: Although dementia patients are prone to depression, it is higher in Alzheimer’s patients. Depression impairs other mental functions, aggravates memory disorders and increases disability levels. However, it is possible to cure depression among Alzheimer’s patients. Despite the progressive symptoms of Alzheimer’s disease, your depression levels fall considerably through proper clinical remedies. This boosts your ability to cope with associated symptoms of Alzheimer’s like functional disability and mental inability. Antidepressant treatments garner help from the Dementia Mood Assessment Scale, which keeps track of your mood fluctuations during treatment.

Stress: Stress in Alzheimer’s patients demands special treatment. Stress can be due to medical, physical, familial, environmental or mental factors. Each stress factor needs correct identification and evaluation for proper and effective treatment. Family tensions and responsibilities can cause excessive stress. This lowers your positive response to different treatments for Alzheimer’s disease. You can make certain structural changes in your house and undertake additional safety measures to prevent any accidents of Alzheimer’s disease patients within your house. Keep visible reminders to indicate the location of different things within the home. This lowers frustration and disorganization levels, reducing mental stress and memory loss problems of Alzheimer’s patients.

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Family: Family members are immediate caregivers in most cases. In others, the caregivers are different individuals. In either case, stress takes a toll on them, too. With the regular progress of Alzheimer's disease, the health of such caregivers suffers as they view a constant decline in health of patient and are unable to restrict it beyond certain limit. Such anxiety levels tend to lower immunity levels.

Family members and caregivers may easily contract different infectious diseases or heart ailments due to constant suppression of emotion. Of course, there are many treatment options for such stress. Emotional support between family members and professional advice helps in giving vent to depression, anger, or a feeling of helplessness. This helps you cope better with Alzheimer’s patients and understand your limits for offering support and care to them.

There is no specific component of treating an Alzheimer’s patient; it depends on individual suffering and endurance limits. You can gather authentic information through different support groups, professional agencies, community programs, medical centers and Alzheimer's Association groups.

Such clinical and emotional treatments help patients and caregivers to cope and face Alzheimer’s disease with greater resolve.

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18. Pharmacologic Treatment of Alzheimer's Disease

The main attributes for development and progress of Alzheimer’s disease are the formation of plaques and different neurofibrillary tangles between neurons of the brain.

Plaques contain protein deposits of beta-amyloid. Neurofibrillary tangles are due to similar protein deposits. These form filaments and disrupt normal functioning of the brain resulting in memory loss, dementia, depression, etc. Various other clinical, genetic, and environmental factors accelerate Alzheimer’s disease.

There is no conclusive scientific evidence of interrelation between these factors or their role in causing Alzheimer’s disease, but they hamper working of neurons and relative synapses. During progress of the disease, acetylcholine levels drop leading to further drop in acetylcholinesterase levels. This finally destroys important neurons.

Effective Pharmacologic Treatments

Acetylcholinesterase: Pharmacologic treatments aim at restricting any fall in acetylcholine and acetylcholinesterase levels. Cholinesterase or Acetylcholinesterase inhibitors are approved pharmacologic drugs for the treatment of Alzheimer’s disease. However, acetylcholinesterase inhibitors are more in vogue as cholinesterase inhibitors often cause severe liver problems, requiring regular clinical care and hospitalization.

Common acetylcholinesterase inhibitors are galantamine (Reminyl), donepezil (Aricept), rivastigmine (Exelon), etc. These drugs also cause side effects like vomiting, nausea, diarrhea and anorexia, etc., but do not cause any serious disorders. You develop immunity to such side effects over time. However, if you discontinue the medication for a long period, you need to start with the smallest dosage to re-develop your body’s resistance to the side-effects.

Acetylcholinesterase drugs offer some improvement in functional and mental abilities of Alzheimer’s patients. It does not act similarly with all patients. If you suffer from various other Copyright © 2006 All rights reserved

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associated illnesses, you experience more side effects and show lower improvements levels. On the positive side, such inhibitors offer some enhancement of different abilities.

Selegiline: This drug shows restricted improvement levels. It shows minor improvement in the cognitive and behavioral abilities but does not show any encouraging levels in overall functional abilities. Side effects are severe with high degrees of anxiety and aggression. Hence, Selegiline therapy is not very popular with Alzheimer’s disease patients.

