When a Loved One Has Alzheimer's Disease

Article from WebMD.com | Medically Reviewed by Shruthi N, MD on May 20, 2024

Could It Be Alzheimer's?

It is common for individuals to experience some forgetfulness as they get older. Therefore, distinguishing between a harmless "senior moment" and Alzheimer's disease is important. Approximately one out of nine individuals aged 65 and above suffer from this severe type of dementia. During the initial phases, Alzheimer's might not be easily noticeable to close ones. However, there are certain early indicators to be mindful of.

What Happens to the Brain? Alzheimer's disease leads to the death of nerve cells and the loss of tissue in the brain. With disease progression, the brain shrinks, and the areas filled with cerebrospinal fluid expand. This damage affects memory, speech, and understanding.

Warning Signs

It can be difficult to accept the possibility of a loved one having this illness, but it is advisable to consult a doctor sooner rather than later. Initially, the diagnosis might reveal a different issue. The symptoms could be attributed to a manageable condition, such as a thyroid imbalance. Moreover, in the case of Alzheimer’s, treatments are most effective when initiated early in the progression of the disease. Here are two (2) main warning signs:

	Memory and Speech In early Alzheimer’s, long-term memories usually remain intact while short-term memories become sketchy. Your loved one may forget conversations you had. They may repeat questions that were already answered. The disease also disrupts speech, so they might struggle to remember common words.
	Behavior In addition to memory loss, Alzheimer’s can cause confusion and behavior changes. Your loved one may get lost in familiar places. Mood swings and lapses in judgment are also common, as is poor hygiene. People who were once stylish may start wearing stained clothes and forget to wash their hair.

Diagnosis, Treatment & Prevention

How Is it Diagnosed? When diagnosing Alzheimer’s, the doctor relies on observations of behavioral changes. Tests like the "mini-cog" assess cognitive abilities and memory. Neurological evaluations and brain imaging help rule out other conditions and provide more information on brain health.

How Is It Treated? There’s no cure for Alzheimer’s and no way to slow the nerve damage it causes in the brain. But there are medications that appear to help maintain mental skills and slow the disease’s effects. If your loved one gets treatment early on, they may be able to stay independent and do their daily tasks for a longer period of time.

Can You Prevent It? Is there any way to reduce the risk of developing this disease? Ongoing research suggests that diet and exercise play a crucial role. Evidence indicates that individuals following a Mediterranean diet, which includes plenty of vegetables, fish, and nuts, and engaging in regular physical activity are at lower risk of developing Alzheimer's disease.

What to Expect

Alzheimer’s takes a different path in every person. Sometimes the symptoms get worse quickly and lead to severe memory loss and confusion within a few years. For other people the changes are gradual. It could take 20 years for the disease to run its course. Most people live 3 to 9 years after diagnosis.

How Will It Change Daily Life? Alzheimer's disease affects concentration, making it hard to do daily tasks like cooking or managing finances. Trouble managing finances can be an early sign. As it advances, recognizing people or places becomes challenging, leading to getting lost or unusual behaviors like using objects incorrectly. Incontinence, balance problems, and language decline are common in later stages.

Should My Loved One Stop Driving? Poor coordination, memory loss, and confusion are a dangerous combination behind the wheel. If you feel your loved one should stop driving, tell them why. If they won’t listen, ask their doctor to step in. If they still insist on driving, contact the Department of Motor Vehicles for an assessment. Then make other plans for their transportation needs.

Can Exercise Help? Physical activity can help your loved one keep some muscle strength and coordination. It might also boost their mood and help them feel less anxious. Check with their doctor to learn which types of exercise are appropriate. Repetitive activities, like walking, gardening, or even folding laundry may be the best at giving them a sense of calm.

The Caregiver's Role

If you are taking care of someone with this illness, you will likely have various roles to fulfill, such as cooking, driving, and managing finances. Although you may be responsible for planning meals and handling money matters, it is important to empower your loved one to be independent where possible. Consider labeling cabinet contents and using sticky notes to remind them of daily activities. Additionally, make sure to purchase a weekly pill organizer for their medications. 

Challenges in Caregiving

In the early stages, people with Alzheimer’s often understand what’s happening to them. They may be ashamed or get anxious. Watch for signs of depression, which the doctor can manage with medication. Later on, your loved one may become paranoid or aggressive and could even turn on you. Remember that the disease is responsible for this change. Tell the doctor about this kind of behavior promptly. Caring for someone with Alzheimer's can be physically and mentally draining. Signs of caregiver stress include:

• Anger, sadness, and mood swings

• Headaches or back pain

• Trouble concentrating

• Trouble sleeping

Prevent caregiver burnout by dedicating a few minutes each day to activities that bring you joy. Maintain connections with friends, engage in hobbies, and seek out a supportive friend or family member. Consider joining a caregiver support group either online or locally through the Alzheimer’s Association. Quick things you need to know:

Sundown Syndrome It is unclear to experts why some individuals with Alzheimer's experience agitation as the evening approaches, which can persist throughout the night. To help alleviate this, ensure the home is well illuminated and draw the curtains before sunset. Engage your loved one in a preferred activity or TV program to distract them. Consider switching to decaffeinated beverages after breakfast.

When Your Loved One Doesn't Know You People with Alzheimer’s may struggle to remember names, even of close individuals. A helpful solution is to display pictures of familiar faces with names. Over time, they may no longer recognize family members, causing distress, especially for caregivers.

Home Health Care

Many people opt to stay in their own homes for as long as possible. Nonetheless, individuals facing difficulties with dressing or using the restroom may find it challenging to do so independently. The support of a home care assistant can be extremely helpful in handling personal hygiene and other daily tasks. Furthermore, reaching out to the local Area Agency on Aging can provide useful information about programs that provide meal delivery or transportation services for older adults.

Assisted-Living Facilities Consider assisted-living facilities for loved ones who need care but not 24/7 nursing. These places offer housing, meals, and activities at a more affordable rate than nursing homes. Look for facilities with specialized Alzheimer's units for tailored care and supervision. Individuals in advanced stages of Alzheimer’s may experience decline in mobility, communication, and responsiveness. The condition can also impact functions like swallowing. Transitioning to hospice care offers pain management and support for terminal illnesses.

Essential Documents Prior to your loved one losing the ability to make decisions, it is advisable to seek legal advice to establish advance directives. These documents detail preferences for medical treatment and end-of-life care. Appointing someone to manage healthcare and financial decisions can help avoid future misunderstandings.

How to Help Children Understand When a family member has Alzheimer’s, children might experience confusion, fear, or resentment. It is important to reassure the child that these emotions are typical and to address their inquiries about the disease truthfully. Encourage them to cherish joyful memories of your loved one by possibly putting together a scrapbook containing pictures from happier days.