NSAID: Regular users of Non Steroidal Anti Inflammatory Drugs (NSAID) report less occurrences of Alzheimer’s disease.

Vitamin E supplements: Although Vitamin E safeguards neurons from the negative effects of beta-amyloid deposits, it does not offer any protection against other nervous diseases. It offers temporary relief but does not improve any cognitive functions. Besides, vitamin E has hardly any effect on comparatively elderly patients with severe dementia, so it is not a very popular pharmacologic treatment for Alzheimer’s disease.

Estrogen: Reports show Alzheimer’s disease is less in women taking estrogen after menopause.

Estrogen protects neurons but does not improve cognitive abilities. Rather, estrogen and progestin, together, accelerate dementia and stroke rates.

Gingko Biloba: Gingko Biloba offers moderate therapeutic benefits for Alzheimer’s patients.

But, it can cause serious side effects like bleeding, seizures and coma.

Different pharmacologic treatments work differently on different patients. Treatment duration and dosages depend on individual condition. Besides, associated illnesses also decide suitable drug or treatment so that you suffer least possible side effects and benefit to the highest level possible from improved cognitive functions. You can change and try different pharmacologic treatments after noticing treatment effects for sufficient time.

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Regular assessment of your functional and mental abilities helps you monitor and plan further treatment courses and options. High treatment costs often dissuade continuance of such therapy in serious patients.

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19. Does Gingko Biloba Treat Alzheimer's Disease?

Gingko Biloba is an herbal extract of leaves of the gingko biloba tree. This is a common herbal medicine in China and many Asian and European countries. It is useful in treating inflammation, giddiness and memory problems and helps increase blood flow to the brain.

Antioxidant properties of gingko biloba negate damage through harmful free radicals.

Memory problems are of varying degrees and due to numerous medical conditions like thyroid, vitamin deficiencies, depression, insufficient nutrition, dehydration, high fever, head injuries and reactions to certain drugs, etc. Hence, proper medical advice and consultation are necessary for the proper use of all drugs or remedies.

Different gingko biloba extracts are available as over-the-counter drugs. There are no specific guidelines regarding dosage or duration for use of gingko biloba extracts. There are also reports of side effects like blood clotting and irregularities in blood circulation with users of gingko biloba extracts. Gingko biloba seems to react with and resists the action of other drugs.

Acceptance of gingko biloba as a treatment for Alzheimer’s disease is still under study and consideration.

Scientific support for curative effects of gingko biloba in Alzheimer’s disease is not encouraging.

Experiments show little improvement in behavioral, cognitive, and functional abilities of Alzheimer’s patients. There is no conclusive proof that gingko biloba can stop or delay the onset of Alzheimer’s disease. Extensive researches and experiments are necessary to determine effectiveness of gingko biloba treatment for Alzheimer’s disease.

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20. A New Ray of Hope for Alzheimer's Treatment

Alzheimer’s disease patients are in need of constant and extensive care as they slowly lose control over different functional and mental abilities. They are incapable of taking care of themselves.

Loss of such abilities affects patients and family members or other caregivers. Although one main cause for Alzheimer’s disease is deposits of amyloid protein, such deposits alone are not responsible for all the severe symptoms of Alzheimer’s disease.

But, treating the causes of amyloid deposits could lower the incidence of Alzheimer’s disease.

New Treatment Options

Amyloid Precursor Proteins and other associated substances are responsible for major dysfunction in the abilities of the brain. Therefore, new treatments hint at two major options for Alzheimer’s disease.

The first option is to create amyloid antigen by injecting beta amyloid protein to create antibodies. These beta amyloid antibodies could delay the onset of Alzheimer’s disease.

The second option is to develop immunity therapy through amyloid beta antibodies and not through protein antibodies. Although high dosages of such antibodies were necessary for effective treatment in the tests, side effects were inflammation and hemorrhage.

Since the second option was fatal, scientists are trying to modify the first option. Injection of amyloid protein antibodies causes meningoenchaphalitis due to autoimmune activation of T-cells.

One viable solution could be to develop vaccines to lessen T-cell activation to a minimum and at same time produce amyloid beta (Aß) antibodies.

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Experiments on mice indicate positive results. Besides, reduction of side effects is possible by injecting antibodies directly into the brain instead of into the body. Such injection into the brain necessitates smaller dosages of antibodies and produce a sharp fall in side effects.

All scientific experiments have been on mice and scientists are trying to learn the effectiveness of such treatments on humans with Alzheimer’s disease. This does offer a new ray of hope for all Alzheimer’s patients and their family members, although research and scientific conclusions are still in a very fluid stage.

There are also plans to develop extremely sensitive and refined research tools to aid in more complicated and extensive experiments.

There have been extensive studies and, though scientists do not know all the causes of A.D., their have been several things learned which they try and believe do help:

Sunlight: Getting enough sunlight and keeping on a regular sleeping pattern, where they sleep at night and are awake in the daytime. (All people need sunlight!)

Vitamin B Therapy: In 1994, McCaddon noted that AD patients lack folic acid. Later, another scientist (Snowden in 2000) discovered that AD patients were low in B-12. (Low B-12 is common in older people as it is not absorbed well.)

Other possibilities are getting antioxidants to help fight free radicals, and keeping the blood circulating well. You must discuss these things with the doctor of the AD patient, and it is not a good idea to start doing everything all at once for these reasons:

• If one thing does work, then you'd be spending money on other therapies that are not needed.

• It is best to not over tax a patient's system with additives.

• Some therapies cause the blood to thin, and you need to be especially careful of bleeding.

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Make sure your loved one gets care and attention, proper vitamins and nutrition.

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21. What Type of Care is the Best

for an Alzheimer's Patient?

Alzheimer’s patients need round-the-clock care and help, which is a huge challenge to family members.

There is no specific care-type which is the best for Alzheimer’s patients. Deciding on particular care-type depends on various factors like individual preferences, extent of disability, budgetary constraints, etc.

Various types of care for Alzheimer’s patients are -

Adult Day Care: These day care centers offer homely comforts and prove to be a second home to Alzheimer’s patients. Centers provide meals and social or recreational activities at modest charges. These centers are helpful for working family members to take care of Alzheimer’s patients while they are at work.

Home: Most families prefer to take care of their Alzheimer’s disease patients at home. You could hire a part-time helper, nurse, or companion. Home offers familiar surroundings for the patient with minor changes in routines or house patterns. This does not create any confusion or adjustment problems to Alzheimer’s patients as their memory power and other functional abilities are on a constant decline.

Assisted Living: These centers provide individuality with trained medical help for needy patients. You can live on your own with other patients nearby and receive help in case you develop serious symptoms.

Retirement Housing: Although such houses provide all individual facilities, it is not suitable for Alzheimer’s disease patients in the advanced stages. Those in the early stages can stay, as they do not need trained help.

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Continuing Care Retirement Communities (CCRC): These centers offer different types and categories of living centers, depending on your budget and the extent of necessary help.

However, Alzheimer’s disease patients should start living at these centers during the initial stages so that centers can plan your necessities and payment options accordingly.

Nursing Homes: Nursing homes are suitable for Alzheimer’s patients if you are unable to manage them at home, with skilled nurses twenty-four hours of the day. You can try to find such nursing homes near your home and within your budget limits.

Hospice Care: This is the best option for Alzheimer’s disease patients in the last stages. They can develop complications at any time and hospice care centers can provide immediate medical aid. Besides, such care centers also provide extensive comfort and dignity to patients, making them feel at home.

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22. Ten Easy Ways to Delay

the Onset of Alzheimer's Disease

Alzheimer’s disease ranks as one of the leading causes of death in people over sixty-five.

Alzheimer’s disease affects brain cells, resulting in slow but sure death with deteriorating mental and physical functional abilities. However, you can delay the onset of Alzheimer’s disease through these simple techniques:

Vascular check: Although blood sugar, blood pressure, and cholesterol levels cause various heart ailments, they are also responsible for Alzheimer’s disease. Maintain your vascular health to delay Alzheimer’s disease.

Fatty acids: Foods rich in n-3 fatty acids, like fish and nuts, lower your risk of Alzheimer’s disease.

Shed Obesity: Healthy body weights may delay the onset or progress of Alzheimer’s disease.

Obesity increases your body mass index (BMI) and propels towards dementia and associated Alzheimer’s disease.

Be active: As you age, you tend to forego simple physical activities like walking, jogging, etc.

Forego passive and sedentary activities like playing video games, watching television, etc.

Instead, take part in a game of tennis or badminton to keep your physical and mental abilities in tip-top shape.

Mental exercises: It is not sufficient to do physical exercises alone; you need to keep your brain active and healthy. Small exercises like solving jigsaw puzzles, crosswords, brainteasers or other logic problems exercise your brain and help maintain your cognitive abilities in good shape.

Quit Smoking and NSAID: These cause Alzheimer’s disease according to some scientific reports. Quit them to maintain good health and delay Alzheimer’s disease.

Soya bean: Soya bean and soy products like cheese, milk, etc. prevent brain degeneration.

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Vitamins: Vitamin E, B, B12 and folic acid help to maintain your cognitive health. Include liberal amounts of yeast, low-fat dairy products, whole grains, leafy greens and lentils, etc. in your daily diets, as they are rich in such vitamins. These foods repair damages to neurons and aid the memory and learning centers of the brain.

Regular Exercises: Maintaining a regular exercise regimen throughout the year helps to reduce the chances of Alzheimer’s disease, strokes and heart diseases, etc.

10. Music: Playing any musical instrument or listening to soothing music relaxes the brain and delays Alzheimer’s disease.

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23. Five Steps to Preventing Alzheimer's Disease

Your brain is a minor part of your total body weight but controls all your activities. Without proper functioning of the brain, you are equivalent to a vegetable.

Maintain excellent brain health to prevent Alzheimer’s disease.

Exercise: The hippocampus part of brain is your memory center, which maintains total awareness. Regular physical exercises like walking, swimming and jogging increase the supply of blood and oxygen to the brain to keep it healthy.

Food: Foods rich in calcium, antioxidants, proteins, and B vitamins are dairy products, soybean, egg yolk, fish, berries, liver, etc. Include these in your daily diet to maintain brain health.

Mental Exercises: Reading books, solving crosswords, puzzles or brainteasers keeps your brain active and healthy.

Love: Love is an excellent brain booster. Shower love on all and receive love in equal measure.

Such actions make you forget your worries and tensions, thereby relaxing your brain.

Get out of Routine: Following predictable routines are unhealthy and boring for your brain. Try new things or ways of doing regular jobs to make it more interesting and enjoyable.

Such regular exercises activate brain cells and your brain continues to develop newer neurons, which aids effective communication. Hence, it reduces the chances of Alzheimer’s disease.

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24. Communication, Challenges and

Gifts for an Alzheimer's Patient

Communication establishes a connection between individuals and transforms them from strangers into friends. You talk and converse with your friends and relatives on all possible topics and enjoy such discussions. However, all these take a back seat when a family member or friend contracts Alzheimer’s disease and begins experiencing its symptoms.

Initial Stages

Early stages of Alzheimer’s do not cause extensive or drastic changes. Alzheimer’s patients recognize their inability to express themselves properly. They search for from lack of proper words. At this stage, an Alzheimer’s patient is well aware of this incapacity and tries to hide it, actually disguising and concealing speaking or memory disabilities.

Sometimes, Alzheimer’s patients detach themselves from their peer group to hide their incapacities. They dispel their inabilities as temporary and unimportant incidents although, inwardly, they are fully aware of the symptoms assuming greater effect on a regular basis.

Communication Techniques

Caregivers can offer extensive support and love to Alzheimer’s patients by following a few communicational techniques.

Abstain from displaying your frustrations, irritation and anger, etc. Alzheimer’s patients are extremely sensitive to such emotions and go ‘into their shell’ immediately.

Be calm and friendly. Talk in simple and straight sentences. Use uncomplicated language, avoiding any ambiguity. Talk distinctly and specifically.

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Proceed in simple terms and do not jump between topics. Sometimes it is best to address them in direct statements rather than offering various options to Alzheimer’s patients. Many options confuse them and they feel their disability more disturbing.

Never show any disrespect to Alzheimer’s patients. Try to keep all discussions and talks for the start of the day, as they are fresher at that time. By evening, they become tired and may not be able to understand or reply properly.

Do not put any pressure on the memory of Alzheimer’s patients. Instead, approach them about how you enjoyed spending time together in the past or specific anecdotes of your times together.

Patience is a prerequisite for caregivers of Alzheimer’s patients. Never rush or hurry them while talking, do not try to finish their sentences or go off to another topic while they are trying to locate an appropriate word.

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